|
CFH FP ER MODERATE SEVERITY
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 99283
|
| Hospital Charge Code |
83652453
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$45.12 |
| Max. Negotiated Rate |
$195.47 |
| Rate for Payer: Aetna Commercial |
$69.36
|
| Rate for Payer: Aetna Medicare Advantage |
$54.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$195.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$195.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$195.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$195.47
|
| Rate for Payer: Cigna Commercial |
$155.45
|
| Rate for Payer: Cigna Medicare Advantage |
$155.45
|
| Rate for Payer: Clover Medicare Advantage |
$72.21
|
| Rate for Payer: Fidelis All Plans |
$45.12
|
| Rate for Payer: Marpai Administrators LLC Commercial |
$53.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$97.09
|
| Rate for Payer: UnitedHealthcare Community & State |
$97.09
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$97.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$73.68
|
|
|
CFH FP EXC. DIAM. 0.6-1.0 CM
|
Facility
|
IP
|
$105.94
|
|
|
Service Code
|
HCPCS 11401
|
| Hospital Charge Code |
83652039
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.89 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.89
|
|
|
CFH FP EXC. DIAM. 0.6-1.0 CM
|
Facility
|
OP
|
$105.94
|
|
|
Service Code
|
HCPCS 11401
|
| Hospital Charge Code |
83652039
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$1,743.30 |
| Rate for Payer: Aetna Commercial |
$1,313.62
|
| Rate for Payer: Aetna Medicare Advantage |
$1,564.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,743.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,743.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$482.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$86.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,743.30
|
| Rate for Payer: Cigna Commercial |
$968.07
|
| Rate for Payer: Cigna Medicare Advantage |
$482.95
|
| Rate for Payer: Clover Medicare Advantage |
$458.80
|
| Rate for Payer: EmblemHealth Commercial |
$1,448.85
|
| Rate for Payer: Humana Medicare Advantage |
$497.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$482.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.78
|
| Rate for Payer: Oxford Commercial |
$21.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.19
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$1,058.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.81
|
|
|
CFH FP EXC DIAM 1.1-2.0 CM
|
Facility
|
IP
|
$540.62
|
|
|
Service Code
|
HCPCS 11402
|
| Hospital Charge Code |
83652041
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$81.09 |
| Max. Negotiated Rate |
$81.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.09
|
|
|
CFH FP EXC DIAM 1.1-2.0 CM
|
Facility
|
OP
|
$540.62
|
|
|
Service Code
|
HCPCS 11402
|
| Hospital Charge Code |
83652041
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$3,036.77 |
| Rate for Payer: Aetna Commercial |
$2,288.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,725.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,036.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,036.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$841.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$109.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,036.77
|
| Rate for Payer: Cigna Commercial |
$1,686.34
|
| Rate for Payer: Cigna Medicare Advantage |
$841.28
|
| Rate for Payer: Clover Medicare Advantage |
$799.22
|
| Rate for Payer: EmblemHealth Commercial |
$2,523.84
|
| Rate for Payer: Humana Medicare Advantage |
$866.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$841.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$162.19
|
| Rate for Payer: Oxford Commercial |
$108.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$108.12
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.33
|
|
|
CFH FP EXC.DIAM 2.1-3.0 CM
|
Facility
|
IP
|
$619.61
|
|
|
Service Code
|
HCPCS 11403
|
| Hospital Charge Code |
83652043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.94 |
| Max. Negotiated Rate |
$92.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.94
|
|
|
CFH FP EXC.DIAM 2.1-3.0 CM
|
Facility
|
OP
|
$619.61
|
|
|
Service Code
|
HCPCS 11403
|
| Hospital Charge Code |
83652043
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$14.93 |
| Max. Negotiated Rate |
$3,036.77 |
| Rate for Payer: Aetna Commercial |
$2,288.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,725.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,036.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,036.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$841.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$206.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,036.77
|
| Rate for Payer: Cigna Commercial |
$1,686.34
|
| Rate for Payer: Cigna Medicare Advantage |
$841.28
|
| Rate for Payer: Clover Medicare Advantage |
$799.22
|
