|
STENT PROTEGE 8X40X120CM
|
Facility
|
IP
|
$6,624.80
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270638627C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$993.72 |
| Max. Negotiated Rate |
$1,603.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,324.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,603.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$993.72
|
|
|
STENT PROTEGE 8X40X120CM
|
Facility
|
OP
|
$6,624.80
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270638627C
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.14 |
| Max. Negotiated Rate |
$3,312.40 |
| Rate for Payer: Aetna Commercial |
$2,517.42
|
| Rate for Payer: Aetna Medicare Advantage |
$1,987.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,689.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,689.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,324.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,689.32
|
| Rate for Payer: Cigna Commercial |
$3,312.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,603.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$993.72
|
| Rate for Payer: UnitedHealthcare Community & State |
$209.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$188.14
|
|
|
STENT PROTEGE 8X40X120CM
|
Facility
|
IP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270638627N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$1,452.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
|
|
STENT PROTEGE 8X40X120CM
|
Facility
|
OP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270638627N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$170.40 |
| Max. Negotiated Rate |
$3,000.00 |
| Rate for Payer: Aetna Commercial |
$2,280.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,530.00
|
| Rate for Payer: Cigna Commercial |
$3,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$189.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$170.40
|
|
|
STENT PROTEGE EVERFLEX 5x40x12
|
Facility
|
OP
|
$4,500.00
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270659312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna Commercial |
$1,710.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,147.50
|
| Rate for Payer: Cigna Commercial |
$2,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$675.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$142.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$127.80
|
|
|
STENT PROTEGE EVERFLEX 5x40x12
|
Facility
|
IP
|
$4,500.00
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
270659312
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$1,089.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$900.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$675.00
|
|
|
STENT PROTEGE EVERFLEX 6FR
|
Facility
|
OP
|
$6,850.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270659311S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$194.54 |
| Max. Negotiated Rate |
$3,425.00 |
| Rate for Payer: Aetna Commercial |
$2,603.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,055.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,746.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,746.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,370.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,746.75
|
| Rate for Payer: Cigna Commercial |
$3,425.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,657.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,027.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$216.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$194.54
|
|
|
STENT PROTEGE EVERFLEX 6FR
|
Facility
|
IP
|
$6,850.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270659311N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$1,657.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,370.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,657.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,027.50
|
|
|
STENT PROTEGE EVERFLEX 6FR
|
Facility
|
IP
|
$6,850.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270659311S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$1,657.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,370.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,657.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,027.50
|
|
|
STENT PROTEGE EVERFLEX 6FR
|
Facility
|
OP
|
$6,850.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270659311N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$194.54 |
| Max. Negotiated Rate |
$3,425.00 |
| Rate for Payer: Aetna Commercial |
$2,603.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,055.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,746.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,746.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,370.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,746.75
|
| Rate for Payer: Cigna Commercial |
$3,425.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,657.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,027.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$216.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$194.54
|
|
|
STENT PROTEGE EVERFLEX 6FR
|
Facility
|
OP
|
$6,850.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270659311
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$194.54 |
| Max. Negotiated Rate |
$3,425.00 |
| Rate for Payer: Aetna Commercial |
$2,603.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,055.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,746.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,746.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,370.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,746.75
|
| Rate for Payer: Cigna Commercial |
$3,425.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,657.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,027.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$216.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$194.54
|
|
|
STENT PROTEGE EVERFLEX 6FR
|
Facility
|
IP
|
$6,850.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270659311
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,027.50 |
| Max. Negotiated Rate |
$1,657.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,370.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,657.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,027.50
|
|
|
STENT PROTEGE EVERFLEX 6fr BIL
|
Facility
|
IP
|
$1,395.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270643430S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$209.25 |
| Max. Negotiated Rate |
$337.59 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$279.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$337.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$209.25
|
|
|
STENT PROTEGE EVERFLEX 6fr BIL
|
Facility
|
IP
|
$1,395.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270643430N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$209.25 |
