|
10X360MM LONG NAIL RT, 125DEG
|
Facility
|
OP
|
$18,793.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705665
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$533.74 |
| Max. Negotiated Rate |
$9,396.90 |
| Rate for Payer: Aetna Commercial |
$7,141.64
|
| Rate for Payer: Aetna Medicare Advantage |
$5,638.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,792.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,792.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,758.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,792.42
|
| Rate for Payer: Cigna Commercial |
$9,396.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,548.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,819.07
|
| Rate for Payer: UnitedHealthcare Community & State |
$593.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$533.74
|
|
|
10 X 420 X 130 TFNA
|
Facility
|
IP
|
$9,942.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686261
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,491.41 |
| Max. Negotiated Rate |
$2,406.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,988.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,406.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,491.41
|
|
|
10 X 420 X 130 TFNA
|
Facility
|
OP
|
$9,942.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686261
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.37 |
| Max. Negotiated Rate |
$4,971.38 |
| Rate for Payer: Aetna Commercial |
$3,778.24
|
| Rate for Payer: Aetna Medicare Advantage |
$2,982.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,535.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,535.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,988.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,535.40
|
| Rate for Payer: Cigna Commercial |
$4,971.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,406.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,491.41
|
| Rate for Payer: UnitedHealthcare Community & State |
$314.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$282.37
|
|
|
11-DEOXYCORTISOL,LC/MS/MS
|
Facility
|
IP
|
$199.70
|
|
|
Service Code
|
HCPCS 82634
|
| Hospital Charge Code |
39900512
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.95 |
| Max. Negotiated Rate |
$29.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.95
|
|
|
11-DEOXYCORTISOL,LC/MS/MS
|
Facility
|
OP
|
$199.70
|
|
|
Service Code
|
HCPCS 82634
|
| Hospital Charge Code |
39900512
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$79.64
|
| Rate for Payer: Aetna Medicare Advantage |
$94.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$106.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$106.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$29.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$70.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$106.21
|
| Rate for Payer: Cigna Commercial |
$99.85
|
| Rate for Payer: Cigna Medicare Advantage |
$29.28
|
| Rate for Payer: Clover Medicare Advantage |
$27.82
|
| Rate for Payer: EmblemHealth Commercial |
$87.84
|
| Rate for Payer: Humana Medicare Advantage |
$30.16
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$29.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$51.92
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$29.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$29.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.67
|
|
|
1.1 DOUBLE G/WIRE
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
270684631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
|
|
1.1 DOUBLE G/WIRE
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
270684631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$50.00 |
| Rate for Payer: Aetna Commercial |
$38.00
|
| Rate for Payer: Aetna Medicare Advantage |
$30.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.50
|
| Rate for Payer: Cigna Commercial |
$50.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.00
|
| Rate for Payer: Oxford Commercial |
$20.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$20.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.84
|
|
|
1.1 GUIDEWIRE
|
Facility
|
IP
|
$205.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270664015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.75 |
| Max. Negotiated Rate |
$49.61 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.61
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.75
|
|
|
1.1 GUIDEWIRE
|
Facility
|
OP
|
$2,360.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270666242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$67.02 |
| Max. Negotiated Rate |
$1,180.00 |
| Rate for Payer: Aetna Commercial |
$896.80
|
| Rate for Payer: Aetna Medicare Advantage |
$708.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$601.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$601.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$472.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$601.80
|
| Rate for Payer: Cigna Commercial |
$1,180.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$571.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$354.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$74.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$67.02
|
|
|
1.1 GUIDEWIRE
|
Facility
|
OP
|
$205.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270664015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.82 |
| Max. Negotiated Rate |
$102.50 |
| Rate for Payer: Aetna Commercial |
$77.90
|
| Rate for Payer: Aetna Medicare Advantage |
$61.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.27
|
| Rate for Payer: Cigna Commercial |
$102.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.61
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.82
|
|
|
1.1 GUIDEWIRE
|
Facility
|
IP
|
$475.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270664042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.25 |
| Max. Negotiated Rate |
$114.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$95.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.25
|
|
|
1.1 GUIDEWIRE
|
Facility
|
OP
|
$475.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270664042
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.49 |
| Max. Negotiated Rate |
$237.50 |
| Rate for Payer: Aetna Commercial |
$180.50
|
| Rate for Payer: Aetna Medicare Advantage |
$142.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$121.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$121.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$95.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$121.12
|
| Rate for Payer: Cigna Commercial |
$237.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.49
|
|
|
1.1 GUIDEWIRE
|
Facility
|
IP
|
$2,360.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
270666242
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$354.00 |
| Max. Negotiated Rate |
$571.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$472.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$571.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$354.00
