|
CATH CONT IRR 30CC 18FR
|
Facility
|
OP
|
$125.00
|
|
| Hospital Charge Code |
270331013
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.25 |
| Max. Negotiated Rate |
$62.50 |
| Rate for Payer: Aetna Commercial |
$37.50
|
| Rate for Payer: Aetna Medicare Advantage |
$37.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.88
|
| Rate for Payer: Cigna Commercial |
$62.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.25
|
| Rate for Payer: Oxford Commercial |
$62.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.50
|
|
|
CATH COUDE 2W 12FR 5CC
|
Facility
|
IP
|
$52.77
|
|
| Hospital Charge Code |
270303245
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.92
|
|
|
CATH COUDE 2W 12FR 5CC
|
Facility
|
OP
|
$52.77
|
|
| Hospital Charge Code |
270303245
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.86 |
| Max. Negotiated Rate |
$26.39 |
| Rate for Payer: Aetna Commercial |
$15.83
|
| Rate for Payer: Aetna Medicare Advantage |
$15.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.46
|
| Rate for Payer: Cigna Commercial |
$26.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.86
|
| Rate for Payer: Oxford Commercial |
$26.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.39
|
|
|
CATH COUDE 2W 14FR 30CC
|
Facility
|
IP
|
$48.33
|
|
| Hospital Charge Code |
270303250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$7.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
|
|
CATH COUDE 2W 14FR 30CC
|
Facility
|
OP
|
$48.33
|
|
| Hospital Charge Code |
270303250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$24.16 |
| Rate for Payer: Aetna Commercial |
$14.50
|
| Rate for Payer: Aetna Medicare Advantage |
$14.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.32
|
| Rate for Payer: Cigna Commercial |
$24.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.28
|
| Rate for Payer: Oxford Commercial |
$24.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$24.16
|
|
|
CATH COUDE 2W 14FR 5CC
|
Facility
|
IP
|
$43.57
|
|
| Hospital Charge Code |
270303285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$6.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
|
|
CATH COUDE 2W 14FR 5CC
|
Facility
|
OP
|
$43.57
|
|
| Hospital Charge Code |
270303285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$21.79 |
| Rate for Payer: Aetna Commercial |
$13.07
|
| Rate for Payer: Aetna Medicare Advantage |
$13.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.11
|
| Rate for Payer: Cigna Commercial |
$21.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.66
|
| Rate for Payer: Oxford Commercial |
$21.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.79
|
|
|
CATH COUDE 2W 16FR 30CC
|
Facility
|
OP
|
$48.33
|
|
| Hospital Charge Code |
270303255
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$24.16 |
| Rate for Payer: Aetna Commercial |
$14.50
|
| Rate for Payer: Aetna Medicare Advantage |
$14.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.32
|
| Rate for Payer: Cigna Commercial |
$24.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.28
|
| Rate for Payer: Oxford Commercial |
$24.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$24.16
|
|
|
CATH COUDE 2W 16FR 30CC
|
Facility
|
IP
|
$48.33
|
|
| Hospital Charge Code |
270303255
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$7.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
|
|
CATH COUDE 2W 16FR 5CC
|
Facility
|
OP
|
$43.57
|
|
| Hospital Charge Code |
270303290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$21.79 |
| Rate for Payer: Aetna Commercial |
$13.07
|
| Rate for Payer: Aetna Medicare Advantage |
$13.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.11
|
| Rate for Payer: Cigna Commercial |
$21.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.66
|
| Rate for Payer: Oxford Commercial |
$21.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.79
|
|
|
CATH COUDE 2W 16FR 5CC
|
Facility
|
IP
|
$43.57
|
|
| Hospital Charge Code |
270303290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$6.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
|
|
CATH COUDE 2W 18FR 30CC
|
Facility
|
OP
|
$47.41
|
|
| Hospital Charge Code |
270303260
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.16 |
| Max. Negotiated Rate |
$23.70 |
| Rate for Payer: Aetna Commercial |
$14.22
|
| Rate for Payer: Aetna Medicare Advantage |
$14.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.09
|
| Rate for Payer: Cigna Commercial |
$23.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.16
|
| Rate for Payer: Oxford Commercial |
$23.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$23.70
|
|
|
CATH COUDE 2W 18FR 30CC
|
