|
BUR ZIM NEURO 5092-222
|
Facility
|
OP
|
$111.75
|
|
| Hospital Charge Code |
270601068
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$55.88 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare Advantage |
$33.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.50
|
| Rate for Payer: Cigna Commercial |
$55.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.53
|
| Rate for Payer: Oxford Commercial |
$55.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$55.88
|
|
|
BUR ZIM NEURO 5092-222
|
Facility
|
IP
|
$111.75
|
|
| Hospital Charge Code |
270601068
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.76 |
| Max. Negotiated Rate |
$16.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.76
|
|
|
BUR ZIM NEURO 5092-222 *****
|
Facility
|
IP
|
$97.00
|
|
| Hospital Charge Code |
1604941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.55 |
| Max. Negotiated Rate |
$14.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.55
|
|
|
BUR ZIM NEURO 5092-222 *****
|
Facility
|
OP
|
$97.00
|
|
| Hospital Charge Code |
1604941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.61 |
| Max. Negotiated Rate |
$48.50 |
| Rate for Payer: Aetna Commercial |
$29.10
|
| Rate for Payer: Aetna Medicare Advantage |
$29.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.73
|
| Rate for Payer: Cigna Commercial |
$48.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.61
|
| Rate for Payer: Oxford Commercial |
$48.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$48.50
|
|
|
BUR ZIM NEURO 5092-224*****
|
Facility
|
OP
|
$93.00
|
|
| Hospital Charge Code |
1604883
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.09 |
| Max. Negotiated Rate |
$46.50 |
| Rate for Payer: Aetna Commercial |
$27.90
|
| Rate for Payer: Aetna Medicare Advantage |
$27.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.71
|
| Rate for Payer: Cigna Commercial |
$46.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.09
|
| Rate for Payer: Oxford Commercial |
$46.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$46.50
|
|
|
BUR ZIM NEURO 5092-224*****
|
Facility
|
IP
|
$93.00
|
|
| Hospital Charge Code |
1604883
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$13.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.95
|
|
|
BUR ZIM NEURO 5092-238******
|
Facility
|
IP
|
$104.00
|
|
| Hospital Charge Code |
1604933
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$15.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.60
|
|
|
BUR ZIM NEURO 5092-238******
|
Facility
|
OP
|
$104.00
|
|
| Hospital Charge Code |
1604933
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.52 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: Aetna Commercial |
$31.20
|
| Rate for Payer: Aetna Medicare Advantage |
$31.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.52
|
| Rate for Payer: Cigna Commercial |
$52.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.52
|
| Rate for Payer: Oxford Commercial |
$52.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$52.00
|
|
|
BUR ZIM NEURO 5092-266******
|
Facility
|
IP
|
$215.00
|
|
| Hospital Charge Code |
1604925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.25 |
| Max. Negotiated Rate |
$32.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.25
|
|
|
BUR ZIM NEURO 5092-266******
|
Facility
|
OP
|
$215.00
|
|
| Hospital Charge Code |
1604925
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.95 |
| Max. Negotiated Rate |
$107.50 |
| Rate for Payer: Aetna Commercial |
$64.50
|
| Rate for Payer: Aetna Medicare Advantage |
$64.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.83
|
| Rate for Payer: Cigna Commercial |
$107.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.95
|
| Rate for Payer: Oxford Commercial |
$107.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$107.50
|
|
|
BUR ZIM NEURO RD CUT5092-230**
|
Facility
|
IP
|
$167.00
|
|
| Hospital Charge Code |
1604917
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.05 |
| Max. Negotiated Rate |
$25.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.05
|
|
|
BUR ZIM NEURO RD CUT5092-230**
|
Facility
|
OP
|
$167.00
|
|
| Hospital Charge Code |
1604917
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.71 |
| Max. Negotiated Rate |
$83.50 |
| Rate for Payer: Aetna Commercial |
$50.10
|
| Rate for Payer: Aetna Medicare Advantage |
$50.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.59
|
| Rate for Payer: Cigna Commercial |
$83.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.71
|
| Rate for Payer: Oxford Commercial |
$83.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$83.50
|
|
|
BUR ZIM OVL 8.0MM 5091-236
|
Facility
|
IP
|
$119.40
|
|
| Hospital Charge Code |
270601070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.91 |
| Max. Negotiated Rate |
$17.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.91
|
|
|
BUR ZIM OVL 8.0MM 5091-236
|
Facility
|
OP
|
$119.40
|
|
| Hospital Charge Code |
