|
CATHETER HICKAMN 9.6FR
|
Facility
|
IP
|
$874.00
|
|
| Hospital Charge Code |
270651791
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$131.10 |
| Max. Negotiated Rate |
$131.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.10
|
|
|
CATHETER HICKAMN 9.6FR
|
Facility
|
OP
|
$874.00
|
|
| Hospital Charge Code |
270651791
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.82 |
| Max. Negotiated Rate |
$437.00 |
| Rate for Payer: Aetna Commercial |
$332.12
|
| Rate for Payer: Aetna Medicare Advantage |
$262.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$222.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$222.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$222.87
|
| Rate for Payer: Cigna Commercial |
$437.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$227.24
|
| Rate for Payer: Oxford Commercial |
$174.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$131.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$174.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.82
|
|
|
CATHETER, HYSTERO
|
Facility
|
OP
|
$192.00
|
|
| Hospital Charge Code |
2008110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.45 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$72.96
|
| Rate for Payer: Aetna Medicare Advantage |
$57.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.96
|
| Rate for Payer: Cigna Commercial |
$96.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.92
|
| Rate for Payer: Oxford Commercial |
$38.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$38.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.45
|
|
|
CATHETER, HYSTERO
|
Facility
|
IP
|
$192.00
|
|
| Hospital Charge Code |
2008110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$28.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.80
|
|
|
CATHETER IMA 6FR
|
Facility
|
OP
|
$37.35
|
|
| Hospital Charge Code |
270658054S
|
|
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 IMA 6FR
|
Facility
|
OP
|
$8.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658054N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$4.00 |
| Rate for Payer: Aetna Commercial |
$3.04
|
| Rate for Payer: Aetna Medicare Advantage |
$2.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.04
|
| Rate for Payer: Cigna Commercial |
$4.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.23
|
|
|
CATHETER IMA 6FR
|
Facility
|
IP
|
$8.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658054N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.20
|
|
|
CATHETER IMA 6FR
|
Facility
|
OP
|
$37.35
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658054
|
|
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 IMA 6FR
|
Facility
|
IP
|
$37.35
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
270658054
|
|
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 IMA 6FR
|
Facility
|
IP
|
$37.35
|
|
| Hospital Charge Code |
270658054S
|
|
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 IMAGER II FLUSH 4FR
|
Facility
|
OP
|
$53.65
|
|
| Hospital Charge Code |
270653627S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.52 |
| Max. Negotiated Rate |
$26.82 |
| Rate for Payer: Aetna Commercial |
$20.39
|
| Rate for Payer: Aetna Medicare Advantage |
$16.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.68
|
| Rate for Payer: Cigna Commercial |
$26.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.95
|
| Rate for Payer: Oxford Commercial |
$10.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.52
|
|
|
CATHETER IMAGER II FLUSH 4FR
|
Facility
|
OP
|
$53.65
|
|
| Hospital Charge Code |
270653627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.52 |
| Max. Negotiated Rate |
$26.82 |
| Rate for Payer: Aetna Commercial |
$20.39
|
| Rate for Payer: Aetna Medicare Advantage |
$16.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.68
|
| Rate for Payer: Cigna Commercial |
$26.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.95
|
| Rate for Payer: Oxford Commercial |
$10.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.52
|
|
|
CATHETER IMAGER II FLUSH 4FR
|
Facility
|
OP
|
$27.91
|
|
| Hospital Charge Code |
270653627N
|
|
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 IMAGER II FLUSH 4FR
|
Facility
|
IP
|
$53.65
|
|
| Hospital Charge Code |
270653627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.05 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.05
|
|
|
CATHETER IMAGER II FLUSH 4FR
|
Facility
|
IP
|
$27.91
|
|
| Hospital Charge Code |
270653627N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$4.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
|
|
CATHETER IMAGER II FLUSH 4FR
|
Facility
|
IP
|
$53.65
|
|
| Hospital Charge Code |
270653627S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.05 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.05
|
|
|
CATHETER IMAGER II FLUSH 5FR
|
Facility
|
OP
|
$55.82
|
|
| Hospital Charge Code |
270653625S
|
|
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 IMAGER II FLUSH 5FR
|
Facility
|
OP
|
$27.91
|
|
| Hospital Charge Code |
270653623
|
|
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 IMAGER II FLUSH 5FR
|
Facility
|
IP
|
$27.91
|
|
| Hospital Charge Code |
270653623
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$4.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
|
|
CATHETER IMAGER II FLUSH 5FR
|
Facility
|
IP
|
$55.82
|
|
| Hospital Charge Code |
270653625S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.37 |
| Max. Negotiated Rate |
$8.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.37
|
|
|
CATHETER IMAGER II FLUSH 5FR
|
Facility
|
OP
|
$27.91
|
|
| Hospital Charge Code |
270653626N
|
|
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 IMAGER II FLUSH 5FR
|
Facility
|
OP
|
$27.91
|
|
| Hospital Charge Code |
270653625N
|
|
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 IMAGER II FLUSH 5FR
|
Facility
|
IP
|
$55.82
|
|
| Hospital Charge Code |
270653625
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.37 |
| Max. Negotiated Rate |
$8.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.37
|
|
|
CATHETER IMAGER II FLUSH 5FR
|
Facility
|
OP
|
$55.82
|
|
| Hospital Charge Code |
270653625
|
|
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 IMAGER II FLUSH 5FR
|
Facility
|
IP
|
$27.91
|
|
| Hospital Charge Code |
270653625N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$4.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.19
|
|