|
GUIDE CATH 7F JL 5SH
|
Facility
|
OP
|
$274.75
|
|
| Hospital Charge Code |
270658388
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$137.38 |
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna Medicare Advantage |
$82.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.06
|
| Rate for Payer: Cigna Commercial |
$137.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
|
|
GUIDE CATH 7F JR 4
|
Facility
|
OP
|
$274.75
|
|
| Hospital Charge Code |
2709002697
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$137.38 |
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna Medicare Advantage |
$82.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.06
|
| Rate for Payer: Cigna Commercial |
$137.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.72
|
| Rate for Payer: Oxford Commercial |
$137.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.38
|
|
|
GUIDE CATH 7F JR 4
|
Facility
|
IP
|
$274.75
|
|
| Hospital Charge Code |
2709002697
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$41.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
|
|
GUIDE CATH 7F JR 4 SH
|
Facility
|
OP
|
$274.75
|
|
| Hospital Charge Code |
2709002698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$137.38 |
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna Medicare Advantage |
$82.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.06
|
| Rate for Payer: Cigna Commercial |
$137.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.72
|
| Rate for Payer: Oxford Commercial |
$137.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.38
|
|
|
GUIDE CATH 7F JR 4 SH
|
Facility
|
IP
|
$274.75
|
|
| Hospital Charge Code |
2709002698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$41.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
|
|
GUIDE CATH 7F JR XB 3.0SH
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636378
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$58.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
GUIDE CATH 7F JR XB 3.0SH
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636378
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna Medicare Advantage |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.20
|
| Rate for Payer: Cigna Commercial |
$120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
GUIDE CATH 7F JR XB 3.OSH
|
Facility
|
OP
|
$274.75
|
|
| Hospital Charge Code |
2709002699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$137.38 |
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna Medicare Advantage |
$82.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.06
|
| Rate for Payer: Cigna Commercial |
$137.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.72
|
| Rate for Payer: Oxford Commercial |
$137.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.38
|
|
|
GUIDE CATH 7F JR XB 3.OSH
|
Facility
|
IP
|
$274.75
|
|
| Hospital Charge Code |
2709002699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$41.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
|
|
GUIDE CATH 7F XB 3.5
|
Facility
|
IP
|
$274.75
|
|
| Hospital Charge Code |
2709002700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$41.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
|
|
GUIDE CATH 7F XB 3.5
|
Facility
|
OP
|
$274.75
|
|
| Hospital Charge Code |
2709002700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$137.38 |
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna Medicare Advantage |
$82.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.06
|
| Rate for Payer: Cigna Commercial |
$137.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.72
|
| Rate for Payer: Oxford Commercial |
$137.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.38
|
|
|
GUIDE CATH 7F XB 3.5
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636379
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna Medicare Advantage |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.20
|
| Rate for Payer: Cigna Commercial |
$120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
GUIDE CATH 7F XB 3.5
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636379
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$58.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
GUIDE CATH 7F XB 3.5 SH
|
Facility
|
IP
|
$220.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636380
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
GUIDE CATH 7F XB 3.5 SH
|
Facility
|
OP
|
$274.75
|
|
| Hospital Charge Code |
2709002701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$137.38 |
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna Medicare Advantage |
$82.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.06
|
| Rate for Payer: Cigna Commercial |
$137.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.72
|
| Rate for Payer: Oxford Commercial |
$137.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.38
|
|
|
GUIDE CATH 7F XB 3.5 SH
|
Facility
|
OP
|
$220.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636380
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$66.00
|
| Rate for Payer: Aetna Medicare Advantage |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.10
|
| Rate for Payer: Cigna Commercial |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
GUIDE CATH 7F XB 3.5 SH
|
Facility
|
IP
|
$274.75
|
|
| Hospital Charge Code |
2709002701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$41.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
|
|
GUIDE CATH 7F XB 4.0
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636381
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$13.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.40
|
|
|
GUIDE CATH 7F XB 4.0
|
Facility
|
OP
|
$274.75
|
|
| Hospital Charge Code |
2709002702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$137.38 |
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna Medicare Advantage |
$82.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.06
|
| Rate for Payer: Cigna Commercial |
$137.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.72
|
| Rate for Payer: Oxford Commercial |
$137.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.38
|
|
|
GUIDE CATH 7F XB 4.0
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636381
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$28.00 |
| Rate for Payer: Aetna Commercial |
$16.80
|
| Rate for Payer: Aetna Medicare Advantage |
$16.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.28
|
| Rate for Payer: Cigna Commercial |
$28.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.40
|
|
|
GUIDE CATH 7F XB 4.0
|
Facility
|
IP
|
$274.75
|
|
| Hospital Charge Code |
2709002702
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$41.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
|
|
GUIDE CATH 7F XB 4.0 SH
|
Facility
|
OP
|
$54.95
|
|
| Hospital Charge Code |
270636382
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$27.48 |
| Rate for Payer: Aetna Commercial |
$16.48
|
| Rate for Payer: Aetna Medicare Advantage |
$16.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.01
|
| Rate for Payer: Cigna Commercial |
$27.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.24
|
|
|
GUIDE CATH 7F XB 4.0 SH
|
Facility
|
OP
|
$274.75
|
|
| Hospital Charge Code |
2709002705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$137.38 |
| Rate for Payer: Aetna Commercial |
$82.42
|
| Rate for Payer: Aetna Medicare Advantage |
$82.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.06
|
| Rate for Payer: Cigna Commercial |
$137.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.72
|
| Rate for Payer: Oxford Commercial |
$137.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.38
|
|
|
GUIDE CATH 7F XB 4.0 SH
|
Facility
|
IP
|
$54.95
|
|
| Hospital Charge Code |
270636382
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$13.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.24
|
|
|
GUIDE CATH 7F XB 4.0 SH
|
Facility
|
IP
|
$274.75
|
|
| Hospital Charge Code |
2709002705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$41.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.21
|
|