| Rate for Payer: EmblemHealth Commercial |
$2,523.84
|
| Rate for Payer: Humana Medicare Advantage |
$866.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$841.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$185.88
|
| Rate for Payer: Oxford Commercial |
$123.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$123.92
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.93
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.42
|
|
|
CFH FP EXC. DIAM. OVER 4.0
|
Facility
|
OP
|
$440.80
|
|
|
Service Code
|
HCPCS 11406
|
| Hospital Charge Code |
83652045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$10.62 |
| Max. Negotiated Rate |
$7,082.74 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,082.74
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$132.24
|
| Rate for Payer: Oxford Commercial |
$88.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$88.16
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.68
|
|
|
CFH FP EXC. DIAM. OVER 4.0
|
Facility
|
IP
|
$440.80
|
|
|
Service Code
|
HCPCS 11406
|
| Hospital Charge Code |
83652045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.12 |
| Max. Negotiated Rate |
$66.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.12
|
|
|
CFH FP EXC.PILONIDAL CYST
|
Facility
|
IP
|
$1,490.00
|
|
|
Service Code
|
HCPCS 11770
|
| Hospital Charge Code |
83652059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$223.50 |
| Max. Negotiated Rate |
$223.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$223.50
|
|
|
CFH FP EXC.PILONIDAL CYST
|
Facility
|
OP
|
$1,490.00
|
|
|
Service Code
|
HCPCS 11770
|
| Hospital Charge Code |
83652059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$35.91 |
| Max. Negotiated Rate |
$12,456.64 |
| Rate for Payer: Aetna Commercial |
$9,386.39
|
| Rate for Payer: Aetna Medicare Advantage |
$11,180.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,456.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,456.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,450.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$292.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12,456.64
|
| Rate for Payer: Cigna Commercial |
$6,917.28
|
| Rate for Payer: Cigna Medicare Advantage |
$3,450.88
|
| Rate for Payer: Clover Medicare Advantage |
$3,278.34
|
| Rate for Payer: EmblemHealth Commercial |
$10,352.64
|
| Rate for Payer: Humana Medicare Advantage |
$3,554.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,450.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$447.00
|
| Rate for Payer: Oxford Commercial |
$298.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$223.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$298.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.48
|
|
|
CFH FP FB REMOVAL,EAR
|
Facility
|
OP
|
$299.00
|
|
|
Service Code
|
HCPCS 69200
|
| Hospital Charge Code |
83652267
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$570.55 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: Aetna Medicare Advantage |
$512.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$158.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$570.55
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$158.06
|
| Rate for Payer: Clover Medicare Advantage |
$150.16
|
| Rate for Payer: EmblemHealth Commercial |
$474.18
|
| Rate for Payer: Humana Medicare Advantage |
$162.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$158.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$89.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.21
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.92
|
|
|
CFH FP FB REMOVAL,EAR
|
Facility
|
IP
|
$299.00
|
|
|
Service Code
|
HCPCS 69200
|
| Hospital Charge Code |
83652267
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$44.85 |
| Max. Negotiated Rate |
$44.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.85
|
|
|
CFH FP FB REMOVAL,EYE-EXTERNAL
|
Facility
|
OP
|
$397.00
|
|
|
Service Code
|
HCPCS 65205
|
| Hospital Charge Code |
83652263
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.57 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: Aetna Medicare Advantage |
$512.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$158.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$570.55
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$158.06
|
| Rate for Payer: Clover Medicare Advantage |
$150.16
|
| Rate for Payer: EmblemHealth Commercial |
$474.18
|
| Rate for Payer: Humana Medicare Advantage |
$162.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$158.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$119.10
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.52
|
|
|
CFH FP FB REMOVAL,EYE-EXTERNAL
|
Facility
|
IP
|
$397.00
|
|
|
Service Code
|
HCPCS 65205
|
| Hospital Charge Code |
83652263
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$59.55 |
| Max. Negotiated Rate |
$59.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.55
|
|
|
CFH FP FLU HIGH DOSE
|
Facility
|
OP
|
$244.01
