|
CATH 7FR JR 4.0
|
Facility
|
OP
|
$45.25
|
|
| Hospital Charge Code |
270612749
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.88 |
| Max. Negotiated Rate |
$22.62 |
| Rate for Payer: Aetna Commercial |
$13.57
|
| Rate for Payer: Aetna Medicare Advantage |
$13.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.54
|
| Rate for Payer: Cigna Commercial |
$22.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.88
|
| Rate for Payer: Oxford Commercial |
$22.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.62
|
|
|
CATH 7FR JR 4.0
|
Facility
|
IP
|
$45.25
|
|
| Hospital Charge Code |
270612749
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$6.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.79
|
|
|
CATH 7FR XB 4.5
|
Facility
|
OP
|
$220.00
|
|
| Hospital Charge Code |
270663272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.60 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$66.00
|
| Rate for Payer: Aetna Medicare Advantage |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.10
|
| Rate for Payer: Cigna Commercial |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.60
|
| Rate for Payer: Oxford Commercial |
$110.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$110.00
|
|
|
CATH 7FR XB 4.5
|
Facility
|
IP
|
$220.00
|
|
| Hospital Charge Code |
270663272
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
CATH 7FR XB LAD 4.5
|
Facility
|
IP
|
$220.00
|
|
| Hospital Charge Code |
270663271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
CATH 7FR XB LAD 4.5
|
Facility
|
OP
|
$220.00
|
|
| Hospital Charge Code |
270663271
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.60 |
| Max. Negotiated Rate |
$110.00 |
| Rate for Payer: Aetna Commercial |
$66.00
|
| Rate for Payer: Aetna Medicare Advantage |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.10
|
| Rate for Payer: Cigna Commercial |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.60
|
| Rate for Payer: Oxford Commercial |
$110.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$110.00
|
|
|
CATH 8*****
|
Facility
|
OP
|
$181.00
|
|
| Hospital Charge Code |
8003469
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$23.53 |
| Max. Negotiated Rate |
$90.50 |
| Rate for Payer: Aetna Commercial |
$54.30
|
| Rate for Payer: Aetna Medicare Advantage |
$54.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.16
|
| Rate for Payer: Cigna Commercial |
$90.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.53
|
| Rate for Payer: Oxford Commercial |
$90.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$90.50
|
|
|
CATH 8*****
|
Facility
|
IP
|
$181.00
|
|
| Hospital Charge Code |
8003469
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$27.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.15
|
|
|
CATH 8FR AL 1.0 100cm
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
270637989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
CATH 8FR AL 1.0 100cm
|
Facility
|
OP
|
$230.00
|
|
| Hospital Charge Code |
270637989
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$69.00
|
| Rate for Payer: Aetna Medicare Advantage |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.65
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.90
|
| Rate for Payer: Oxford Commercial |
$115.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$115.00
|
|
|
CATH 8FR AL 1.5 100cm
|
Facility
|
OP
|
$230.00
|
|
| Hospital Charge Code |
270637992
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$69.00
|
| Rate for Payer: Aetna Medicare Advantage |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.65
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.90
|
| Rate for Payer: Oxford Commercial |
$115.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$115.00
|
|
|
CATH 8FR AL 1.5 100cm
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
270637992
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
CATH 8FR AL 2.0 100cm
|
Facility
|
OP
|
$230.00
|
|
| Hospital Charge Code |
270637993
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$69.00
|
| Rate for Payer: Aetna Medicare Advantage |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.65
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.90
|
| Rate for Payer: Oxford Commercial |
$115.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$115.00
|
|
|
CATH 8FR AL 2.0 100cm
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
270637993
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
CATH 8FR AL .75 100cm
|
Facility
|
OP
|
$230.00
|
|
| Hospital Charge Code |
270637990
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$115.00 |
| Rate for Payer: Aetna Commercial |
$69.00
|
| Rate for Payer: Aetna Medicare Advantage |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.65
|
| Rate for Payer: Cigna Commercial |
$115.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.90
|
| Rate for Payer: Oxford Commercial |
$115.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$115.00
|
|
|
CATH 8FR AL .75 100cm
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
270637990
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|
|
CATH 8FR AR 1.0 100cm
|
Facility
|
IP
|
$247.50
|
|
| Hospital Charge Code |
270637987
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.12 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.12
|
|
|
CATH 8FR AR 1.0 100cm
|
Facility
|
OP
|
$247.50
|
|
| Hospital Charge Code |
270637987
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.17 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Aetna Commercial |
$74.25
|
| Rate for Payer: Aetna Medicare Advantage |
$74.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.11
|
| Rate for Payer: Cigna Commercial |
$123.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.17
|
| Rate for Payer: Oxford Commercial |
$123.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$123.75
|
|
|
CATH 8FR JCR 3.5cm
|
Facility
|
OP
|
$255.00
|
|
| Hospital Charge Code |
270367736
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna Medicare Advantage |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$65.03
|
| Rate for Payer: Cigna Commercial |
$127.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.15
|
| Rate for Payer: Oxford Commercial |
$127.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$127.50
|
|
|
CATH 8FR JCR 3.5cm
|
Facility
|
IP
|
$255.00
|
|
| Hospital Charge Code |
270367736
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$38.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.25
|
|
|
CATH 8FR LCB 100cm
|
Facility
|
IP
|
$255.00
|
|
| Hospital Charge Code |
270637996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$38.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.25
|
|
|
CATH 8FR LCB 100cm
|
Facility
|
OP
|
$255.00
|
|
| Hospital Charge Code |
270637996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna Medicare Advantage |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$65.03
|
| Rate for Payer: Cigna Commercial |
$127.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.15
|
| Rate for Payer: Oxford Commercial |
$127.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$127.50
|
|
|
CATH 8FR MPA 1.0 100cm 588842
|
Facility
|
IP
|
$255.00
|
|
| Hospital Charge Code |
270637995C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$61.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$51.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.25
|
|
|
CATH 8FR MPA 1.0 100cm 588842
|
Facility
|
OP
|
$255.00
|
|
| Hospital Charge Code |
270637995C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna Medicare Advantage |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$65.03
|
| Rate for Payer: Cigna Commercial |
$127.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.25
|
|
|
CATH 8FR NR 4.0
|
Facility
|
IP
|
$230.00
|
|
| Hospital Charge Code |
270637739
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.66
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.50
|
|