|
CATH COUDE 2W 12FR 5CC
|
Facility
|
IP
|
$52.77
|
|
| Hospital Charge Code |
270303245
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$7.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.92
|
|
|
CATH COUDE 2W 12FR 5CC
|
Facility
|
OP
|
$52.77
|
|
| Hospital Charge Code |
270303245
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$26.39 |
| Rate for Payer: Aetna Commercial |
$20.05
|
| Rate for Payer: Aetna Medicare Advantage |
$15.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.46
|
| Rate for Payer: Cigna Commercial |
$26.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.72
|
| Rate for Payer: Oxford Commercial |
$10.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.50
|
|
|
CATH COUDE 2W 14FR 30CC
|
Facility
|
OP
|
$48.33
|
|
| Hospital Charge Code |
270303250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.37 |
| Max. Negotiated Rate |
$24.16 |
| Rate for Payer: Aetna Commercial |
$18.37
|
| Rate for Payer: Aetna Medicare Advantage |
$14.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.32
|
| Rate for Payer: Cigna Commercial |
$24.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.57
|
| Rate for Payer: Oxford Commercial |
$9.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.37
|
|
|
CATH COUDE 2W 14FR 30CC
|
Facility
|
IP
|
$48.33
|
|
| Hospital Charge Code |
270303250
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$7.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
|
|
CATH COUDE 2W 14FR 5CC
|
Facility
|
OP
|
$43.57
|
|
| Hospital Charge Code |
270303285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$21.79 |
| Rate for Payer: Aetna Commercial |
$16.56
|
| Rate for Payer: Aetna Medicare Advantage |
$13.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.11
|
| Rate for Payer: Cigna Commercial |
$21.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.33
|
| Rate for Payer: Oxford Commercial |
$8.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.71
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.24
|
|
|
CATH COUDE 2W 14FR 5CC
|
Facility
|
IP
|
$43.57
|
|
| Hospital Charge Code |
270303285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$6.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
|
|
CATH COUDE 2W 16FR 30CC
|
Facility
|
OP
|
$48.33
|
|
| Hospital Charge Code |
270303255
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.37 |
| Max. Negotiated Rate |
$24.16 |
| Rate for Payer: Aetna Commercial |
$18.37
|
| Rate for Payer: Aetna Medicare Advantage |
$14.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.32
|
| Rate for Payer: Cigna Commercial |
$24.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.57
|
| Rate for Payer: Oxford Commercial |
$9.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.37
|
|
|
CATH COUDE 2W 16FR 30CC
|
Facility
|
IP
|
$48.33
|
|
| Hospital Charge Code |
270303255
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$7.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
|
|
CATH COUDE 2W 16FR 5CC
|
Facility
|
OP
|
$43.57
|
|
| Hospital Charge Code |
270303290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$21.79 |
| Rate for Payer: Aetna Commercial |
$16.56
|
| Rate for Payer: Aetna Medicare Advantage |
$13.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.11
|
| Rate for Payer: Cigna Commercial |
$21.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.33
|
| Rate for Payer: Oxford Commercial |
$8.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.71
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.24
|
|
|
CATH COUDE 2W 16FR 5CC
|
Facility
|
IP
|
$43.57
|
|
| Hospital Charge Code |
270303290
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$6.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
|
|
CATH COUDE 2W 18FR 30CC
|
Facility
|
OP
|
$47.41
|
|
| Hospital Charge Code |
270303260
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$23.70 |
| Rate for Payer: Aetna Commercial |
$18.02
|
| Rate for Payer: Aetna Medicare Advantage |
$14.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.09
|
| Rate for Payer: Cigna Commercial |
$23.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.33
|
| Rate for Payer: Oxford Commercial |
$9.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.48
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.35
|
|
|
CATH COUDE 2W 18FR 30CC
|
Facility
|
IP
|
$47.41
|
|
| Hospital Charge Code |
270303260
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.11 |
| Max. Negotiated Rate |
$7.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.11
|
|
|
CATH COUDE 2W 18FR 5CC
|
Facility
|
OP
|
$43.57
|
|
| Hospital Charge Code |
270303295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$21.79 |
| Rate for Payer: Aetna Commercial |
$16.56
|
| Rate for Payer: Aetna Medicare Advantage |
$13.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.11