|
|
|
Service Code
|
HCPCS 90662
|
| Hospital Charge Code |
83652315
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.88 |
| Max. Negotiated Rate |
$122.00 |
| Rate for Payer: Aetna Commercial |
$92.72
|
| Rate for Payer: Aetna Medicare Advantage |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.22
|
| Rate for Payer: Cigna Commercial |
$122.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.47
|
|
|
CFH FP FLU HIGH DOSE
|
Facility
|
IP
|
$244.01
|
|
|
Service Code
|
HCPCS 90662
|
| Hospital Charge Code |
83652315
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$36.60 |
| Max. Negotiated Rate |
$59.05 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.60
|
|
|
CFH FP GROUP PSY-THRPY
|
Facility
|
OP
|
$291.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83652359
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$435.65 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$435.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$435.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$39.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$435.65
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$87.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.71
|
|
|
CFH FP GROUP PSY-THRPY
|
Facility
|
IP
|
$291.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
83652359
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$43.65 |
| Max. Negotiated Rate |
$43.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.65
|
|
|
CFH FP HEPVAX A & B
|
Facility
|
IP
|
$142.00
|
|
|
Service Code
|
HCPCS 90636
|
| Hospital Charge Code |
83652305
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$34.36 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.30
|
|
|
CFH FP HEPVAX A & B
|
Facility
|
OP
|
$142.00
|
|
|
Service Code
|
HCPCS 90636
|
| Hospital Charge Code |
83652305
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.42 |
| Max. Negotiated Rate |
$215.75 |
| Rate for Payer: Aetna Commercial |
$53.96
|
| Rate for Payer: Aetna Medicare Advantage |
$42.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$215.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.21
|
| Rate for Payer: Cigna Commercial |
$71.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.76
|
|
|
CFH FP I&D ABSCESS/CYST/SINGLE
|
Facility
|
IP
|
$369.90
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
83652001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.48 |
| Max. Negotiated Rate |
$55.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.48
|
|
|
CFH FP I&D ABSCESS/CYST/SINGLE
|
Facility
|
OP
|
$369.90
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
83652001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$962.01 |
| Rate for Payer: Aetna Commercial |
$648.34
|
| Rate for Payer: Aetna Medicare Advantage |
$772.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$860.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$860.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$238.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$860.41
|
| Rate for Payer: Cigna Commercial |
$477.79
|
| Rate for Payer: Cigna Medicare Advantage |
$238.36
|
| Rate for Payer: Clover Medicare Advantage |
$226.44
|
| Rate for Payer: EmblemHealth Commercial |
$715.08
|
| Rate for Payer: Humana Medicare Advantage |
$245.51
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$238.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$110.97
|
| Rate for Payer: Oxford Commercial |
$73.98
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$73.98
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$962.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.80
|
|
|
CFH FP INTRALESIONAL LESION
|
Facility
|
OP
|
$372.00
|
|
|
Service Code
|
HCPCS 11900
|
| Hospital Charge Code |
83652061
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.97 |
| Max. Negotiated Rate |
$860.41 |
| Rate for Payer: Aetna Commercial |
$648.34
|
| Rate for Payer: Aetna Medicare Advantage |
$772.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$860.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$860.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$238.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$860.41
|
| Rate for Payer: Cigna Commercial |
$477.79
|
| Rate for Payer: Cigna Medicare Advantage |
$238.36
|
| Rate for Payer: Clover Medicare Advantage |
$226.44
|
| Rate for Payer: EmblemHealth Commercial |
$715.08
|
| Rate for Payer: Humana Medicare Advantage |
$245.51
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$238.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$111.60
|
| Rate for Payer: Oxford Commercial |
$74.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$74.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.86
|
|
|
CFH FP INTRALESIONAL LESION
|
Facility
|
IP
|
$372.00
|
|
|
Service Code
|
HCPCS 11900
|
| Hospital Charge Code |
83652061
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.80 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
|
