|
PACEMAKER MEDT KDR601
|
Facility
|
IP
|
$21,873.65
|
|
| Hospital Charge Code |
270615845
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,281.05 |
| Max. Negotiated Rate |
$5,293.42 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,374.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,293.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,281.05
|
|
|
PACEMAKER MEDT KDR601
|
Facility
|
OP
|
$21,873.65
|
|
| Hospital Charge Code |
270615845
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,281.05 |
| Max. Negotiated Rate |
$10,936.83 |
| Rate for Payer: Aetna Commercial |
$6,562.10
|
| Rate for Payer: Aetna Medicare Advantage |
$6,562.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,577.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,577.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,374.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,577.78
|
| Rate for Payer: Cigna Commercial |
$10,936.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,293.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,281.05
|
|
|
PACEMAKER MEDT KDR603
|
Facility
|
OP
|
$21,873.65
|
|
| Hospital Charge Code |
270616773C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,281.05 |
| Max. Negotiated Rate |
$10,936.83 |
| Rate for Payer: Aetna Commercial |
$6,562.10
|
| Rate for Payer: Aetna Medicare Advantage |
$6,562.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,577.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,577.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,374.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,577.78
|
| Rate for Payer: Cigna Commercial |
$10,936.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,293.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,281.05
|
|
|
PACEMAKER MEDT KDR603
|
Facility
|
IP
|
$21,873.65
|
|
| Hospital Charge Code |
270616773C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,281.05 |
| Max. Negotiated Rate |
$5,293.42 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,374.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,293.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,281.05
|
|
|
PACEMAKER MEDT KDR603
|
Facility
|
IP
|
$21,873.65
|
|
| Hospital Charge Code |
270616773
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,281.05 |
| Max. Negotiated Rate |
$5,293.42 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,374.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,293.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,281.05
|
|
|
PACEMAKER MEDT KDR603
|
Facility
|
OP
|
$21,873.65
|
|
| Hospital Charge Code |
270616773
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,281.05 |
| Max. Negotiated Rate |
$10,936.83 |
| Rate for Payer: Aetna Commercial |
$6,562.10
|
| Rate for Payer: Aetna Medicare Advantage |
$6,562.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,577.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,577.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,374.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,577.78
|
| Rate for Payer: Cigna Commercial |
$10,936.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,293.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,281.05
|
|
|
PACEMAKER MEDT KDR701
|
Facility
|
IP
|
$24,998.45
|
|
| Hospital Charge Code |
270616251C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,749.77 |
| Max. Negotiated Rate |
$6,049.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,999.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,049.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,749.77
|
|
|
PACEMAKER MEDT KDR701
|
Facility
|
OP
|
$24,998.45
|
|
| Hospital Charge Code |
270616251C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,749.77 |
| Max. Negotiated Rate |
$12,499.23 |
| Rate for Payer: Aetna Commercial |
$7,499.53
|
| Rate for Payer: Aetna Medicare Advantage |
$7,499.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,374.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,374.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,999.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,374.60
|
| Rate for Payer: Cigna Commercial |
$12,499.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,049.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,749.77
|
|
|
PACEMAKER MEDT KDR701
|
Facility
|
IP
|
$24,998.45
|
|
| Hospital Charge Code |
270616251
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,749.77 |
| Max. Negotiated Rate |
$6,049.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,999.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,049.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,749.77
|
|
|
PACEMAKER MEDT KDR701
|
Facility
|
OP
|
$24,998.45
|
|
| Hospital Charge Code |
270616251
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,749.77 |
| Max. Negotiated Rate |
$12,499.23 |
| Rate for Payer: Aetna Commercial |
$7,499.53
|
| Rate for Payer: Aetna Medicare Advantage |
$7,499.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,374.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,374.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,999.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,374.60
|
| Rate for Payer: Cigna Commercial |
$12,499.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,049.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,749.77
|
|
|
PACEMAKER MEDT KDR703
|
Facility
|
OP
|
$24,998.45
|
|
| Hospital Charge Code |
270617172C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,749.77 |
| Max. Negotiated Rate |
$12,499.23 |
| Rate for Payer: Aetna Commercial |
$7,499.53
|
| Rate for Payer: Aetna Medicare Advantage |
$7,499.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,374.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,374.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,999.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,374.60
|
| Rate for Payer: Cigna Commercial |
$12,499.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,049.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,749.77
|
|
|
PACEMAKER MEDT KDR703
|
Facility
|
IP
|
$24,998.45
|
|
| Hospital Charge Code |
270617172C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,749.77 |
| Max. Negotiated Rate |
$6,049.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,999.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,049.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,749.77
|
|
|
PACEMAKER MEDT KDR703
|
Facility
|
IP
|
$24,998.45
|
|
| Hospital Charge Code |
270617172
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,749.77 |
| Max. Negotiated Rate |
$6,049.62 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,999.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,049.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,749.77
