|
CANCELLOUS 4.0MM X 16MM
|
Facility
|
IP
|
$330.00
|
|
| Hospital Charge Code |
270657763
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$49.50 |
| Max. Negotiated Rate |
$79.86 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$66.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.50
|
|
|
CANCELLOUS 4.0MM X 16MM
|
Facility
|
OP
|
$330.00
|
|
| Hospital Charge Code |
270657763
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: Aetna Commercial |
$125.40
|
| Rate for Payer: Aetna Medicare Advantage |
$99.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.15
|
| Rate for Payer: Cigna Commercial |
$165.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.37
|
|
|
CANCELLOUS CHIPS CRUSHED 15 CC
|
Facility
|
IP
|
$2,175.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700443
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$326.25 |
| Max. Negotiated Rate |
$526.35 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$435.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$526.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$326.25
|
|
|
CANCELLOUS CHIPS CRUSHED 15 CC
|
Facility
|
OP
|
$2,175.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700443
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$1,087.50 |
| Rate for Payer: Aetna Commercial |
$826.50
|
| Rate for Payer: Aetna Medicare Advantage |
$652.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$554.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$554.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$435.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$554.62
|
| Rate for Payer: Cigna Commercial |
$1,087.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$526.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$326.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$68.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$61.77
|
|
|
CANCELLOUS MORSELIZED 5CC
|
Facility
|
IP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684819
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$146.25 |
| Max. Negotiated Rate |
$235.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
|
|
CANCELLOUS MORSELIZED 5CC
|
Facility
|
OP
|
$975.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270684819
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.69 |
| Max. Negotiated Rate |
$487.50 |
| Rate for Payer: Aetna Commercial |
$370.50
|
| Rate for Payer: Aetna Medicare Advantage |
$292.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$248.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$248.62
|
| Rate for Payer: Cigna Commercial |
$487.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$235.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$146.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$30.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.69
|
|
|
CANCER ANTIGEN 125 (CA125)
|
Facility
|
OP
|
$602.00
|
|
|
Service Code
|
HCPCS 86304
|
| Hospital Charge Code |
38472156
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$301.00 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare Advantage |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.49
|
| Rate for Payer: Cigna Commercial |
$301.00
|
| Rate for Payer: Cigna Medicare Advantage |
$20.81
|
| Rate for Payer: Clover Medicare Advantage |
$19.77
|
| Rate for Payer: EmblemHealth Commercial |
$62.43
|
| Rate for Payer: Humana Medicare Advantage |
$21.43
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$156.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.10
|
|
|
CANCER ANTIGEN 125 (CA125)
|
Facility
|
IP
|
$602.00
|
|
|
Service Code
|
HCPCS 86304
|
| Hospital Charge Code |
38472156
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$90.30 |
| Max. Negotiated Rate |
$90.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.30
|
|
|
CANCER ANTIGEN 15-3 (CA 15-3)
|
Facility
|
OP
|
$602.00
|
|
|
Service Code
|
HCPCS 86300
|
| Hospital Charge Code |
38476214
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$301.00 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare Advantage |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.49
|
| Rate for Payer: Cigna Commercial |
$301.00
|
| Rate for Payer: Cigna Medicare Advantage |
$20.81
|
| Rate for Payer: Clover Medicare Advantage |
$19.77
|
| Rate for Payer: EmblemHealth Commercial |
$62.43
|
| Rate for Payer: Humana Medicare Advantage |
$21.43
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$156.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.10
|
|
|
CANCER ANTIGEN 15-3 (CA 15-3)
|
Facility
|
IP
|
$602.00
|
|
|
Service Code
|
HCPCS 86300
|
| Hospital Charge Code |
38476214
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$90.30 |
| Max. Negotiated Rate |
$90.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.30
|
|
|
CANCER ANTIGEN 19-9 (CA 19-9)
|
Facility
|
IP
|
$402.00
|
|
|
Service Code
|
HCPCS 86301
|
| Hospital Charge Code |
38476215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$60.30 |
| Max. Negotiated Rate |
$60.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.30
|
|
|
CANCER ANTIGEN 19-9 (CA 19-9)
|
Facility
|
OP
|
$402.00
|
|
|
Service Code
|
HCPCS 86301
|
| Hospital Charge Code |
38476215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.42 |
| Max. Negotiated Rate |
$201.00 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare Advantage |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.49
|
| Rate for Payer: Cigna Commercial |
$201.00
|
| Rate for Payer: Cigna Medicare Advantage |
$20.81
|
| Rate for Payer: Clover Medicare Advantage |
$19.77
|
