|
CATH FLEXIMA BILIARY REG 10FR
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270624213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$102.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$85.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
CATH FLEXIMA BILIARY REG 10FR
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270624213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$85.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.07
|
|
|
CATH FLEXIMA BILIARY REG 12FR
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270624214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$102.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$85.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
CATH FLEXIMA BILIARY REG 12FR
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270624214
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$85.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.07
|
|
|
CATH FLEXIMA BILIARY REG 14FR
|
Facility
|
IP
|
$405.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270625345
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.75 |
| Max. Negotiated Rate |
$98.01 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$81.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.75
|
|
|
CATH FLEXIMA BILIARY REG 14FR
|
Facility
|
OP
|
$405.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270625345
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Aetna Commercial |
$153.90
|
| Rate for Payer: Aetna Medicare Advantage |
$121.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$103.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$103.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$81.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$103.28
|
| Rate for Payer: Cigna Commercial |
$202.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.50
|
|
|
CATH FLEXIMA BILIARY REG 8FR
|
Facility
|
IP
|
$401.25
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270624212
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.19 |
| Max. Negotiated Rate |
$97.10 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.19
|
|
|
CATH FLEXIMA BILIARY REG 8FR
|
Facility
|
OP
|
$401.25
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270624212
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$200.62 |
| Rate for Payer: Aetna Commercial |
$152.47
|
| Rate for Payer: Aetna Medicare Advantage |
$120.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$102.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$102.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$102.32
|
| Rate for Payer: Cigna Commercial |
$200.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.19
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.40
|
|
|
CATH FLEXIMA NEPHROS REG 10FR
|
Facility
|
OP
|
$401.25
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623766N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$200.62 |
| Rate for Payer: Aetna Commercial |
$152.47
|
| Rate for Payer: Aetna Medicare Advantage |
$120.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$102.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$102.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$102.32
|
| Rate for Payer: Cigna Commercial |
$200.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.19
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.40
|
|
|
CATH FLEXIMA NEPHROS REG 10FR
|
Facility
|
IP
|
$399.95
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623766S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.99 |
| Max. Negotiated Rate |
$96.79 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$79.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$96.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.99
|
|
|
CATH FLEXIMA NEPHROS REG 10FR
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623766
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$85.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.07
|
|
|
CATH FLEXIMA NEPHROS REG 10FR
|
Facility
|
IP
|
$401.25
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623766N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.19 |
| Max. Negotiated Rate |
$97.10 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.19
|
|
|
CATH FLEXIMA NEPHROS REG 10FR
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623766
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$102.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$85.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
CATH FLEXIMA NEPHROS REG 10FR
|
Facility
|
OP
|
$399.95
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623766S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$199.97 |
| Rate for Payer: Aetna Commercial |
$151.98
|
| Rate for Payer: Aetna Medicare Advantage |
$119.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$101.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$101.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$79.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$101.99
|
| Rate for Payer: Cigna Commercial |
$199.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$96.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.99
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.36
|
|
|
CATH FLEXIMA NEPHROS REG 12FR
|
Facility
|
IP
|
$399.95
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623971S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.99 |
| Max. Negotiated Rate |
$96.79 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$79.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$96.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.99
|
|
|
CATH FLEXIMA NEPHROS REG 12FR
|
Facility
|
IP
|
$425.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623971
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$102.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$85.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
CATH FLEXIMA NEPHROS REG 12FR
|
Facility
|
IP
|
$401.25
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623971N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$60.19 |
| Max. Negotiated Rate |
$97.10 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.19
|
|
|
CATH FLEXIMA NEPHROS REG 12FR
|
Facility
|
OP
|
$399.95
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623971S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$199.97 |
| Rate for Payer: Aetna Commercial |
$151.98
|
| Rate for Payer: Aetna Medicare Advantage |
$119.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$101.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$101.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$79.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$101.99
|
| Rate for Payer: Cigna Commercial |
$199.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$96.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.99
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.36
|
|
|
CATH FLEXIMA NEPHROS REG 12FR
|
Facility
|
OP
|
$425.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623971
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$85.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.07
|
|
|
CATH FLEXIMA NEPHROS REG 12FR
|
Facility
|
OP
|
$401.25
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270623971N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$200.62 |
| Rate for Payer: Aetna Commercial |
$152.47
|
| Rate for Payer: Aetna Medicare Advantage |
$120.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$102.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$102.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$102.32
|
| Rate for Payer: Cigna Commercial |
$200.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.19
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.40
|
|
|
CATH FLEXIMA NEPHROS REG 14FR
|
Facility
|
IP
|
$395.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270624215
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.25 |
| Max. Negotiated Rate |
$95.59 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$79.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$95.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
|
|
CATH FLEXIMA NEPHROS REG 14FR
|
Facility
|
OP
|
$395.00
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270624215
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$197.50 |
| Rate for Payer: Aetna Commercial |
$150.10
|
| Rate for Payer: Aetna Medicare Advantage |
$118.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$79.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100.72
|
| Rate for Payer: Cigna Commercial |
$197.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$95.59
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.22
|
|
|
CATH FLEXIMA NEPHROS REG 8FR
|
Facility
|
IP
|
$399.95
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270601342S
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.99 |
| Max. Negotiated Rate |
$96.79 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$79.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$96.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.99
|
|
|
CATH FLEXIMA NEPHROS REG 8FR
|
Facility
|
OP
|
$401.25
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270601342N
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$200.62 |
| Rate for Payer: Aetna Commercial |
$152.47
|
| Rate for Payer: Aetna Medicare Advantage |
$120.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$102.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$102.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$80.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$102.32
|
| Rate for Payer: Cigna Commercial |
$200.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.19
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.40
|
|
|
CATH FLEXIMA NEPHROS REG 8FR
|
Facility
|
OP
|
$399.95
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
270601342
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$199.97 |
| Rate for Payer: Aetna Commercial |
$151.98
|
| Rate for Payer: Aetna Medicare Advantage |
$119.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$101.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$101.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$79.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$101.99
|
| Rate for Payer: Cigna Commercial |
$199.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$96.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.99
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.36
|
|