|
LINER ZIM ACETB 10 60 61106028
|
Facility
|
IP
|
$4,069.65
|
|
| Hospital Charge Code |
270605997
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$610.45 |
| Max. Negotiated Rate |
$984.86 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$813.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$984.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$610.45
|
|
|
LINER ZIM ACETB 10 62 61106228
|
Facility
|
IP
|
$4,137.65
|
|
| Hospital Charge Code |
270611865
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.65 |
| Max. Negotiated Rate |
$1,001.31 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$827.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,001.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$620.65
|
|
|
LINER ZIM ACETB 10 62 61106228
|
Facility
|
OP
|
$4,137.65
|
|
| Hospital Charge Code |
270611865
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.65 |
| Max. Negotiated Rate |
$2,068.82 |
| Rate for Payer: Aetna Commercial |
$1,241.30
|
| Rate for Payer: Aetna Medicare Advantage |
$1,241.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,055.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,055.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$827.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,055.10
|
| Rate for Payer: Cigna Commercial |
$2,068.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,001.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$620.65
|
|
|
LINER ZIM ACETB 20 56 61205628
|
Facility
|
IP
|
$4,137.65
|
|
| Hospital Charge Code |
270608924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.65 |
| Max. Negotiated Rate |
$1,001.31 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$827.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,001.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$620.65
|
|
|
LINER ZIM ACETB 20 56 61205628
|
Facility
|
OP
|
$4,137.65
|
|
| Hospital Charge Code |
270608924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$620.65 |
| Max. Negotiated Rate |
$2,068.82 |
| Rate for Payer: Aetna Commercial |
$1,241.30
|
| Rate for Payer: Aetna Medicare Advantage |
$1,241.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,055.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,055.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$827.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,055.10
|
| Rate for Payer: Cigna Commercial |
$2,068.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,001.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$620.65
|
|
|
LINER ZIM ACETB 28 48 63104828
|
Facility
|
IP
|
$8,091.25
|
|
| Hospital Charge Code |
270621550
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,213.69 |
| Max. Negotiated Rate |
$1,958.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,618.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,958.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,213.69
|
|
|
LINER ZIM ACETB 28 48 63104828
|
Facility
|
OP
|
$8,091.25
|
|
| Hospital Charge Code |
270621550
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,213.69 |
| Max. Negotiated Rate |
$4,045.62 |
| Rate for Payer: Aetna Commercial |
$2,427.38
|
| Rate for Payer: Aetna Medicare Advantage |
$2,427.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,063.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,063.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,618.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,063.27
|
| Rate for Payer: Cigna Commercial |
$4,045.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,958.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,213.69
|
|
|
LINER ZIM ACETB 28 50 63105028
|
Facility
|
OP
|
$5,654.60
|
|
| Hospital Charge Code |
270619085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$848.19 |
| Max. Negotiated Rate |
$2,827.30 |
| Rate for Payer: Aetna Commercial |
$1,696.38
|
| Rate for Payer: Aetna Medicare Advantage |
$1,696.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,441.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,441.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,130.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,441.92
|
| Rate for Payer: Cigna Commercial |
$2,827.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,368.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$848.19
|
|
|
LINER ZIM ACETB 28 50 63105028
|
Facility
|
IP
|
$5,654.60
|
|
| Hospital Charge Code |
270619085
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$848.19 |
| Max. Negotiated Rate |
$1,368.41 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,130.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,368.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$848.19
|
|
|
LINER ZIM ACETB 28 56 63105628
|
Facility
|
OP
|
$5,393.65
|
|
| Hospital Charge Code |
270621171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$809.05 |
| Max. Negotiated Rate |
$2,696.82 |
| Rate for Payer: Aetna Commercial |
$1,618.10
|
| Rate for Payer: Aetna Medicare Advantage |
$1,618.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,375.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,375.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,078.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,375.38
|
| Rate for Payer: Cigna Commercial |
$2,696.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,305.26
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$809.05
|
|
|
LINER ZIM ACETB 28 56 63105628
|
Facility
|
IP
|
$5,393.65
|
|
| Hospital Charge Code |
270621171
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$809.05 |
| Max. Negotiated Rate |
$1,305.26 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,078.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,305.26
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$809.05
|
|
|
LINER ZIM ACETB 28 58 63105828
|
Facility
|
OP
|
$5,880.80
|
|
| Hospital Charge Code |
270619924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$882.12 |
| Max. Negotiated Rate |
$2,940.40 |
| Rate for Payer: Aetna Commercial |
$1,764.24
|
| Rate for Payer: Aetna Medicare Advantage |
$1,764.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,499.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,499.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,176.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,499.60
