|
ANGIOCATH IV CATH 22G 1
|
Facility
|
IP
|
$15.91
|
|
| Hospital Charge Code |
270649597
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$2.39 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.39
|
|
|
ANGIOCATH IV CATH 22G 1
|
Facility
|
OP
|
$15.91
|
|
| Hospital Charge Code |
270649597
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$7.96 |
| Rate for Payer: Aetna Commercial |
$6.05
|
| Rate for Payer: Aetna Medicare Advantage |
$4.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.06
|
| Rate for Payer: Cigna Commercial |
$7.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.14
|
| Rate for Payer: Oxford Commercial |
$3.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.18
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.45
|
|
|
ANGIOCATH IV CATH 24G 3/4
|
Facility
|
IP
|
$16.87
|
|
| Hospital Charge Code |
270649598
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$2.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.53
|
|
|
ANGIOCATH IV CATH 24G 3/4
|
Facility
|
OP
|
$16.87
|
|
| Hospital Charge Code |
270649598
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$8.44 |
| Rate for Payer: Aetna Commercial |
$6.41
|
| Rate for Payer: Aetna Medicare Advantage |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.30
|
| Rate for Payer: Cigna Commercial |
$8.44
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.39
|
| Rate for Payer: Oxford Commercial |
$3.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.48
|
|
|
ANGIO EXTREM UNILATERAL S&I
|
Facility
|
IP
|
$11,803.00
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
2011602
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,770.45 |
| Max. Negotiated Rate |
$1,770.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,770.45
|
|
|
ANGIO EXTREM UNILATERAL S&I
|
Facility
|
IP
|
$11,803.00
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
74110050
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,770.45 |
| Max. Negotiated Rate |
$1,770.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,770.45
|
|
|
ANGIO EXTREM UNILATERAL S&I
|
Facility
|
OP
|
$11,803.00
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
2011602
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$124.74 |
| Max. Negotiated Rate |
$13,607.37 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$124.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,607.37
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,068.78
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,770.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$372.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$335.21
|
|
|
ANGIO EXTREM UNILATERAL S&I
|
Facility
|
OP
|
$11,803.00
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
74110050
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$124.74 |
| Max. Negotiated Rate |
$13,607.37 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$124.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,607.37
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,068.78
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,770.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$372.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$335.21
|
|
|
ANGIOGRAPHY EXTREM BI S&I
|
Facility
|
OP
|
$21,359.77
|
|
|
Service Code
|
HCPCS 75716
|
| Hospital Charge Code |
366875716
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$207.90 |
| Max. Negotiated Rate |
$13,607.37 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$207.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,607.37
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,553.54
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,203.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$674.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$606.62
|
|
|
ANGIOGRAPHY EXTREM BI S&I
|
Facility
|
IP
|
$21,359.77
|
|
|
Service Code
|
HCPCS 75716
|
| Hospital Charge Code |
366875716
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$3,203.97 |
| Max. Negotiated Rate |
$3,203.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,203.97
|
|
|
ANGIO INTERNAL MAMMARY
|
Facility
|
IP
|
$13,882.20
|
|
|
Service Code
|
HCPCS 75756
|
| Hospital Charge Code |
2011601
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,082.33 |
| Max. Negotiated Rate |
$2,082.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,082.33
|
|
|
ANGIO INTERNAL MAMMARY
|
Facility
|
OP
|
$13,882.20
|
|
|
Service Code
|
HCPCS 75756
|
| Hospital Charge Code |
2011601
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$114.76 |
| Max. Negotiated Rate |
$13,607.37 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$114.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,607.37
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,609.37
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,082.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$438.68
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$394.25
|
|
|
ANGIOMAT ILLUMENA CONTRAST SYR
|
Facility
|
IP
|
$32.29
|
|
| Hospital Charge Code |
270667071S
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$4.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.84
|
|
|
ANGIOMAT ILLUMENA CONTRAST SYR
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
270667071N
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.71 |
| Max. Negotiated Rate |
$12.50 |
| Rate for Payer: Aetna Commercial |
$9.50
|
| Rate for Payer: Aetna Medicare Advantage |
$7.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6.38
|
| Rate for Payer: Cigna Commercial |
$12.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.50
|
| Rate for Payer: Oxford Commercial |
$5.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.71
