|
CATH APEX MONORAIL 8mmx2.50mm
|
Facility
|
IP
|
$1,225.00
|
|
| Hospital Charge Code |
2709007373
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$183.75 |
| Max. Negotiated Rate |
$183.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$183.75
|
|
|
CATH AR I 6F
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636302
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$58.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
CATH AR I 6F
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636302
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna Medicare Advantage |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.20
|
| Rate for Payer: Cigna Commercial |
$120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
CATH AR I 7FR 77811000
|
Facility
|
IP
|
$277.70
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636360N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$67.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.66
|
|
|
CATH AR I 7FR 77811000
|
Facility
|
OP
|
$220.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.00 |
| 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) NJ Health |
$44.00
|
| 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 |
$53.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
CATH AR I 7FR 77811000
|
Facility
|
IP
|
$220.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636360
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$53.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.00
|
|
|
CATH AR I 7FR 77811000
|
Facility
|
OP
|
$277.70
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636360N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$138.85 |
| Rate for Payer: Aetna Commercial |
$83.31
|
| Rate for Payer: Aetna Medicare Advantage |
$83.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.81
|
| Rate for Payer: Cigna Commercial |
$138.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.66
|
|
|
CATH AR II 533643
|
Facility
|
IP
|
$42.25
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270622011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$10.22 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
|
|
CATH AR II 533643
|
Facility
|
OP
|
$42.25
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270622011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$21.12 |
| Rate for Payer: Aetna Commercial |
$12.68
|
| Rate for Payer: Aetna Medicare Advantage |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.77
|
| Rate for Payer: Cigna Commercial |
$21.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.34
|
|
|
CATH AR II 6F 67011200
|
Facility
|
OP
|
$277.70
|
|
| Hospital Charge Code |
270636304
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$138.85 |
| Rate for Payer: Aetna Commercial |
$83.31
|
| Rate for Payer: Aetna Medicare Advantage |
$83.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.81
|
| Rate for Payer: Cigna Commercial |
$138.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.66
|
|
|
CATH AR II 6F 67011200
|
Facility
|
IP
|
$277.70
|
|
| Hospital Charge Code |
270636304
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$67.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.66
|
|
|
CATH AR II 7F 77811200
|
Facility
|
IP
|
$277.70
|
|
| Hospital Charge Code |
270636362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$67.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.66
|
|
|
CATH AR II 7F 77811200
|
Facility
|
OP
|
$277.70
|
|
| Hospital Charge Code |
270636362
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$138.85 |
| Rate for Payer: Aetna Commercial |
$83.31
|
| Rate for Payer: Aetna Medicare Advantage |
$83.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.81
|
| Rate for Payer: Cigna Commercial |
$138.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.66
|
|
|
CATH AR II 7FR 77811200
|
Facility
|
OP
|
$279.85
|
|
| Hospital Charge Code |
270636362C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.98 |
| Max. Negotiated Rate |
$139.93 |
| Rate for Payer: Aetna Commercial |
$83.95
|
| Rate for Payer: Aetna Medicare Advantage |
$83.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$71.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$71.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$71.36
|
| Rate for Payer: Cigna Commercial |
$139.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.98
|
|
|
CATH AR II 7FR 77811200
|
Facility
|
IP
|
$279.85
|
|
| Hospital Charge Code |
270636362C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.98 |
| Max. Negotiated Rate |
$67.72 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.98
|
|
|
CATH AR II SH 6F 67011300
|
Facility
|
IP
|
$277.70
|
|
| Hospital Charge Code |
270636305
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$67.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.66
|
|
|
CATH AR II SH 6F 67011300
|
Facility
|
OP
|
$277.70
|
|
| Hospital Charge Code |
270636305
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$138.85 |
| Rate for Payer: Aetna Commercial |
$83.31
|
| Rate for Payer: Aetna Medicare Advantage |
$83.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.81
|
| Rate for Payer: Cigna Commercial |
$138.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.66
|
|
|
CATH AR I SH 6F 637011100
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636303
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$58.08 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
CATH AR I SH 6F 637011100
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270636303
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$120.00 |
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna Medicare Advantage |
$72.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.20
|
| Rate for Payer: Cigna Commercial |
$120.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
CATH AR I SH 7F 77811100
|
Facility
|
OP
|
$277.70
|
|
| Hospital Charge Code |
270636361
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$138.85 |
| Rate for Payer: Aetna Commercial |
$83.31
|
| Rate for Payer: Aetna Medicare Advantage |
$83.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.81
|
| Rate for Payer: Cigna Commercial |
$138.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.66
|
|
|
CATH AR I SH 7F 77811100
|
Facility
|
IP
|
$277.70
|
|
| Hospital Charge Code |
270636361
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$67.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.66
|
|
|
CATH ARMADA 14 PTA 1.2x12x145
|
Facility
|
OP
|
$1,320.00
|
|
| Hospital Charge Code |
270705175
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$171.60 |
| Max. Negotiated Rate |
$660.00 |
| Rate for Payer: Aetna Commercial |
$396.00
|
| Rate for Payer: Aetna Medicare Advantage |
$396.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$336.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$336.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$336.60
|
| Rate for Payer: Cigna Commercial |
$660.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$171.60
|
| Rate for Payer: Oxford Commercial |
$660.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$198.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$660.00
|
|
|
CATH ARMADA 14 PTA 1.2x12x145
|
Facility
|
IP
|
$1,320.00
|
|
| Hospital Charge Code |
270705175
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$198.00 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$198.00
|
|
|
CATH ARMADA 14 PTA 1.2x20x145
|
Facility
|
OP
|
$1,320.00
|
|
| Hospital Charge Code |
270705180
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$171.60 |
| Max. Negotiated Rate |
$660.00 |
| Rate for Payer: Aetna Commercial |
$396.00
|
| Rate for Payer: Aetna Medicare Advantage |
$396.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$336.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$336.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$336.60
|
| Rate for Payer: Cigna Commercial |
$660.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$171.60
|
| Rate for Payer: Oxford Commercial |
$660.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$198.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$660.00
|
|
|
CATH ARMADA 14 PTA 1.2x20x145
|
Facility
|
IP
|
$1,320.00
|
|
| Hospital Charge Code |
270705180
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$198.00 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$198.00
|
|