Facility
|
IP
|
$47.41
|
|
| Hospital Charge Code |
270303260
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.11 |
| Max. Negotiated Rate |
$7.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.11
|
|
|
CATH COUDE 2W 18FR 5CC
|
Facility
|
IP
|
$43.57
|
|
| Hospital Charge Code |
270303295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$6.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
|
|
CATH COUDE 2W 18FR 5CC
|
Facility
|
OP
|
$43.57
|
|
| Hospital Charge Code |
270303295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$21.79 |
| Rate for Payer: Aetna Commercial |
$13.07
|
| Rate for Payer: Aetna Medicare Advantage |
$13.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.11
|
| Rate for Payer: Cigna Commercial |
$21.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.66
|
| Rate for Payer: Oxford Commercial |
$21.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.79
|
|
|
CATH COUDE 2W 20FR 30CC
|
Facility
|
IP
|
$48.80
|
|
| Hospital Charge Code |
270303265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.32 |
| Max. Negotiated Rate |
$7.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.32
|
|
|
CATH COUDE 2W 20FR 30CC
|
Facility
|
OP
|
$48.80
|
|
| Hospital Charge Code |
270303265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.34 |
| Max. Negotiated Rate |
$24.40 |
| Rate for Payer: Aetna Commercial |
$14.64
|
| Rate for Payer: Aetna Medicare Advantage |
$14.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.44
|
| Rate for Payer: Cigna Commercial |
$24.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.34
|
| Rate for Payer: Oxford Commercial |
$24.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$24.40
|
|
|
CATH COUDE 2W 22FR 30CC
|
Facility
|
IP
|
$48.33
|
|
| Hospital Charge Code |
270303270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$7.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
|
|
CATH COUDE 2W 22FR 30CC
|
Facility
|
OP
|
$48.33
|
|
| Hospital Charge Code |
270303270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$24.16 |
| Rate for Payer: Aetna Commercial |
$14.50
|
| Rate for Payer: Aetna Medicare Advantage |
$14.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.32
|
| Rate for Payer: Cigna Commercial |
$24.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.28
|
| Rate for Payer: Oxford Commercial |
$24.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$24.16
|
|
|
CATH COUDE 2W 24FR 30CC
|
Facility
|
OP
|
$128.00
|
|
| Hospital Charge Code |
270303275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.64 |
| Max. Negotiated Rate |
$64.00 |
| Rate for Payer: Aetna Commercial |
$38.40
|
| Rate for Payer: Aetna Medicare Advantage |
$38.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.64
|
| Rate for Payer: Cigna Commercial |
$64.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.64
|
| Rate for Payer: Oxford Commercial |
$64.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$64.00
|
|
|
CATH COUDE 2W 24FR 30CC
|
Facility
|
IP
|
$128.00
|
|
| Hospital Charge Code |
270303275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$19.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
|
|
CATH COUDE 2W 26FR 30CC
|
Facility
|
OP
|
$128.00
|
|
| Hospital Charge Code |
270303280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.64 |
| Max. Negotiated Rate |
$64.00 |
| Rate for Payer: Aetna Commercial |
$38.40
|
| Rate for Payer: Aetna Medicare Advantage |
$38.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.64
|
| Rate for Payer: Cigna Commercial |
$64.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.64
|
| Rate for Payer: Oxford Commercial |
$64.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$64.00
|
|
|
CATH COUDE 2W 26FR 30CC
|
Facility
|
IP
|
$128.00
|
|
| Hospital Charge Code |
270303280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$19.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
|
|
CATH COUDE 30 CC****
|
Facility
|
OP
|
$64.00
|
|
| Hospital Charge Code |
8002768
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$8.32 |
| Max. Negotiated Rate |
$32.00 |
| Rate for Payer: Aetna Commercial |
$19.20
|
| Rate for Payer: Aetna Medicare Advantage |
$19.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.32
|
| Rate for Payer: Cigna Commercial |
$32.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.32
|
| Rate for Payer: Oxford Commercial |
$32.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$32.00
|
|
|
CATH COUDE 30 CC****
|
Facility
|
IP
|
$64.00
|
|
| Hospital Charge Code |
8002768
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$9.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.60
|
|