|
CATHETER,GUIDING
|
Facility
|
IP
|
$899.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
4800935
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.85 |
| Max. Negotiated Rate |
$217.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$179.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$217.56
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$197.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$134.85
|
|
|
CATHETER GUIDING C1
|
Facility
|
IP
|
$437.75
|
|
| Hospital Charge Code |
270666825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$65.66 |
| Max. Negotiated Rate |
$105.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$87.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$96.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.66
|
|
|
CATHETER GUIDING C1
|
Facility
|
OP
|
$437.75
|
|
| Hospital Charge Code |
270666825
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.55 |
| Max. Negotiated Rate |
$218.88 |
| Rate for Payer: Aetna Commercial |
$166.34
|
| Rate for Payer: Aetna Medicare Advantage |
$131.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$111.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$111.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$87.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$111.63
|
| Rate for Payer: Cigna Commercial |
$218.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$96.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.66
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.60
|
|
|
CATHETER GUIDING C2
|
Facility
|
OP
|
$437.75
|
|
| Hospital Charge Code |
270666826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.55 |
| Max. Negotiated Rate |
$218.88 |
| Rate for Payer: Aetna Commercial |
$166.34
|
| Rate for Payer: Aetna Medicare Advantage |
$131.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$111.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$111.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$87.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$111.63
|
| Rate for Payer: Cigna Commercial |
$218.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$96.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.66
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.60
|
|
|
CATHETER GUIDING C2
|
Facility
|
IP
|
$437.75
|
|
| Hospital Charge Code |
270666826
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$65.66 |
| Max. Negotiated Rate |
$105.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$87.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$96.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.66
|
|
|
CATHETER GUIDING LIMA
|
Facility
|
OP
|
$437.75
|
|
| Hospital Charge Code |
270666827
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.55 |
| Max. Negotiated Rate |
$218.88 |
| Rate for Payer: Aetna Commercial |
$166.34
|
| Rate for Payer: Aetna Medicare Advantage |
$131.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$111.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$111.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$87.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$111.63
|
| Rate for Payer: Cigna Commercial |
$218.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$96.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.66
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.60
|
|
|
CATHETER GUIDING LIMA
|
Facility
|
IP
|
$437.75
|
|
| Hospital Charge Code |
270666827
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$65.66 |
| Max. Negotiated Rate |
$105.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$87.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$96.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.66
|
|
|
CATHETER HEADWAY DUO 167 STR
|
Facility
|
IP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270693916S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$1,452.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,320.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
|
|
CATHETER HEADWAY DUO 167 STR
|
Facility
|
OP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270693916S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$144.60 |
| Max. Negotiated Rate |
$3,000.00 |
| Rate for Payer: Aetna Commercial |
$2,280.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,530.00
|
| Rate for Payer: Cigna Commercial |
$3,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,320.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$144.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$159.00
|
|
|
CATHETER HEMATURA 30CC 24FR
|
Facility
|
IP
|
$101.23
|
|
| Hospital Charge Code |
270659391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$15.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.18
|
|
|
CATHETER HEMATURA 30CC 24FR
|
Facility
|
OP
|
$101.23
|
|
| Hospital Charge Code |
270659391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$50.62 |
| Rate for Payer: Aetna Commercial |
$38.47
|
| Rate for Payer: Aetna Medicare Advantage |
$30.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.81
|
| Rate for Payer: Cigna Commercial |
$50.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.37
|
| Rate for Payer: Oxford Commercial |
$20.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$20.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.68
|
|
|
CATHETER HEMODIALYSIS 2L 15FR
|
Facility
|
IP
|
$1,810.65
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
270680129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$271.60 |
| Max. Negotiated Rate |
$438.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$362.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$438.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$398.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$271.60
|
|
|
CATHETER HEMODIALYSIS 2L 15FR
|
Facility
|
OP
|
$1,810.65
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
270680129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$43.64 |
| Max. Negotiated Rate |
$905.33 |
| Rate for Payer: Aetna Commercial |
$688.05
|
