|
CATH THORAC 32FR RT ANG
|
Facility
|
IP
|
$39.83
|
|
| Hospital Charge Code |
270600389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.97
|
|
|
CATH THORAC 32FR STR
|
Facility
|
OP
|
$62.96
|
|
| Hospital Charge Code |
270600390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.18 |
| Max. Negotiated Rate |
$31.48 |
| Rate for Payer: Aetna Commercial |
$18.89
|
| Rate for Payer: Aetna Medicare Advantage |
$18.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.05
|
| Rate for Payer: Cigna Commercial |
$31.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.18
|
| Rate for Payer: Oxford Commercial |
$31.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$31.48
|
|
|
CATH THORAC 32FR STR
|
Facility
|
IP
|
$62.96
|
|
| Hospital Charge Code |
270600390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$9.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.44
|
|
|
CATH THORAC 32FR STR & R/A ***
|
Facility
|
OP
|
$49.00
|
|
| Hospital Charge Code |
1606169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.37 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Aetna Commercial |
$14.70
|
| Rate for Payer: Aetna Medicare Advantage |
$14.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.49
|
| Rate for Payer: Cigna Commercial |
$24.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.37
|
| Rate for Payer: Oxford Commercial |
$24.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$24.50
|
|
|
CATH THORAC 32FR STR & R/A ***
|
Facility
|
IP
|
$49.00
|
|
| Hospital Charge Code |
1606169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$7.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.35
|
|
|
CATH THORAC 36FR RT ANG
|
Facility
|
OP
|
$100.85
|
|
| Hospital Charge Code |
270600900
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$50.42 |
| Rate for Payer: Aetna Commercial |
$30.25
|
| Rate for Payer: Aetna Medicare Advantage |
$30.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.72
|
| Rate for Payer: Cigna Commercial |
$50.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.11
|
| Rate for Payer: Oxford Commercial |
$50.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$50.42
|
|
|
CATH THORAC 36FR RT ANG
|
Facility
|
IP
|
$100.85
|
|
| Hospital Charge Code |
270600900
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$15.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.13
|
|
|
CATH THORAC 36FR STR
|
Facility
|
IP
|
$31.90
|
|
| Hospital Charge Code |
270600391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$4.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.79
|
|
|
CATH THORAC 36FR STR
|
Facility
|
OP
|
$31.90
|
|
| Hospital Charge Code |
270600391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$15.95 |
| Rate for Payer: Aetna Commercial |
$9.57
|
| Rate for Payer: Aetna Medicare Advantage |
$9.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.13
|
| Rate for Payer: Cigna Commercial |
$15.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.15
|
| Rate for Payer: Oxford Commercial |
$15.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.95
|
|
|
CATH THORAC 36FR STR & R/A****
|
Facility
|
OP
|
$33.00
|
|
| Hospital Charge Code |
1606177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.29 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Aetna Commercial |
$9.90
|
| Rate for Payer: Aetna Medicare Advantage |
$9.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.41
|
| Rate for Payer: Cigna Commercial |
$16.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.29
|
| Rate for Payer: Oxford Commercial |
$16.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$16.50
|
|
|
CATH THORAC 36FR STR & R/A****
|
Facility
|
IP
|
$33.00
|
|
| Hospital Charge Code |
1606177
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$4.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.95
|
|
|
CATH THORACIC 32FR 8032
|
Facility
|
OP
|
$20.28
|
|
| Hospital Charge Code |
270649070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$10.14 |
| Rate for Payer: Aetna Commercial |
$6.08
|
| Rate for Payer: Aetna Medicare Advantage |
$6.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.17
|
| Rate for Payer: Cigna Commercial |
$10.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.64
|
| Rate for Payer: Oxford Commercial |
$10.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.14
|
|
|
CATH THORACIC 32FR 8032
|
Facility
|
IP
|
$20.28
|
|
| Hospital Charge Code |
270649070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$3.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.04
|
|
|
CATH THORACIC RT ANGLE 28 FR
|
Facility
|
IP
|
$30.20
|
|
| Hospital Charge Code |
270649074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$4.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.53
|
|
|
CATH THORACIC RT ANGLE 28 FR
|
Facility
|
OP
|
$30.20
|
|
| Hospital Charge Code |
270649074
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$15.10 |
| Rate for Payer: Aetna Commercial |
$9.06
|
| Rate for Payer: Aetna Medicare Advantage |
$9.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.70