| Max. Negotiated Rate |
$337.59 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$279.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$337.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$209.25
|
|
|
STENT PROTEGE EVERFLEX 6fr BIL
|
Facility
|
OP
|
$1,395.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270643430S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$697.50 |
| Rate for Payer: Aetna Commercial |
$530.10
|
| Rate for Payer: Aetna Medicare Advantage |
$418.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$355.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$355.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$279.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$355.73
|
| Rate for Payer: Cigna Commercial |
$697.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$337.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$209.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$44.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.62
|
|
|
STENT PROTEGE EVERFLEX 6fr BIL
|
Facility
|
IP
|
$4,500.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270643430
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$675.00 |
| Max. Negotiated Rate |
$1,089.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$900.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$675.00
|
|
|
STENT PROTEGE EVERFLEX 6fr BIL
|
Facility
|
OP
|
$1,395.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270643430N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.62 |
| Max. Negotiated Rate |
$697.50 |
| Rate for Payer: Aetna Commercial |
$530.10
|
| Rate for Payer: Aetna Medicare Advantage |
$418.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$355.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$355.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$279.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$355.73
|
| Rate for Payer: Cigna Commercial |
$697.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$337.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$209.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$44.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.62
|
|
|
STENT PROTEGE EVERFLEX 6fr BIL
|
Facility
|
OP
|
$4,500.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270643430
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$127.80 |
| Max. Negotiated Rate |
$2,250.00 |
| Rate for Payer: Aetna Commercial |
$1,710.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,147.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,147.50
|
| Rate for Payer: Cigna Commercial |
$2,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$675.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$142.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$127.80
|
|
|
STENT PROTEGE EVERFLEX 6FR BIL
|
Facility
|
OP
|
$6,975.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270643435S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.09 |
| Max. Negotiated Rate |
$3,487.50 |
| Rate for Payer: Aetna Commercial |
$2,650.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,092.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,778.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,778.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,395.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,778.62
|
| Rate for Payer: Cigna Commercial |
$3,487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,687.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,046.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$220.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$198.09
|
|
|
STENT PROTEGE EVERFLEX 6FR BIL
|
Facility
|
IP
|
$6,975.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270643435S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,046.25 |
| Max. Negotiated Rate |
$1,687.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,395.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,687.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,046.25
|
|
|
STENT PROTEGE EVERFLEX 6FR BIL
|
Facility
|
IP
|
$6,624.80
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270643435
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$993.72 |
| Max. Negotiated Rate |
$1,603.20 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,324.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,603.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$993.72
|
|
|
STENT PROTEGE EVERFLEX 6FR BIL
|
Facility
|
OP
|
$6,624.80
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270643435
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.14 |
| Max. Negotiated Rate |
$3,312.40 |
| Rate for Payer: Aetna Commercial |
$2,517.42
|
| Rate for Payer: Aetna Medicare Advantage |
$1,987.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,689.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,689.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,324.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,689.32
|
| Rate for Payer: Cigna Commercial |
$3,312.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,603.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$993.72
|
| Rate for Payer: UnitedHealthcare Community & State |
$209.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$188.14
|
|
|
STENT PROTEGE EVERFLEX 6FR BIL
|
Facility
|
IP
|
$7,975.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270657479N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,196.25 |
| Max. Negotiated Rate |
$1,929.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,595.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,929.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,196.25
|
|
|
STENT PROTEGE EVERFLEX 6FR BIL
|
Facility
|
IP
|
$7,750.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270657479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,162.50 |
| Max. Negotiated Rate |
$1,875.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,550.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,875.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,162.50
|
|
|
STENT PROTEGE EVERFLEX 6FR BIL
|
Facility
|
OP
|
$7,750.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270657479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$220.10 |
| Max. Negotiated Rate |
$3,875.00 |
| Rate for Payer: Aetna Commercial |
$2,945.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,325.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,976.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,976.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,550.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,976.25
|
| Rate for Payer: Cigna Commercial |
$3,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,875.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,162.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$244.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$220.10
|
|
