|
CATHETER 5F PIGTAIL
|
Facility
|
IP
|
$47.50
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270658266N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$11.49 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.12
|
|
|
CATHETER 5F PIGTAIL
|
Facility
|
OP
|
$47.50
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270658266N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$23.75 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare Advantage |
$14.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.11
|
| Rate for Payer: Cigna Commercial |
$23.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.35
|
|
|
CATHETER 5F PIGTAIL
|
Facility
|
IP
|
$45.25
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270658266S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$10.95 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.79
|
|
|
CATHETER 5F RCB
|
Facility
|
OP
|
$237.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$118.75 |
| Rate for Payer: Aetna Commercial |
$90.25
|
| Rate for Payer: Aetna Medicare Advantage |
$71.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.56
|
| Rate for Payer: Cigna Commercial |
$118.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.62
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.75
|
|
|
CATHETER 5F RCB
|
Facility
|
IP
|
$237.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$35.62 |
| Max. Negotiated Rate |
$57.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.62
|
|
|
CATHETER 5FR CTR FLUSH 65CM
|
Facility
|
OP
|
$27.91
|
|
| Hospital Charge Code |
270651795N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$13.96 |
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna Medicare Advantage |
$8.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.12
|
| Rate for Payer: Cigna Commercial |
$13.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.26
|
| Rate for Payer: Oxford Commercial |
$5.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.58
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.79
|
|
|
CATHETER 5FR CTR FLUSH 65CM
|
Facility
|
OP
|
$55.82
|
|
| Hospital Charge Code |
270651795
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.59 |
| Max. Negotiated Rate |
$27.91 |
| Rate for Payer: Aetna Commercial |
$21.21
|
| Rate for Payer: Aetna Medicare Advantage |
$16.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.23
|
| Rate for Payer: Cigna Commercial |
$27.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.51
|
| Rate for Payer: Oxford Commercial |
$11.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.16
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.59
|
|
|
CATHETER 5FR CTR FLUSH 65CM
|
Facility
|
IP
|
$27.91
|
|
| Hospital Charge Code |
270651795N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$4.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
|
|
CATHETER 5FR CTR FLUSH 65CM
|
Facility
|
OP
|
$55.82
|
|
| Hospital Charge Code |
270651795S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.59 |
| Max. Negotiated Rate |
$27.91 |
| Rate for Payer: Aetna Commercial |
$21.21
|
| Rate for Payer: Aetna Medicare Advantage |
$16.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.23
|
| Rate for Payer: Cigna Commercial |
$27.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.51
|
| Rate for Payer: Oxford Commercial |
$11.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.16
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.59
|
|
|
CATHETER 5FR CTR FLUSH 65CM
|
Facility
|
IP
|
$55.82
|
|
| Hospital Charge Code |
270651795S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.37 |
| Max. Negotiated Rate |
$8.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.37
|
|
|
CATHETER 5FR CTR FLUSH 65CM
|
Facility
|
IP
|
$55.82
|
|
| Hospital Charge Code |
270651795
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.37 |
| Max. Negotiated Rate |
$8.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.37
|
|
|
CATHETER 5FR JR 3.5
|
Facility
|
IP
|
$37.35
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658168S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$9.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.60
|
|
|
CATHETER 5FR JR 3.5
|
Facility
|
OP
|
$37.35
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658168S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$18.68 |
| Rate for Payer: Aetna Commercial |
$14.19
|
| Rate for Payer: Aetna Medicare Advantage |
$11.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.52
|
| Rate for Payer: Cigna Commercial |
$18.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.06
|
|
|
CATHETER 5FR JR 3.5
|
Facility
|
IP
|
$47.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658168N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$11.49 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.12
|
|
|
CATHETER 5FR JR 3.5
|
Facility
|
OP
|
$37.35
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658168
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$18.68 |
| Rate for Payer: Aetna Commercial |
$14.19
|
| Rate for Payer: Aetna Medicare Advantage |
$11.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.52
|
| Rate for Payer: Cigna Commercial |
$18.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.06
|
|
|
CATHETER 5FR JR 3.5
|
Facility
|
OP
|
$47.50
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658168N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$23.75 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare Advantage |
$14.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12.11
|
| Rate for Payer: Cigna Commercial |
$23.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.35
|
|
|
CATHETER 5FR JR 3.5
|
Facility
|
IP
|
$37.35
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658168
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$9.04 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.60
|
|
|
CATHETER 5FR JR4
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270654458
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.68 |
| Max. Negotiated Rate |
$9.17 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.68
|
|
|
CATHETER 5FR JR4
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270654458S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$18.95 |
| Rate for Payer: Aetna Commercial |
$14.40
|
| Rate for Payer: Aetna Medicare Advantage |
$11.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.66
|
| Rate for Payer: Cigna Commercial |
$18.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.08
|
|
|
CATHETER 5FR JR4
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270654458
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$18.95 |
| Rate for Payer: Aetna Commercial |
$14.40
|
| Rate for Payer: Aetna Medicare Advantage |
$11.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.66
|
| Rate for Payer: Cigna Commercial |
$18.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.08
|
|
|
CATHETER 5FR JR4
|
Facility
|
OP
|
$18.68
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270654458N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$9.34 |
| Rate for Payer: Aetna Commercial |
$7.10
|
| Rate for Payer: Aetna Medicare Advantage |
$5.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.76
|
| Rate for Payer: Cigna Commercial |
$9.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.53
|
|
|
CATHETER 5FR JR4
|
Facility
|
IP
|
$18.68
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270654458N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$4.52 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.74
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.80
|
|
|
CATHETER 5FR JR4
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270654458S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5.68 |
| Max. Negotiated Rate |
$9.17 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.17
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.68
|
|
|
CATHETER 5FR PIG TAIL 65CM
|
Facility
|
IP
|
$56.65
|
|
| Hospital Charge Code |
270663792
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$8.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.50
|
|
|
CATHETER 5FR PIG TAIL 65CM
|
Facility
|
OP
|
$56.65
|
|
| Hospital Charge Code |
270663792
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.61 |
| Max. Negotiated Rate |
$28.32 |
| Rate for Payer: Aetna Commercial |
$21.53
|
| Rate for Payer: Aetna Medicare Advantage |
$17.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.45
|
| Rate for Payer: Cigna Commercial |
$28.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.73
|
| Rate for Payer: Oxford Commercial |
$11.33
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.33
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.61
|
|