|
| Rate for Payer: Cigna Commercial |
$2,940.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,423.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$882.12
|
|
|
LINER ZIM ACETB 28 58 63105828
|
Facility
|
IP
|
$5,880.80
|
|
| Hospital Charge Code |
270619924
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$882.12 |
| Max. Negotiated Rate |
$1,423.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,176.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,423.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$882.12
|
|
|
LINER ZIM ACETB 28 62 63106228
|
Facility
|
IP
|
$4,173.65
|
|
| Hospital Charge Code |
270616874
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$626.05 |
| Max. Negotiated Rate |
$1,010.02 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$834.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,010.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$626.05
|
|
|
LINER ZIM ACETB 28 62 63106228
|
Facility
|
OP
|
$4,173.65
|
|
| Hospital Charge Code |
270616874
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$626.05 |
| Max. Negotiated Rate |
$2,086.82 |
| Rate for Payer: Aetna Commercial |
$1,252.10
|
| Rate for Payer: Aetna Medicare Advantage |
$1,252.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,064.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,064.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$834.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,064.28
|
| Rate for Payer: Cigna Commercial |
$2,086.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,010.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$626.05
|
|
|
LINER ZIM BIPOLAR 44 50014428
|
Facility
|
OP
|
$1,666.55
|
|
| Hospital Charge Code |
270626160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.98 |
| Max. Negotiated Rate |
$833.27 |
| Rate for Payer: Aetna Commercial |
$499.96
|
| Rate for Payer: Aetna Medicare Advantage |
$499.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$424.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$424.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$333.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$424.97
|
| Rate for Payer: Cigna Commercial |
$833.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$403.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.98
|
|
|
LINER ZIM BIPOLAR 44 50014428
|
Facility
|
IP
|
$1,666.55
|
|
| Hospital Charge Code |
270626160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.98 |
| Max. Negotiated Rate |
$403.31 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$333.31
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$403.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.98
|
|
|
LINER ZIM CUP HIP 28 50014728
|
Facility
|
IP
|
$1,666.55
|
|
| Hospital Charge Code |
270625371
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.98 |
| Max. Negotiated Rate |
$403.31 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$333.31
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$403.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.98
|
|
|
LINER ZIM CUP HIP 28 50014728
|
Facility
|
OP
|
$1,666.55
|
|
| Hospital Charge Code |
270625371
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.98 |
| Max. Negotiated Rate |
$833.27 |
| Rate for Payer: Aetna Commercial |
$499.96
|
| Rate for Payer: Aetna Medicare Advantage |
$499.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$424.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$424.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$333.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$424.97
|
| Rate for Payer: Cigna Commercial |
$833.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$403.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.98
|
|
|
LINER ZIM HIP 53 28 50015328
|
Facility
|
IP
|
$1,666.55
|
|
| Hospital Charge Code |
270627235
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.98 |
| Max. Negotiated Rate |
$403.31 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$333.31
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$403.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.98
|
|
|
LINER ZIM HIP 53 28 50015328
|
Facility
|
OP
|
$1,666.55
|
|
| Hospital Charge Code |
270627235
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$249.98 |
| Max. Negotiated Rate |
$833.27 |
| Rate for Payer: Aetna Commercial |
$499.96
|
| Rate for Payer: Aetna Medicare Advantage |
$499.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$424.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$424.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$333.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$424.97
|
| Rate for Payer: Cigna Commercial |
$833.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$403.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$249.98
|
|
|
LINES BIOSPY ********
|
Facility
|
IP
|
$168.00
|
|
| Hospital Charge Code |
8002297
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$25.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.20
|
|
|
LINES BIOSPY ********
|
Facility
|
OP
|
$168.00
|
|
| Hospital Charge Code |
8002297
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$21.84 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna Commercial |
$50.40
|
| Rate for Payer: Aetna Medicare Advantage |
$50.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.84
|
| Rate for Payer: Cigna Commercial |
$84.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.84
|
| Rate for Payer: Oxford Commercial |
$84.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$84.00
|
|
|
LINES BLOOD C3 RENAL
|
Facility
|
IP
|
$44.85
|
|
| Hospital Charge Code |
270606421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$6.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.73
|
|
|
LINES BLOOD C3 RENAL
|
Facility
|
OP
|
$44.85
|
|
| Hospital Charge Code |
270606421
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.83 |
| Max. Negotiated Rate |
$22.43 |
| Rate for Payer: Aetna Commercial |
$13.46
|
| Rate for Payer: Aetna Medicare Advantage |
$13.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.44
|
| Rate for Payer: Cigna Commercial |
$22.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.83
|
| Rate for Payer: Oxford Commercial |
$22.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.43
|
|