| Rate for Payer: Aetna Medicare Advantage |
$543.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$461.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$461.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$362.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$461.72
|
| Rate for Payer: Cigna Commercial |
$905.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$438.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$398.34
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$271.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$43.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$47.98
|
|
|
CATHETER,HEMODIALYSIS,LONG-TRM
|
Facility
|
IP
|
$21.40
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
4800940
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$5.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$4.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.21
|
|
|
CATHETER,HEMODIALYSIS,LONG-TRM
|
Facility
|
OP
|
$21.40
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
4800940
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$10.70 |
| Rate for Payer: Aetna Commercial |
$8.13
|
| Rate for Payer: Aetna Medicare Advantage |
$6.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.46
|
| Rate for Payer: Cigna Commercial |
$10.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$4.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.21
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.57
|
|
|
CATHETER HEMODIALYSIS NS 27 CM
|
Facility
|
IP
|
$1,500.75
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
270681579
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.11 |
| Max. Negotiated Rate |
$363.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$330.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.11
|
|
|
CATHETER HEMODIALYSIS NS 27 CM
|
Facility
|
OP
|
$1,500.75
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
270681579
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.17 |
| Max. Negotiated Rate |
$750.38 |
| Rate for Payer: Aetna Commercial |
$570.28
|
| Rate for Payer: Aetna Medicare Advantage |
$450.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.69
|
| Rate for Payer: Cigna Commercial |
$750.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$330.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.77
|
|
|
CATHETER,HEMODIALYSIS,SHRT-TR
|
Facility
|
IP
|
$21.40
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
4800895
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$5.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$4.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.21
|
|
|
CATHETER,HEMODIALYSIS,SHRT-TR
|
Facility
|
OP
|
$21.40
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
4800895
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$10.70 |
| Rate for Payer: Aetna Commercial |
$8.13
|
| Rate for Payer: Aetna Medicare Advantage |
$6.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.46
|
| Rate for Payer: Cigna Commercial |
$10.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$4.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.21
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.57
|
|
|
CATHETER HEMODIALYSIS TIP 23CM
|
Facility
|
IP
|
$1,500.75
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
270681411C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.11 |
| Max. Negotiated Rate |
$363.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$330.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.11
|
|
|
CATHETER HEMODIALYSIS TIP 23CM
|
Facility
|
IP
|
$1,500.75
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
270681411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.11 |
| Max. Negotiated Rate |
$363.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$330.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.11
|
|
|
CATHETER HEMODIALYSIS TIP 23CM
|
Facility
|
OP
|
$1,500.75
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
270681411C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.17 |
| Max. Negotiated Rate |
$750.38 |
| Rate for Payer: Aetna Commercial |
$570.28
|
| Rate for Payer: Aetna Medicare Advantage |
$450.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.69
|
| Rate for Payer: Cigna Commercial |
$750.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$330.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.77
|
|
|
CATHETER HEMODIALYSIS TIP 23CM
|
Facility
|
IP
|
$1,500.75
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
270681411N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.11 |
| Max. Negotiated Rate |
$363.18 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$330.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.11
|
|
|
CATHETER HEMODIALYSIS TIP 23CM
|
Facility
|
OP
|
$1,500.75
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
270681411N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.17 |
| Max. Negotiated Rate |
$750.38 |
| Rate for Payer: Aetna Commercial |
$570.28
|
| Rate for Payer: Aetna Medicare Advantage |
$450.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.69
|
| Rate for Payer: Cigna Commercial |
$750.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$330.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.77
|
|
|
CATHETER HEMODIALYSIS TIP 23CM
|
Facility
|
OP
|
$1,500.75
|
|
|
Service Code
|
HCPCS C1750
|
| Hospital Charge Code |
270681411
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.17 |
| Max. Negotiated Rate |
$750.38 |
| Rate for Payer: Aetna Commercial |
$570.28
|
| Rate for Payer: Aetna Medicare Advantage |
$450.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$382.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$382.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$300.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$382.69
|
| Rate for Payer: Cigna Commercial |
$750.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$363.18
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$330.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.77
|
|