|
|
|
11MM/125DEG TI CANN TFNA 320MM
|
Facility
|
OP
|
$14,063.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
278704757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$399.39 |
| Max. Negotiated Rate |
$7,031.50 |
| Rate for Payer: Aetna Commercial |
$5,343.94
|
| Rate for Payer: Aetna Medicare Advantage |
$4,218.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,586.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,586.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,812.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,586.07
|
| Rate for Payer: Cigna Commercial |
$7,031.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,403.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,109.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$444.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$399.39
|
|
|
11MM/125DEG TI CANN TFNA 320MM
|
Facility
|
IP
|
$14,063.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
270704757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,109.45 |
| Max. Negotiated Rate |
$3,403.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,812.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,403.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,109.45
|
|
|
11MM/125DEG TI CANN TFNA 320MM
|
Facility
|
OP
|
$14,063.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
270704757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$399.39 |
| Max. Negotiated Rate |
$7,031.50 |
| Rate for Payer: Aetna Commercial |
$5,343.94
|
| Rate for Payer: Aetna Medicare Advantage |
$4,218.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,586.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,586.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,812.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,586.07
|
| Rate for Payer: Cigna Commercial |
$7,031.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,403.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,109.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$444.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$399.39
|
|
|
11MM/125DEG TI CANN TFNA 320MM
|
Facility
|
IP
|
$14,063.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
278704757
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,109.45 |
| Max. Negotiated Rate |
$3,403.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,812.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,403.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,109.45
|
|
|
11MM/125DEG TI CANN TNFA
|
Facility
|
OP
|
$14,213.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$403.65 |
| Max. Negotiated Rate |
$7,106.50 |
| Rate for Payer: Aetna Commercial |
$5,400.94
|
| Rate for Payer: Aetna Medicare Advantage |
$4,263.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,624.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,624.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,842.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,624.32
|
| Rate for Payer: Cigna Commercial |
$7,106.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,439.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,131.95
|
| Rate for Payer: UnitedHealthcare Community & State |
$449.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$403.65
|
|
|
11MM/125DEG TI CANN TNFA
|
Facility
|
IP
|
$14,213.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704346
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,131.95 |
| Max. Negotiated Rate |
$3,439.55 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,842.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,439.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,131.95
|
|
|
11MM/130DEG TI CANN TFNA360MM/
|
Facility
|
IP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,447.97 |
| Max. Negotiated Rate |
$2,336.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
|
|
11MM/130DEG TI CANN TFNA360MM/
|
Facility
|
OP
|
$9,653.15
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270675364
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$274.15 |
| Max. Negotiated Rate |
$4,826.57 |
| Rate for Payer: Aetna Commercial |
$3,668.20
|
| Rate for Payer: Aetna Medicare Advantage |
$2,895.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,461.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,930.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,461.55
|
| Rate for Payer: Cigna Commercial |
$4,826.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,336.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.97
|
| Rate for Payer: UnitedHealthcare Community & State |
$305.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$274.15
|
|
|
11MM/130 DEG TI CANN THN 400
|
Facility
|
IP
|
$9,942.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,491.41 |
| Max. Negotiated Rate |
$2,406.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,988.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,406.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,491.41
|
|
|
11MM/130 DEG TI CANN THN 400
|
Facility
|
OP
|
$9,942.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.37 |
| Max. Negotiated Rate |
$4,971.38 |
| Rate for Payer: Aetna Commercial |
$3,778.24
|
| Rate for Payer: Aetna Medicare Advantage |
$2,982.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,535.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,535.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,988.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,535.40
|
| Rate for Payer: Cigna Commercial |
$4,971.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,406.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,491.41
|
| Rate for Payer: UnitedHealthcare Community & State |
$314.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$282.37
|
|
|
11MM/130DEG TI CAN TFNA340MM/R
|
Facility
|
IP
|
$9,942.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678928
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,491.41 |
| Max. Negotiated Rate |
$2,406.15 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,988.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,406.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,491.41
|
|
|
11MM/130DEG TI CAN TFNA340MM/R
|
Facility
|
OP
|
$9,942.75
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270678928
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$282.37 |
| Max. Negotiated Rate |
$4,971.38 |
| Rate for Payer: Aetna Commercial |
$3,778.24
|
| Rate for Payer: Aetna Medicare Advantage |
$2,982.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,535.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,535.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,988.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,535.40
|
| Rate for Payer: Cigna Commercial |
$4,971.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,406.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,491.41
|
| Rate for Payer: UnitedHealthcare Community & State |
$314.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$282.37
|
|