|
CATHETER IMAGER II FLUSH 5FR
|
Facility
|
OP
|
$55.82
|
|
| Hospital Charge Code |
270653625S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$27.91 |
| Rate for Payer: Aetna Commercial |
$21.21
|
| Rate for Payer: Aetna Medicare Advantage |
$16.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.23
|
| Rate for Payer: Cigna Commercial |
$27.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.75
|
| Rate for Payer: Oxford Commercial |
$11.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.16
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.48
|
|
|
CATHETER IMAGER II FLUSH 5FR
|
Facility
|
IP
|
$55.82
|
|
| Hospital Charge Code |
270653625S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.37 |
| Max. Negotiated Rate |
$8.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.37
|
|
|
CATHETER IMAGER II FLUSH 5FR
|
Facility
|
OP
|
$27.91
|
|
| Hospital Charge Code |
270653625N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.67 |
| Max. Negotiated Rate |
$13.96 |
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna Medicare Advantage |
$8.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.12
|
| Rate for Payer: Cigna Commercial |
$13.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.37
|
| Rate for Payer: Oxford Commercial |
$5.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.58
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.74
|
|
|
CATHETER IMAGER II FLUSH 5FR
|
Facility
|
IP
|
$27.91
|
|
| Hospital Charge Code |
270653625N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$4.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
|
|
CATHETER IMAGER II FLUSH 5FR
|
Facility
|
OP
|
$55.82
|
|
| Hospital Charge Code |
270653625
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$27.91 |
| Rate for Payer: Aetna Commercial |
$21.21
|
| Rate for Payer: Aetna Medicare Advantage |
$16.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.23
|
| Rate for Payer: Cigna Commercial |
$27.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.75
|
| Rate for Payer: Oxford Commercial |
$11.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.16
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.48
|
|
|
CATHETER IMAGER II FLUSH 5FR
|
Facility
|
OP
|
$27.91
|
|
| Hospital Charge Code |
270653626N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.67 |
| Max. Negotiated Rate |
$13.96 |
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna Medicare Advantage |
$8.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.12
|
| Rate for Payer: Cigna Commercial |
$13.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.37
|
| Rate for Payer: Oxford Commercial |
$5.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.58
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.74
|
|
|
CATHETER IMAGER II FLUSH 5FR
|
Facility
|
IP
|
$55.82
|
|
| Hospital Charge Code |
270653625
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.37 |
| Max. Negotiated Rate |
$8.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.37
|
|
|
CATHETER IMPR BRAIDED 5FR 65CM
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270675626N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
|
|
CATHETER IMPR BRAIDED 5FR 65CM
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270675626
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$22.80
|
| Rate for Payer: Aetna Medicare Advantage |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.30
|
| Rate for Payer: Cigna Commercial |
$30.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.59
|
|
|
CATHETER IMPR BRAIDED 5FR 65CM
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270675626
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
|
|
CATHETER IMPR BRAIDED 5FR 65CM
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270675626S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
|
|
CATHETER IMPR BRAIDED 5FR 65CM
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270675626S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$22.80
|
| Rate for Payer: Aetna Medicare Advantage |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.30
|
| Rate for Payer: Cigna Commercial |
$30.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.59
|
|
|
CATHETER IMPR BRAIDED 5FR 65CM
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270675626N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$22.80
|
| Rate for Payer: Aetna Medicare Advantage |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.30
|
| Rate for Payer: Cigna Commercial |
$30.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.59
|
|
|
CATHETER IMPR BRAIDED 5FR 90CM
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270675627
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
|
|
CATHETER IMPR BRAIDED 5FR 90CM
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270675627
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$22.80
|
| Rate for Payer: Aetna Medicare Advantage |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.30
|
| Rate for Payer: Cigna Commercial |
$30.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.59
|
|
|
CATHETER IMPR BRAIDED 5FR 90CM
|
Facility
|
OP
|
$66.00
|
|
| Hospital Charge Code |
675627
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.59 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Aetna Commercial |
$25.08
|
| Rate for Payer: Aetna Medicare Advantage |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.83
|
| Rate for Payer: Cigna Commercial |
$33.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.75
|
|
|
CATHETER IMPR BRAIDED 5FR 90CM
|
Facility
|
IP
|
$66.00
|
|
| Hospital Charge Code |
675627
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.90 |
| Max. Negotiated Rate |
$15.97 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.97
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$14.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.90
|
|
|
CATHETER IMPRESS BERENSTEIN 5
|
Facility
|
OP
|
$337.50
|
|
| Hospital Charge Code |
270657622
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$168.75 |
| Rate for Payer: Aetna Commercial |
$128.25
|
| Rate for Payer: Aetna Medicare Advantage |
$101.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$67.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.06
|
| Rate for Payer: Cigna Commercial |
$168.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$81.67
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.62
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.94
|
|
|
CATHETER IMPRESS BERENSTEIN 5
|
Facility
|
IP
|
$337.50
|
|
| Hospital Charge Code |
270657622
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$81.67 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$67.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$81.67
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$74.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.62
|
|
|
CATHETER IMPRESS BERENSTEIN 5F
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270658011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
|
|
CATHETER IMPRESS BERENSTEIN 5F
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270658011S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$22.80
|
| Rate for Payer: Aetna Medicare Advantage |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.30
|
| Rate for Payer: Cigna Commercial |
$30.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.59
|
|
|
CATHETER IMPRESS BERENSTEIN 5F
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270658011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$22.80
|
| Rate for Payer: Aetna Medicare Advantage |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.30
|
| Rate for Payer: Cigna Commercial |
$30.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.59
|
|
|
CATHETER IMPRESS BERENSTEIN 5F
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
270658011S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$14.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.52
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$13.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
|
|
CATHETER IMPRESS KA2 FR5
|
Facility
|
OP
|
$13.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$6.75 |
| Rate for Payer: Aetna Commercial |
$5.13
|
| Rate for Payer: Aetna Medicare Advantage |
$4.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.44
|
| Rate for Payer: Cigna Commercial |
$6.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.27
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.02
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.36
|
|
|
CATHETER IMPRESS KA2 FR5
|
Facility
|
IP
|
$13.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$3.27 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.27
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.02
|
|
