|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270CH0028
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$195.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.84
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270CH0026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$195.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.84
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270CH0014
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$195.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.84
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0011
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270CH0015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$195.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.84
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270CH0021
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$195.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.84
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270CH0020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$195.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.84
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0028
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
OP
|
$925.00
|
|
| Hospital Charge Code |
270658396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.29 |
| Max. Negotiated Rate |
$462.50 |
| Rate for Payer: Aetna Commercial |
$351.50
|
| Rate for Payer: Aetna Medicare Advantage |
$277.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$235.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$235.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$185.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$235.88
|
| Rate for Payer: Cigna Commercial |
$462.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$223.85
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$203.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.51
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0027
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0020
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0033
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0030
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0019
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0022
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0014
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
OP
|
$975.00
|
|
| Hospital Charge Code |
270CH0030
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$195.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.84
|
|
|
CATHETER BALLOON HIGH PRESSURE
|
Facility
|
IP
|
$975.00
|
|
| Hospital Charge Code |
270CH0024
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$146.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
