|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100962
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100945
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100954
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100967
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100964
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100958
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100966
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100944
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100946
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100951
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100959
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100947
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100948
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100957
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100953
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100950
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100956
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100943
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100965
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100968
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100963
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100960
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100955
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100949
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|
|
ROOM & BOARD-ICU
|
Facility
|
IP
|
$20,000.00
|
|
| Hospital Charge Code |
100995
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,607.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,607.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,793.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
|