|
LEAD MEDT PCEMKR 4003M
|
Facility
|
OP
|
$4,968.85
|
|
| Hospital Charge Code |
270602748C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$745.33 |
| Max. Negotiated Rate |
$2,484.43 |
| Rate for Payer: Aetna Commercial |
$1,490.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1,490.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,267.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,267.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$993.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,267.06
|
| Rate for Payer: Cigna Commercial |
$2,484.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,202.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$745.33
|
|
|
LEAD MEDT PCEMKR 4003M
|
Facility
|
IP
|
$4,968.85
|
|
| Hospital Charge Code |
270602748C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$745.33 |
| Max. Negotiated Rate |
$1,202.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$993.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,202.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$745.33
|
|
|
LEAD MEDT PCEMKR 4003M
|
Facility
|
OP
|
$4,968.85
|
|
| Hospital Charge Code |
270602748
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$745.33 |
| Max. Negotiated Rate |
$2,484.43 |
| Rate for Payer: Aetna Commercial |
$1,490.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1,490.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,267.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,267.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$993.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,267.06
|
| Rate for Payer: Cigna Commercial |
$2,484.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,202.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$745.33
|
|
|
LEAD MEDT PCEMKR 4003M
|
Facility
|
IP
|
$4,968.85
|
|
| Hospital Charge Code |
270602748
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$745.33 |
| Max. Negotiated Rate |
$1,202.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$993.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,202.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$745.33
|
|
|
LEAD MEDT PCEMKR 4057M
|
Facility
|
IP
|
$2,179.20
|
|
| Hospital Charge Code |
270602755
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$326.88 |
| Max. Negotiated Rate |
$527.37 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$435.84
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$527.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$326.88
|
|
|
LEAD MEDT PCEMKR 4057M
|
Facility
|
OP
|
$2,179.20
|
|
| Hospital Charge Code |
270602755
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$326.88 |
| Max. Negotiated Rate |
$1,089.60 |
| Rate for Payer: Aetna Commercial |
$653.76
|
| Rate for Payer: Aetna Medicare Advantage |
$653.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$555.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$555.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$435.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$555.70
|
| Rate for Payer: Cigna Commercial |
$1,089.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$527.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$326.88
|
|
|
LEAD MEDT PCEMKR 4058M
|
Facility
|
OP
|
$3,125.00
|
|
| Hospital Charge Code |
270602756C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$468.75 |
| Max. Negotiated Rate |
$1,562.50 |
| Rate for Payer: Aetna Commercial |
$937.50
|
| Rate for Payer: Aetna Medicare Advantage |
$937.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$796.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$796.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$796.88
|
| Rate for Payer: Cigna Commercial |
$1,562.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$756.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$468.75
|
|
|
LEAD MEDT PCEMKR 4058M
|
Facility
|
IP
|
$3,125.00
|
|
| Hospital Charge Code |
270602756C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$468.75 |
| Max. Negotiated Rate |
$756.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$756.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$468.75
|
|
|
LEAD MEDT PCEMKR 4058M
|
Facility
|
OP
|
$3,125.00
|
|
| Hospital Charge Code |
270602756
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$468.75 |
| Max. Negotiated Rate |
$1,562.50 |
| Rate for Payer: Aetna Commercial |
$937.50
|
| Rate for Payer: Aetna Medicare Advantage |
$937.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$796.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$796.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$625.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$796.88
|
| Rate for Payer: Cigna Commercial |
$1,562.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$756.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$468.75
|
|
|
LEAD MEDT PCEMKR 4058M
|
Facility
|
IP
|
$3,125.00
|
|
| Hospital Charge Code |
270602756
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$468.75 |
| Max. Negotiated Rate |
$756.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$756.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$468.75
|
|
|
LEAD MEDT PCEMKR 4058M-58
|
Facility
|
OP
|
$2,724.00
|
|
| Hospital Charge Code |
270608017
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$408.60 |
| Max. Negotiated Rate |
$1,362.00 |
| Rate for Payer: Aetna Commercial |
$817.20
|
| Rate for Payer: Aetna Medicare Advantage |
$817.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$694.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$694.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$544.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$694.62
|
| Rate for Payer: Cigna Commercial |
$1,362.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$659.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$408.60
|
|
|
LEAD MEDT PCEMKR 4058M-58
|
Facility
|
IP
|
$2,724.00
|
|
| Hospital Charge Code |
270608017
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$408.60 |
| Max. Negotiated Rate |
$659.21 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$544.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$659.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$408.60
|
|
|
LEAD MEDT PCEMKR 4068-52
|
Facility
|
IP
|
$3,026.45
|
|
| Hospital Charge Code |
270607755
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$453.97 |
| Max. Negotiated Rate |
$732.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$605.29
