|
CATH CRD CARD AL111 7F 533647T
|
Facility
|
OP
|
$42.25
|
|
| Hospital Charge Code |
270614269
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$21.12 |
| Rate for Payer: Aetna Commercial |
$16.05
|
| Rate for Payer: Aetna Medicare Advantage |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.77
|
| Rate for Payer: Cigna Commercial |
$21.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.68
|
| Rate for Payer: Oxford Commercial |
$8.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.12
|
|
|
CATH CRD CARD AL11 524-842
|
Facility
|
IP
|
$128.00
|
|
| Hospital Charge Code |
270607617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$19.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
|
|
CATH CRD CARD AL11 524-842
|
Facility
|
OP
|
$128.00
|
|
| Hospital Charge Code |
270607617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$64.00 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare Advantage |
$38.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.64
|
| Rate for Payer: Cigna Commercial |
$64.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.40
|
| Rate for Payer: Oxford Commercial |
$25.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$25.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.39
|
|
|
CATH CRD CARD AL11 6F 533-646T
|
Facility
|
IP
|
$42.25
|
|
| Hospital Charge Code |
270614263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$6.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
|
|
CATH CRD CARD AL11 6F 533-646T
|
Facility
|
OP
|
$42.25
|
|
| Hospital Charge Code |
270614263
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$21.12 |
| Rate for Payer: Aetna Commercial |
$16.05
|
| Rate for Payer: Aetna Medicare Advantage |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.77
|
| Rate for Payer: Cigna Commercial |
$21.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.68
|
| Rate for Payer: Oxford Commercial |
$8.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.12
|
|
|
CATH CRD CARD AL1 524-840
|
Facility
|
OP
|
$128.00
|
|
| Hospital Charge Code |
270607616
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.08 |
| Max. Negotiated Rate |
$64.00 |
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare Advantage |
$38.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.64
|
| Rate for Payer: Cigna Commercial |
$64.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.40
|
| Rate for Payer: Oxford Commercial |
$25.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$25.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.39
|
|
|
CATH CRD CARD AL1 524-840
|
Facility
|
IP
|
$128.00
|
|
| Hospital Charge Code |
270607616
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$19.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
|
|
CATH CRD CARD AR11 524-843
|
Facility
|
IP
|
$131.25
|
|
| Hospital Charge Code |
270607615
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.69 |
| Max. Negotiated Rate |
$19.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.69
|
|
|
CATH CRD CARD AR11 524-843
|
Facility
|
OP
|
$131.25
|
|
| Hospital Charge Code |
270607615
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.16 |
| Max. Negotiated Rate |
$65.62 |
| Rate for Payer: Aetna Commercial |
$49.88
|
| Rate for Payer: Aetna Medicare Advantage |
$39.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.47
|
| Rate for Payer: Cigna Commercial |
$65.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.38
|
| Rate for Payer: Oxford Commercial |
$26.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.48
|
|
|
CATH CRD CARD IM 6F 533-660
|
Facility
|
OP
|
$42.25
|
|
| Hospital Charge Code |
270612510
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$21.12 |
| Rate for Payer: Aetna Commercial |
$16.05
|
| Rate for Payer: Aetna Medicare Advantage |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.77
|
| Rate for Payer: Cigna Commercial |
$21.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.68
|
| Rate for Payer: Oxford Commercial |
$8.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.12
|
|
|
CATH CRD CARD IM 6F 533-660
|
Facility
|
IP
|
$42.25
|
|
| Hospital Charge Code |
270612510
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$6.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
|
|
CATH CRD CARD JL4.0 100cm
|
Facility
|
IP
|
$248.25
|
|
| Hospital Charge Code |
270605715
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.24 |
| Max. Negotiated Rate |
$37.24 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.24
|
|
|
CATH CRD CARD JL4.0 100cm
|
Facility
|
OP
|
$248.25
|
|
| Hospital Charge Code |
270605715
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.98 |
| Max. Negotiated Rate |
$124.12 |
| Rate for Payer: Aetna Commercial |
$94.33
|
| Rate for Payer: Aetna Medicare Advantage |