|
| Rate for Payer: Cigna Commercial |
$15.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.93
|
| Rate for Payer: Oxford Commercial |
$15.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.10
|
|
|
CATH THORACIC RT ANGLE 36FR
|
Facility
|
IP
|
$30.20
|
|
| Hospital Charge Code |
270649075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$4.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.53
|
|
|
CATH THORACIC RT ANGLE 36FR
|
Facility
|
OP
|
$30.20
|
|
| Hospital Charge Code |
270649075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$15.10 |
| Rate for Payer: Aetna Commercial |
$9.06
|
| Rate for Payer: Aetna Medicare Advantage |
$9.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.70
|
| Rate for Payer: Cigna Commercial |
$15.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.93
|
| Rate for Payer: Oxford Commercial |
$15.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.10
|
|
|
CATH THORACIS 28FR STR
|
Facility
|
OP
|
$31.90
|
|
| Hospital Charge Code |
270600387
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$15.95 |
| Rate for Payer: Aetna Commercial |
$9.57
|
| Rate for Payer: Aetna Medicare Advantage |
$9.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.13
|
| Rate for Payer: Cigna Commercial |
$15.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.15
|
| Rate for Payer: Oxford Commercial |
$15.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.95
|
|
|
CATH THORACIS 28FR STR
|
Facility
|
IP
|
$31.90
|
|
| Hospital Charge Code |
270600387
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$4.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.79
|
|
|
CATH THROMB6F5F125CM119CMPENUM
|
Facility
|
IP
|
$7,450.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
270691852S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,117.50 |
| Max. Negotiated Rate |
$1,802.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,490.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,802.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,117.50
|
|
|
CATH THROMB6F5F125CM119CMPENUM
|
Facility
|
OP
|
$7,450.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
270691852S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,117.50 |
| Max. Negotiated Rate |
$3,725.00 |
| Rate for Payer: Aetna Commercial |
$2,235.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,235.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,899.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,899.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,490.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,899.75
|
| Rate for Payer: Cigna Commercial |
$3,725.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,802.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,117.50
|
|
|
CATH THROMBECT AXS VECTA 146CM
|
Facility
|
IP
|
$7,520.50
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
270700314S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,128.08 |
| Max. Negotiated Rate |
$1,819.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,504.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,819.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,128.08
|
|
|
CATH THROMBECT AXS VECTA 146CM
|
Facility
|
OP
|
$7,520.50
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
270700314S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,128.08 |
| Max. Negotiated Rate |
$3,760.25 |
| Rate for Payer: Aetna Commercial |
$2,256.15
|
| Rate for Payer: Aetna Medicare Advantage |
$2,256.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,917.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,917.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,504.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,917.73
|
| Rate for Payer: Cigna Commercial |
$3,760.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,819.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,128.08
|
|
|
CATH THROMBECT INDIGO FLASH16F
|
Facility
|
IP
|
$48,875.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
270698774S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,331.25 |
| Max. Negotiated Rate |
$11,827.75 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9,775.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,827.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,331.25
|
|
|
CATH THROMBECT INDIGO FLASH16F
|
Facility
|
OP
|
$48,875.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
270698774S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,331.25 |
| Max. Negotiated Rate |
$24,437.50 |
| Rate for Payer: Aetna Commercial |
$14,662.50
|
| Rate for Payer: Aetna Medicare Advantage |
$14,662.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,463.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,463.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9,775.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12,463.12
|
| Rate for Payer: Cigna Commercial |
$24,437.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,827.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,331.25
|
|