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$732.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$453.97
|
|
|
LEAD MEDT PCEMKR 4068-52
|
Facility
|
OP
|
$3,026.45
|
|
| Hospital Charge Code |
270607755
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$453.97 |
| Max. Negotiated Rate |
$1,513.22 |
| Rate for Payer: Aetna Commercial |
$907.93
|
| Rate for Payer: Aetna Medicare Advantage |
$907.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$771.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$771.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$605.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$771.74
|
| Rate for Payer: Cigna Commercial |
$1,513.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$732.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$453.97
|
|
|
LEAD MEDT PCEMKR 4068-58
|
Facility
|
IP
|
$6,208.85
|
|
| Hospital Charge Code |
270610217
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$931.33 |
| Max. Negotiated Rate |
$1,502.54 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,241.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,502.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$931.33
|
|
|
LEAD MEDT PCEMKR 4068-58
|
Facility
|
OP
|
$6,208.85
|
|
| Hospital Charge Code |
270610217
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$931.33 |
| Max. Negotiated Rate |
$3,104.43 |
| Rate for Payer: Aetna Commercial |
$1,862.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1,862.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,583.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,583.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,241.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,583.26
|
| Rate for Payer: Cigna Commercial |
$3,104.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,502.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$931.33
|
|
|
LEAD MEDT PCEMKR 4068-58CM
|
Facility
|
IP
|
$3,026.45
|
|
| Hospital Charge Code |
270613934
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$453.97 |
| Max. Negotiated Rate |
$732.40 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$605.29
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$732.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$453.97
|
|
|
LEAD MEDT PCEMKR 4068-58CM
|
Facility
|
OP
|
$3,026.45
|
|
| Hospital Charge Code |
270613934
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$453.97 |
| Max. Negotiated Rate |
$1,513.22 |
| Rate for Payer: Aetna Commercial |
$907.93
|
| Rate for Payer: Aetna Medicare Advantage |
$907.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$771.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$771.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$605.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$771.74
|
| Rate for Payer: Cigna Commercial |
$1,513.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$732.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$453.97
|
|
|
LEAD MEDT PCEMKR 4503M
|
Facility
|
IP
|
$4,968.85
|
|
| Hospital Charge Code |
270602749
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$745.33 |
| Max. Negotiated Rate |
$1,202.46 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$993.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,202.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$745.33
|
|
|
LEAD MEDT PCEMKR 4503M
|
Facility
|
OP
|
$4,968.85
|
|
| Hospital Charge Code |
270602749
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$745.33 |
| Max. Negotiated Rate |
$2,484.43 |
| Rate for Payer: Aetna Commercial |
$1,490.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1,490.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,267.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,267.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$993.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,267.06
|
| Rate for Payer: Cigna Commercial |
$2,484.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,202.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$745.33
|
|
|
LEAD MEDT PCEMKR 4557M
|
Facility
|
OP
|
$2,724.00
|
|
| Hospital Charge Code |
270602757
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$408.60 |
| Max. Negotiated Rate |
$1,362.00 |
| Rate for Payer: Aetna Commercial |
$817.20
|
| Rate for Payer: Aetna Medicare Advantage |
$817.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$694.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$694.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$544.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$694.62
|
| Rate for Payer: Cigna Commercial |
$1,362.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$659.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$408.60
|
|
|
LEAD MEDT PCEMKR 4557M
|
Facility
|
IP
|
$2,724.00
|
|
| Hospital Charge Code |
270602757
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$408.60 |
| Max. Negotiated Rate |
$659.21 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$544.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$659.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$408.60
|
|
|
LEAD MEDT PCEMKR 4558M-53
|
Facility
|
OP
|
$2,724.00
|
|
| Hospital Charge Code |
270602758
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$408.60 |
| Max. Negotiated Rate |
$1,362.00 |
| Rate for Payer: Aetna Commercial |
$817.20
|
| Rate for Payer: Aetna Medicare Advantage |
$817.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$694.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$694.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$544.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$694.62
|
| Rate for Payer: Cigna Commercial |
$1,362.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$659.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$408.60
|
|
|
LEAD MEDT PCEMKR 4558M-53
|
Facility
|
IP
|
$3,000.00
|
|
| Hospital Charge Code |
270602758C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$450.00 |
| Max. Negotiated Rate |
$726.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$600.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$726.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$450.00
|
|
|
LEAD MEDT PCEMKR 4558M-53
|
Facility
|
IP
|
$2,724.00
|
|
| Hospital Charge Code |
270602758
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$408.60 |
| Max. Negotiated Rate |
$659.21 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$544.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$659.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$408.60
|
|