|
|
|
ANGIOMAT ILLUMENA CONTRAST SYR
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
270667071N
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$3.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.75
|
|
|
ANGIOMAT ILLUMENA CONTRAST SYR
|
Facility
|
OP
|
$32.29
|
|
| Hospital Charge Code |
270667071S
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$16.14 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare Advantage |
$9.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.23
|
| Rate for Payer: Cigna Commercial |
$16.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.40
|
| Rate for Payer: Oxford Commercial |
$6.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.46
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.92
|
|
|
ANGIOMAT ILLUMENA CONTRAST SYR
|
Facility
|
IP
|
$32.29
|
|
| Hospital Charge Code |
270667071
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$4.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.84
|
|
|
ANGIOMAT ILLUMENA CONTRAST SYR
|
Facility
|
OP
|
$32.29
|
|
| Hospital Charge Code |
270667071
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$16.14 |
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare Advantage |
$9.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.23
|
| Rate for Payer: Cigna Commercial |
$16.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.40
|
| Rate for Payer: Oxford Commercial |
$6.46
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.46
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.92
|
|
|
ANGIOPLASTY WITH STENT
|
Facility
|
OP
|
$15,539.00
|
|
|
Service Code
|
HCPCS 31635
|
| Hospital Charge Code |
1600000519
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$441.31 |
| Max. Negotiated Rate |
$7,670.60 |
| Rate for Payer: Aetna Commercial |
$5,751.63
|
| Rate for Payer: Aetna Medicare Advantage |
$6,851.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,670.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,670.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,114.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,670.60
|
| Rate for Payer: Cigna Commercial |
$4,238.63
|
| Rate for Payer: Cigna Medicare Advantage |
$2,114.57
|
| Rate for Payer: Clover Medicare Advantage |
$2,008.84
|
| Rate for Payer: EmblemHealth Commercial |
$6,343.71
|
| Rate for Payer: Humana Medicare Advantage |
$2,178.01
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,114.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,040.14
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,330.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$491.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,114.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,114.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$441.31
|
|
|
ANGIOPLASTY WITH STENT
|
Facility
|
IP
|
$15,539.00
|
|
|
Service Code
|
HCPCS 31635
|
| Hospital Charge Code |
1600000519
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,330.85 |
| Max. Negotiated Rate |
$2,330.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,330.85
|
|
|
ANGIO SEAL STS 6FR 610119
|
Facility
|
OP
|
$1,450.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
270632654
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$41.18 |
| Max. Negotiated Rate |
$725.00 |
| Rate for Payer: Aetna Commercial |
$551.00
|
| Rate for Payer: Aetna Medicare Advantage |
$435.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$369.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$369.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$290.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$369.75
|
| Rate for Payer: Cigna Commercial |
$725.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$350.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$41.18
|
|
|
ANGIO SEAL STS 6FR 610119
|
Facility
|
IP
|
$1,450.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
270632654
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$217.50 |
| Max. Negotiated Rate |
$350.90 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$290.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$350.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.50
|
|
|
ANGIOSEAL VIP 6FR
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
270637740N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$120.50 |
| Rate for Payer: Aetna Commercial |
$91.58
|
| Rate for Payer: Aetna Medicare Advantage |
$72.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.45
|
| Rate for Payer: Cigna Commercial |
$120.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.15
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.84
|
|
|
ANGIOSEAL VIP 6FR
|
Facility
|
OP
|
$995.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
270637740S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$28.26 |
| Max. Negotiated Rate |
$497.50 |
| Rate for Payer: Aetna Commercial |
$378.10
|
| Rate for Payer: Aetna Medicare Advantage |
$298.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$253.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$253.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$199.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$253.72
|
| Rate for Payer: Cigna Commercial |
$497.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$240.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.26
|
|
|
ANGIOSEAL VIP 6FR
|
Facility
|
IP
|
$995.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
270637740S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.25 |
| Max. Negotiated Rate |
$240.79 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$199.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$240.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.25
|
|
