|
INTRODUCER PINN 6F 25CM RSS605
|
Facility
|
OP
|
$118.75
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270643051C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.81 |
| Max. Negotiated Rate |
$59.38 |
| Rate for Payer: Aetna Commercial |
$35.62
|
| Rate for Payer: Aetna Medicare Advantage |
$35.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.28
|
| Rate for Payer: Cigna Commercial |
$59.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.81
|
|
|
INTRODUCER PINN 6FR 10C RSS602
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642942C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$12.58 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
INTRODUCER PINN 6FR 10C RSS602
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642942C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Aetna Commercial |
$15.60
|
| Rate for Payer: Aetna Medicare Advantage |
$15.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.26
|
| Rate for Payer: Cigna Commercial |
$26.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
INTRODUCER PINNA 5F 10 RSS502
|
Facility
|
IP
|
$45.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642944S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.83 |
| Max. Negotiated Rate |
$11.01 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.83
|
|
|
INTRODUCER PINNA 5F 10 RSS502
|
Facility
|
OP
|
$45.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642944S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.83 |
| Max. Negotiated Rate |
$22.75 |
| Rate for Payer: Aetna Commercial |
$13.65
|
| Rate for Payer: Aetna Medicare Advantage |
$13.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.60
|
| Rate for Payer: Cigna Commercial |
$22.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.83
|
|
|
INTRODUCER PINNA 5F 10 RSS502
|
Facility
|
IP
|
$45.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642944N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.83 |
| Max. Negotiated Rate |
$11.01 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.83
|
|
|
INTRODUCER PINNA 5F 10 RSS502
|
Facility
|
OP
|
$45.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642944N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.83 |
| Max. Negotiated Rate |
$22.75 |
| Rate for Payer: Aetna Commercial |
$13.65
|
| Rate for Payer: Aetna Medicare Advantage |
$13.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.60
|
| Rate for Payer: Cigna Commercial |
$22.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.83
|
|
|
INTRODUCER PINNA 5F 10 RSS502
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642944C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$12.58 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
INTRODUCER PINNA 5F 10 RSS502
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642944C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Aetna Commercial |
$15.60
|
| Rate for Payer: Aetna Medicare Advantage |
$15.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.26
|
| Rate for Payer: Cigna Commercial |
$26.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
INTRODUCER PINNAC 7F 10 RSS702
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642943C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Aetna Commercial |
$15.60
|
| Rate for Payer: Aetna Medicare Advantage |
$15.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.26
|
| Rate for Payer: Cigna Commercial |
$26.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
INTRODUCER PINNAC 7F 10 RSS702
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642943C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$12.58 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
INTRODUCER PINNACLE .038IN 8FR
|
Facility
|
IP
|
$56.65
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270683727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$13.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.50
|
|
|
INTRODUCER PINNACLE .038IN 8FR
|
Facility
|
OP
|
$56.65
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270683727
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$28.32 |
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: Aetna Medicare Advantage |
$17.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.45
|
| Rate for Payer: Cigna Commercial |
$28.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.50
|
|
|
INTRODUCER PINNACLE 6FR 10CM
|
Facility
|
OP
|
$56.65
|
|
|
Service Code
|
HCPCS C1893
|
| Hospital Charge Code |
270642942N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$28.32 |
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: Aetna Medicare Advantage |
$17.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.45
|
| Rate for Payer: Cigna Commercial |
$28.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.50
|
|
|
INTRODUCER PINNACLE 6FR 10CM
|
Facility
|
IP
|
$56.65
|
|
|
Service Code
|
HCPCS C1893
|
| Hospital Charge Code |
270642942N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$13.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.50
|
|
|
INTRODUCER PINNACLE 6FR 25 CM
|
Facility
|
IP
|
$1,294.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270643051N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$194.10 |
| Max. Negotiated Rate |
$313.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$258.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$313.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.10
|
|
|
INTRODUCER PINNACLE 6FR 25 CM
|
Facility
|
OP
|
$1,294.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270643051N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$194.10 |
| Max. Negotiated Rate |
$647.00 |
| Rate for Payer: Aetna Commercial |
$388.20
|
| Rate for Payer: Aetna Medicare Advantage |
$388.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$329.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$329.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$258.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$329.97
|
| Rate for Payer: Cigna Commercial |
$647.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$313.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$194.10
|
|
|
INTRODUCER PINNACLE 7FR 10CM
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642943S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$12.58 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
INTRODUCER PINNACLE 7FR 10CM
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$12.58 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
INTRODUCER PINNACLE 7FR 10CM
|
Facility
|
IP
|
$566.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642943N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.97 |
| Max. Negotiated Rate |
$137.09 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$113.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.97
|
|
|
INTRODUCER PINNACLE 7FR 10CM
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642943
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Aetna Commercial |
$15.60
|
| Rate for Payer: Aetna Medicare Advantage |
$15.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.26
|
| Rate for Payer: Cigna Commercial |
$26.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
INTRODUCER PINNACLE 7FR 10CM
|
Facility
|
OP
|
$566.50
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642943N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.97 |
| Max. Negotiated Rate |
$283.25 |
| Rate for Payer: Aetna Commercial |
$169.95
|
| Rate for Payer: Aetna Medicare Advantage |
$169.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$144.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$144.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$113.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$144.46
|
| Rate for Payer: Cigna Commercial |
$283.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.97
|
|
|
INTRODUCER PINNACLE 7FR 10CM
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270642943S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Aetna Commercial |
$15.60
|
| Rate for Payer: Aetna Medicare Advantage |
$15.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.26
|
| Rate for Payer: Cigna Commercial |
$26.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
INTRODUCER PINNACLE 7FR 25cm
|
Facility
|
IP
|
$118.75
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270643052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.81 |
| Max. Negotiated Rate |
$28.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.81
|
|
|
INTRODUCER PINNACLE 7FR 25cm
|
Facility
|
OP
|
$118.75
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
270643052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.81 |
| Max. Negotiated Rate |
$59.38 |
| Rate for Payer: Aetna Commercial |
$35.62
|
| Rate for Payer: Aetna Medicare Advantage |
$35.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.28
|
| Rate for Payer: Cigna Commercial |
$59.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.81
|
|