|
ROOM & BOARD TCU PRIVATE
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100821
|
|
Hospital Revenue Code
|
120
|
| Min. Negotiated Rate |
$2,700.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD TCU SEMI PRIVATE
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100822
|
|
Hospital Revenue Code
|
120
|
| Min. Negotiated Rate |
$2,700.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100091
|
|
Hospital Revenue Code
|
121
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100994
|
|
Hospital Revenue Code
|
128
|
| Min. Negotiated Rate |
$2,321.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Oxford Commercial |
$2,321.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,634.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100992
|
|
Hospital Revenue Code
|
169
|
| Min. Negotiated Rate |
$2,700.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100976
|
|
Hospital Revenue Code
|
111
|
| Min. Negotiated Rate |
$2,700.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100991
|
|
Hospital Revenue Code
|
121
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100984
|
|
Hospital Revenue Code
|
126
|
| Min. Negotiated Rate |
$2,700.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100987
|
|
Hospital Revenue Code
|
123
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100972
|
|
Hospital Revenue Code
|
121
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100978
|
|
Hospital Revenue Code
|
121
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100975
|
|
Hospital Revenue Code
|
111
|
| Min. Negotiated Rate |
$2,700.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100989
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$2,274.00 |
| Max. Negotiated Rate |
$8,116.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,274.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,116.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$25,000.00
|
|
| Hospital Charge Code |
100979
|
|
Hospital Revenue Code
|
122
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,750.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100974
|
|
Hospital Revenue Code
|
121
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100971
|
|
Hospital Revenue Code
|
121
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100983
|
|
Hospital Revenue Code
|
124
|
| Min. Negotiated Rate |
$1,109.00 |
| Max. Negotiated Rate |
$3,360.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,109.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,360.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100973
|
|
Hospital Revenue Code
|
121
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100993
|
|
Hospital Revenue Code
|
124
|
| Min. Negotiated Rate |
$1,109.00 |
| Max. Negotiated Rate |
$3,360.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,109.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,360.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100988
|
|
Hospital Revenue Code
|
122
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$25,000.00
|
|
| Hospital Charge Code |
100990
|
|
Hospital Revenue Code
|
122
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,750.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
101001
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$2,700.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100982
|
|
Hospital Revenue Code
|
124
|
| Min. Negotiated Rate |
$1,109.00 |
| Max. Negotiated Rate |
$3,360.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,109.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,360.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100980
|
|
Hospital Revenue Code
|
124
|
| Min. Negotiated Rate |
$1,109.00 |
| Max. Negotiated Rate |
$3,360.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,109.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,360.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|
|
ROOM & BOARD-TELEMETRY
|
Facility
|
IP
|
$18,000.00
|
|
| Hospital Charge Code |
100977
|
|
Hospital Revenue Code
|
121
|
| Min. Negotiated Rate |
$2,086.00 |
| Max. Negotiated Rate |
$6,764.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,086.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,764.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,700.00
|
|