|
| Rate for Payer: Cigna Commercial |
$21.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.33
|
| Rate for Payer: Oxford Commercial |
$8.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$8.71
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.24
|
|
|
CATH COUDE 2W 18FR 5CC
|
Facility
|
IP
|
$43.57
|
|
| Hospital Charge Code |
270303295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$6.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.54
|
|
|
CATH COUDE 2W 20FR 30CC
|
Facility
|
OP
|
$48.80
|
|
| Hospital Charge Code |
270303265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$24.40 |
| Rate for Payer: Aetna Commercial |
$18.54
|
| Rate for Payer: Aetna Medicare Advantage |
$14.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.44
|
| Rate for Payer: Cigna Commercial |
$24.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.69
|
| Rate for Payer: Oxford Commercial |
$9.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.76
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.39
|
|
|
CATH COUDE 2W 20FR 30CC
|
Facility
|
IP
|
$48.80
|
|
| Hospital Charge Code |
270303265
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.32 |
| Max. Negotiated Rate |
$7.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.32
|
|
|
CATH COUDE 2W 22FR 30CC
|
Facility
|
IP
|
$48.33
|
|
| Hospital Charge Code |
270303270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$7.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
|
|
CATH COUDE 2W 22FR 30CC
|
Facility
|
OP
|
$48.33
|
|
| Hospital Charge Code |
270303270
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.37 |
| Max. Negotiated Rate |
$24.16 |
| Rate for Payer: Aetna Commercial |
$18.37
|
| Rate for Payer: Aetna Medicare Advantage |
$14.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.32
|
| Rate for Payer: Cigna Commercial |
$24.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.57
|
| Rate for Payer: Oxford Commercial |
$9.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.67
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.37
|
|
|
CATH COUDE 3W 22FR
|
Facility
|
OP
|
$137.14
|
|
| Hospital Charge Code |
27064778
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.89 |
| Max. Negotiated Rate |
$68.57 |
| Rate for Payer: Aetna Commercial |
$52.11
|
| Rate for Payer: Aetna Medicare Advantage |
$41.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.97
|
| Rate for Payer: Cigna Commercial |
$68.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.66
|
| Rate for Payer: Oxford Commercial |
$27.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$27.43
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.89
|
|
|
CATH COUDE 3W 22FR
|
Facility
|
IP
|
$137.14
|
|
| Hospital Charge Code |
27064778
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.57 |
| Max. Negotiated Rate |
$20.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.57
|
|
|
CATH COUNCIL TIP 2WAY 16FR 5CC
|
Facility
|
OP
|
$61.76
|
|
| Hospital Charge Code |
270625258
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$30.88 |
| Rate for Payer: Aetna Commercial |
$23.47
|
| Rate for Payer: Aetna Medicare Advantage |
$18.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.75
|
| Rate for Payer: Cigna Commercial |
$30.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.06
|
| Rate for Payer: Oxford Commercial |
$12.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.75
|
|
|
CATH COUNCIL TIP 2WAY 16FR 5CC
|
Facility
|
IP
|
$61.76
|
|
| Hospital Charge Code |
270625258
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$9.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.26
|
|
|
CATH COUNCL TIP 20 5 200196L20
|
Facility
|
IP
|
$61.76
|
|
| Hospital Charge Code |
270633135
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$9.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.26
|
|
|
CATH COUNCL TIP 20 5 200196L20
|
Facility
|
OP
|
$61.76
|
|
| Hospital Charge Code |
270633135
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$30.88 |
| Rate for Payer: Aetna Commercial |
$23.47
|
| Rate for Payer: Aetna Medicare Advantage |
$18.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.75
|
| Rate for Payer: Cigna Commercial |
$30.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.06
|
| Rate for Payer: Oxford Commercial |
$12.35
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$12.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.75
|
|
|
CATH COYOTE 3x150MM 150CM
|
Facility
|
IP
|
$1,866.90
|
|
| Hospital Charge Code |
270676336
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$280.04 |
| Max. Negotiated Rate |
$451.79 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$373.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$451.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$280.04
|
|