270601070
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.52 |
| Max. Negotiated Rate |
$59.70 |
| Rate for Payer: Aetna Commercial |
$35.82
|
| Rate for Payer: Aetna Medicare Advantage |
$35.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.45
|
| Rate for Payer: Cigna Commercial |
$59.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.52
|
| Rate for Payer: Oxford Commercial |
$59.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$59.70
|
|
|
BUR ZIM OVL MED 5.5MM 5091-238
|
Facility
|
IP
|
$175.15
|
|
| Hospital Charge Code |
270601066
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.27 |
| Max. Negotiated Rate |
$26.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.27
|
|
|
BUR ZIM OVL MED 5.5MM 5091-238
|
Facility
|
OP
|
$175.15
|
|
| Hospital Charge Code |
270601066
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.77 |
| Max. Negotiated Rate |
$87.58 |
| Rate for Payer: Aetna Commercial |
$52.55
|
| Rate for Payer: Aetna Medicare Advantage |
$52.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.66
|
| Rate for Payer: Cigna Commercial |
$87.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.77
|
| Rate for Payer: Oxford Commercial |
$87.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$87.58
|
|
|
BUR ZIM OVL ST 5.5MM 5092-238
|
Facility
|
OP
|
$254.45
|
|
| Hospital Charge Code |
270606868
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.08 |
| Max. Negotiated Rate |
$127.22 |
| Rate for Payer: Aetna Commercial |
$76.33
|
| Rate for Payer: Aetna Medicare Advantage |
$76.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$64.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$64.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$64.88
|
| Rate for Payer: Cigna Commercial |
$127.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.08
|
| Rate for Payer: Oxford Commercial |
$127.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$127.22
|
|
|
BUR ZIM OVL ST 5.5MM 5092-238
|
Facility
|
IP
|
$254.45
|
|
| Hospital Charge Code |
270606868
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.17 |
| Max. Negotiated Rate |
$38.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.17
|
|
|
BUR ZIM RD 3.0MM 5091-126
|
Facility
|
OP
|
$206.45
|
|
| Hospital Charge Code |
270605620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$103.22 |
| Rate for Payer: Aetna Commercial |
$61.94
|
| Rate for Payer: Aetna Medicare Advantage |
$61.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.64
|
| Rate for Payer: Cigna Commercial |
$103.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.84
|
| Rate for Payer: Oxford Commercial |
$103.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.22
|
|
|
BUR ZIM RD 3.0MM 5091-126
|
Facility
|
IP
|
$206.45
|
|
| Hospital Charge Code |
270605620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.97 |
| Max. Negotiated Rate |
$30.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.97
|
|
|
BUR ZIM SD CUT TAPER 5091-206
|
Facility
|
OP
|
$312.00
|
|
| Hospital Charge Code |
270608841
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.56 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$93.60
|
| Rate for Payer: Aetna Medicare Advantage |
$93.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.56
|
| Rate for Payer: Cigna Commercial |
$156.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.56
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
|
|
BUR ZIM SD CUT TAPER 5091-206
|
Facility
|
IP
|
$312.00
|
|
| Hospital Charge Code |
270608841
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.80
|
|
|
BUR ZIM ST CRBD 2.0MM 5092-224
|
Facility
|
OP
|
$100.55
|
|
| Hospital Charge Code |
270605570
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.07 |
| Max. Negotiated Rate |
$50.27 |
| Rate for Payer: Aetna Commercial |
$30.16
|
| Rate for Payer: Aetna Medicare Advantage |
$30.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.64
|
| Rate for Payer: Cigna Commercial |
$50.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.07
|
| Rate for Payer: Oxford Commercial |
$50.27
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$50.27
|
|
|
BUR ZIM ST CRBD 2.0MM 5092-224
|
Facility
|
IP
|
$100.55
|
|
| Hospital Charge Code |
270605570
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.08 |
| Max. Negotiated Rate |
$15.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.08
|
|
|
BUR ZIM ST CRBD 5.5MM 5091-138
|
Facility
|
OP
|
$295.25
|
|
| Hospital Charge Code |
270607173
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.38 |
| Max. Negotiated Rate |
$147.62 |
| Rate for Payer: Aetna Commercial |
$88.58
|
| Rate for Payer: Aetna Medicare Advantage |
$88.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.29
|
| Rate for Payer: Cigna Commercial |
$147.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.38
|
| Rate for Payer: Oxford Commercial |
$147.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$147.62
|
|