$74.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.30
|
| Rate for Payer: Cigna Commercial |
$124.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$74.47
|
| Rate for Payer: Oxford Commercial |
$49.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$49.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.58
|
|
|
CATH CRD CARD JL4.0 523-840
|
Facility
|
OP
|
$131.25
|
|
| Hospital Charge Code |
270607610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.16 |
| Max. Negotiated Rate |
$65.62 |
| Rate for Payer: Aetna Commercial |
$49.88
|
| Rate for Payer: Aetna Medicare Advantage |
$39.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.47
|
| Rate for Payer: Cigna Commercial |
$65.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.38
|
| Rate for Payer: Oxford Commercial |
$26.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.48
|
|
|
CATH CRD CARD JL4.0 523-840
|
Facility
|
IP
|
$131.25
|
|
| Hospital Charge Code |
270607610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.69 |
| Max. Negotiated Rate |
$19.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.69
|
|
|
CATH CRD CARD JL4.5 6F 533-627
|
Facility
|
IP
|
$42.25
|
|
| Hospital Charge Code |
270600705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$6.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
|
|
CATH CRD CARD JL4.5 6F 533-627
|
Facility
|
OP
|
$42.25
|
|
| Hospital Charge Code |
270600705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$21.12 |
| Rate for Payer: Aetna Commercial |
$16.05
|
| Rate for Payer: Aetna Medicare Advantage |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.77
|
| Rate for Payer: Cigna Commercial |
$21.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.68
|
| Rate for Payer: Oxford Commercial |
$8.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.12
|
|
|
CATH CRD CARD JL5.0 6F 533-622
|
Facility
|
IP
|
$42.25
|
|
| Hospital Charge Code |
270605100
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$6.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
|
|
CATH CRD CARD JL5.0 6F 533-622
|
Facility
|
OP
|
$42.25
|
|
| Hospital Charge Code |
270605100
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$21.12 |
| Rate for Payer: Aetna Commercial |
$16.05
|
| Rate for Payer: Aetna Medicare Advantage |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.77
|
| Rate for Payer: Cigna Commercial |
$21.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.68
|
| Rate for Payer: Oxford Commercial |
$8.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.12
|
|
|
CATH CRD CARD JL6.0 523-842
|
Facility
|
IP
|
$131.25
|
|
| Hospital Charge Code |
270607611
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.69 |
| Max. Negotiated Rate |
$19.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.69
|
|
|
CATH CRD CARD JL6.0 523-842
|
Facility
|
OP
|
$131.25
|
|
| Hospital Charge Code |
270607611
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.16 |
| Max. Negotiated Rate |
$65.62 |
| Rate for Payer: Aetna Commercial |
$49.88
|
| Rate for Payer: Aetna Medicare Advantage |
$39.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.47
|
| Rate for Payer: Cigna Commercial |
$65.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.38
|
| Rate for Payer: Oxford Commercial |
$26.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.48
|
|
|
CATH CRD CARD JL6.0 523-844
|
Facility
|
IP
|
$131.25
|
|
| Hospital Charge Code |
270607613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.69 |
| Max. Negotiated Rate |
$19.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.69
|
|
|
CATH CRD CARD JL6.0 523-844
|
Facility
|
OP
|
$131.25
|
|
| Hospital Charge Code |
270607613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.16 |
| Max. Negotiated Rate |
$65.62 |
| Rate for Payer: Aetna Commercial |
$49.88
|
| Rate for Payer: Aetna Medicare Advantage |
$39.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.47
|
| Rate for Payer: Cigna Commercial |
$65.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.38
|
| Rate for Payer: Oxford Commercial |
$26.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.48
|
|
|
CATH CRD CARD JR3.5 6F 533-619
|
Facility
|
IP
|
$42.25
|
|
| Hospital Charge Code |
270603817
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$6.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
|
|
CATH CRD CARD JR3.5 6F 533-619
|
Facility
|
OP
|
$42.25
|
|
| Hospital Charge Code |
270603817
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$21.12 |
| Rate for Payer: Aetna Commercial |
$16.05
|
| Rate for Payer: Aetna Medicare Advantage |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.77
|
| Rate for Payer: Cigna Commercial |
$21.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.68
|
| Rate for Payer: Oxford Commercial |
$8.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.12
|
|