|
|
|
PACEMAKER MEDT KDR703
|
Facility
|
OP
|
$24,998.45
|
|
| Hospital Charge Code |
270617172
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,749.77 |
| Max. Negotiated Rate |
$12,499.23 |
| Rate for Payer: Aetna Commercial |
$7,499.53
|
| Rate for Payer: Aetna Medicare Advantage |
$7,499.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,374.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,374.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,999.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,374.60
|
| Rate for Payer: Cigna Commercial |
$12,499.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,049.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,749.77
|
|
|
PACEMAKER MEDT KDR706
|
Facility
|
IP
|
$25,718.45
|
|
| Hospital Charge Code |
270622589C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,857.77 |
| Max. Negotiated Rate |
$6,223.86 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,143.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,223.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,857.77
|
|
|
PACEMAKER MEDT KDR706
|
Facility
|
OP
|
$25,718.45
|
|
| Hospital Charge Code |
270622589C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,857.77 |
| Max. Negotiated Rate |
$12,859.23 |
| Rate for Payer: Aetna Commercial |
$7,715.53
|
| Rate for Payer: Aetna Medicare Advantage |
$7,715.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,558.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,558.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,143.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,558.20
|
| Rate for Payer: Cigna Commercial |
$12,859.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,223.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,857.77
|
|
|
PACEMAKER MEDT KDR706
|
Facility
|
OP
|
$19,998.75
|
|
| Hospital Charge Code |
270622589
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,999.81 |
| Max. Negotiated Rate |
$9,999.38 |
| Rate for Payer: Aetna Commercial |
$5,999.62
|
| Rate for Payer: Aetna Medicare Advantage |
$5,999.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,099.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,099.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,999.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,099.68
|
| Rate for Payer: Cigna Commercial |
$9,999.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,839.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.81
|
|
|
PACEMAKER MEDT KDR706
|
Facility
|
IP
|
$19,998.75
|
|
| Hospital Charge Code |
270622589
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,999.81 |
| Max. Negotiated Rate |
$4,839.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,999.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,839.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.81
|
|
|
PACEMAKER MEDT KDR901
|
Facility
|
IP
|
$32,177.65
|
|
| Hospital Charge Code |
270626858C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,826.65 |
| Max. Negotiated Rate |
$7,786.99 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6,435.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,786.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,826.65
|
|
|
PACEMAKER MEDT KDR901
|
Facility
|
OP
|
$32,177.65
|
|
| Hospital Charge Code |
270626858C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,826.65 |
| Max. Negotiated Rate |
$16,088.83 |
| Rate for Payer: Aetna Commercial |
$9,653.30
|
| Rate for Payer: Aetna Medicare Advantage |
$9,653.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,205.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,205.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6,435.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,205.30
|
| Rate for Payer: Cigna Commercial |
$16,088.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,786.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,826.65
|
|
|
PACEMAKER MEDT KDR901
|
Facility
|
IP
|
$32,177.65
|
|
| Hospital Charge Code |
270626858
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,826.65 |
| Max. Negotiated Rate |
$7,786.99 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6,435.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,786.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,826.65
|
|
|
PACEMAKER MEDT KDR901
|
Facility
|
OP
|
$32,177.65
|
|
| Hospital Charge Code |
270626858
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,826.65 |
| Max. Negotiated Rate |
$16,088.83 |
| Rate for Payer: Aetna Commercial |
$9,653.30
|
| Rate for Payer: Aetna Medicare Advantage |
$9,653.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,205.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,205.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6,435.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,205.30
|
| Rate for Payer: Cigna Commercial |
$16,088.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,786.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,826.65
|
|
|
PACEMAKER MEDT KSR401B
|
Facility
|
IP
|
$20,966.45
|
|
| Hospital Charge Code |
270616039
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,144.97 |
| Max. Negotiated Rate |
$5,073.88 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,193.29
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,073.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,144.97
|
|
|
PACEMAKER MEDT KSR401B
|
Facility
|
OP
|
$20,966.45
|
|
| Hospital Charge Code |
270616039
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,144.97 |
| Max. Negotiated Rate |
$10,483.23 |
| Rate for Payer: Aetna Commercial |
$6,289.94
|
| Rate for Payer: Aetna Medicare Advantage |
$6,289.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,346.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,346.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,193.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,346.44
|
| Rate for Payer: Cigna Commercial |
$10,483.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,073.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,144.97
|
|
|
PACEMAKER MEDT KSR403B
|
Facility
|
OP
|
$20,966.45
|
|
| Hospital Charge Code |
270607505C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,144.97 |
| Max. Negotiated Rate |
$10,483.23 |
| Rate for Payer: Aetna Commercial |
$6,289.94
|
| Rate for Payer: Aetna Medicare Advantage |
$6,289.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,346.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,346.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,193.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,346.44
|
| Rate for Payer: Cigna Commercial |
$10,483.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,073.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,144.97
|
|