| Rate for Payer: EmblemHealth Commercial |
$62.43
|
| Rate for Payer: Humana Medicare Advantage |
$21.43
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$104.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.42
|
|
|
Cancer Antigen (CA) 125, Serum
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 86304
|
| Hospital Charge Code |
39888021
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare Advantage |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.49
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$20.81
|
| Rate for Payer: Clover Medicare Advantage |
$19.77
|
| Rate for Payer: EmblemHealth Commercial |
$62.43
|
| Rate for Payer: Humana Medicare Advantage |
$21.43
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$173.57
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.96
|
|
|
Cancer Antigen (CA) 125, Serum
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 86304
|
| Hospital Charge Code |
39888021
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
CANCER SCREEN PSA
|
Facility
|
OP
|
$129.00
|
|
|
Service Code
|
HCPCS 84152
|
| Hospital Charge Code |
38477153
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.66 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$50.02
|
| Rate for Payer: Aetna Medicare Advantage |
$59.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$66.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$66.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$66.71
|
| Rate for Payer: Cigna Commercial |
$64.50
|
| Rate for Payer: Cigna Medicare Advantage |
$18.39
|
| Rate for Payer: Clover Medicare Advantage |
$17.47
|
| Rate for Payer: EmblemHealth Commercial |
$55.17
|
| Rate for Payer: Humana Medicare Advantage |
$18.94
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$18.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.54
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.71
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.66
|
|
|
CANCER SCREEN PSA
|
Facility
|
IP
|
$129.00
|
|
|
Service Code
|
HCPCS 84152
|
| Hospital Charge Code |
38477153
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.35 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.35
|
|
|
CANDIDA ALBICANS ANTIBODIES
|
Facility
|
OP
|
$239.00
|
|
|
Service Code
|
HCPCS 86628
|
| Hospital Charge Code |
38476194
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$32.67
|
| Rate for Payer: Aetna Medicare Advantage |
$38.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.57
|
| Rate for Payer: Cigna Commercial |
$119.50
|
| Rate for Payer: Cigna Medicare Advantage |
$12.01
|
| Rate for Payer: Clover Medicare Advantage |
$11.41
|
| Rate for Payer: EmblemHealth Commercial |
$36.03
|
| Rate for Payer: Humana Medicare Advantage |
$12.37
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$62.14
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.61
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.79
|
|
|
CANDIDA ALBICANS ANTIBODIES
|
Facility
|
IP
|
$239.00
|
|
|
Service Code
|
HCPCS 86628
|
| Hospital Charge Code |
38476194
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.85 |
| Max. Negotiated Rate |
$35.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.85
|
|
|
CANE-ADJUSTABLE ALUMINUM
|
Facility
|
OP
|
$22.00
|
|
| Hospital Charge Code |
270653701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.62 |
| Max. Negotiated Rate |
$11.00 |
| Rate for Payer: Aetna Commercial |
$8.36
|
| Rate for Payer: Aetna Medicare Advantage |
$6.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.61
|
| Rate for Payer: Cigna Commercial |
$11.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.72
|
| Rate for Payer: Oxford Commercial |
$4.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.62
|
|
|
CANE-ADJUSTABLE ALUMINUM
|
Facility
|
IP
|
$22.00
|
|
| Hospital Charge Code |
270653701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$3.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.30
|
|
|
CANE BLOND REG
|
Facility
|
IP
|
$20.42
|
|
| Hospital Charge Code |
270300465
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
|
|
CANE BLOND REG
|
Facility
|
OP
|
$20.42
|
|
| Hospital Charge Code |
270300465
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$10.21 |
| Rate for Payer: Aetna Commercial |
$7.76
|
| Rate for Payer: Aetna Medicare Advantage |
$6.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.21
|
| Rate for Payer: Cigna Commercial |
$10.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.31
|
| Rate for Payer: Oxford Commercial |
$4.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.08
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
CANE WALNUT LG
|
Facility
|
OP
|
$57.65
|
|
| Hospital Charge Code |
270300460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.64 |
| Max. Negotiated Rate |
$28.82 |
| Rate for Payer: Aetna Commercial |
$21.91
|
| Rate for Payer: Aetna Medicare Advantage |
$17.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.70
|
| Rate for Payer: Cigna Commercial |
$28.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.99
|
| Rate for Payer: Oxford Commercial |
$11.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.64
|
|
|
CANE WALNUT LG
|
Facility
|
IP
|
$57.65
|
|
| Hospital Charge Code |
270300460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$8.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.65
|
|
|
CANISTER INVIA 300ML FOR NPWT
|
Facility
|
IP
|
$77.60
|
|
| Hospital Charge Code |
270687287
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.64 |
| Max. Negotiated Rate |
$11.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.64
|
|