|
CT SINUSES WO & W CONT
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70488
|
| Hospital Charge Code |
2200271
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT SINUS W/ CONTRAST
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70487
|
| Hospital Charge Code |
2205426
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$145.87 |
| Max. Negotiated Rate |
$3,354.00 |
| Rate for Payer: Aetna Commercial |
$566.79
|
| Rate for Payer: Aetna Medicare Advantage |
$675.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$208.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$752.19
|
| Rate for Payer: Cigna Commercial |
$417.70
|
| Rate for Payer: Cigna Medicare Advantage |
$145.87
|
| Rate for Payer: Clover Medicare Advantage |
$197.96
|
| Rate for Payer: EmblemHealth Commercial |
$625.14
|
| Rate for Payer: Humana Medicare Advantage |
$214.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$208.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,850.00
|
| Rate for Payer: Oxford Commercial |
$2,443.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,354.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$228.95
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$251.75
|
|
|
CT SINUS W/ CONTRAST
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70487
|
| Hospital Charge Code |
2205426
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT SINUS W HEADSET
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70486
|
| Hospital Charge Code |
2250423
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$86.94 |
| Max. Negotiated Rate |
$3,354.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$266.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,850.00
|
| Rate for Payer: Oxford Commercial |
$2,443.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,354.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$228.95
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$251.75
|
|
|
CT SINUS W HEADSET
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70486
|
| Hospital Charge Code |
2250423
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT SINUS W/O CONTRAST
|
Facility
|
OP
|
$1,120.75
|
|
|
Service Code
|
HCPCS 70486
|
| Hospital Charge Code |
2205427
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$27.01 |
| Max. Negotiated Rate |
$3,354.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$266.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$336.23
|
| Rate for Payer: Oxford Commercial |
$2,443.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,354.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.70
|
|
|
CT SINUS W/O CONTRAST
|
Facility
|
IP
|
$1,120.75
|
|
|
Service Code
|
HCPCS 70486
|
| Hospital Charge Code |
2205427
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$168.11 |
| Max. Negotiated Rate |
$168.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.11
|
|
|
CT SINUS W/O HEADSET
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70486
|
| Hospital Charge Code |
2250422
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT SINUS W/O HEADSET
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70486
|
| Hospital Charge Code |
2250422
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$86.94 |
| Max. Negotiated Rate |
$3,354.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$266.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,850.00
|
| Rate for Payer: Oxford Commercial |
$2,443.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,354.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$228.95
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$251.75
|
|
|
CT SINUS W&W/O CONTRAST
|
Facility
|
IP
|
$1,217.65
|
|
|
Service Code
|
HCPCS 70487
|
| Hospital Charge Code |
2200270
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$182.65 |
| Max. Negotiated Rate |
$182.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$182.65
|
|
|
CT SINUS W&W/O CONTRAST
|
Facility
|
OP
|
$1,217.65
|
|
|
Service Code
|
HCPCS 70487
|
| Hospital Charge Code |
2200270
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$29.35 |
| Max. Negotiated Rate |
$3,354.00 |
| Rate for Payer: Aetna Commercial |
$566.79
|
| Rate for Payer: Aetna Medicare Advantage |
$675.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$208.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$752.19
|
| Rate for Payer: Cigna Commercial |
$417.70
|
| Rate for Payer: Cigna Medicare Advantage |
$145.87
|
| Rate for Payer: Clover Medicare Advantage |
$197.96
|
| Rate for Payer: EmblemHealth Commercial |
$625.14
|
| Rate for Payer: Humana Medicare Advantage |
$214.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$208.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$365.30
|
| Rate for Payer: Oxford Commercial |
$2,443.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$182.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,354.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$29.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.27
|
|
|
CT SINUS W/ & W/O CONTRAST
|
Facility
|
OP
|
$1,810.20
|
|
|
Service Code
|
HCPCS 70488
|
| Hospital Charge Code |
2205425
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$43.63 |
| Max. Negotiated Rate |
$3,354.00 |
| Rate for Payer: Aetna Commercial |
$566.79
|
| Rate for Payer: Aetna Medicare Advantage |
$675.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$208.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$338.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$752.19
|
| Rate for Payer: Cigna Commercial |
$417.70
|
| Rate for Payer: Cigna Medicare Advantage |
$145.87
|
| Rate for Payer: Clover Medicare Advantage |
$197.96
|
| Rate for Payer: EmblemHealth Commercial |
$625.14
|
| Rate for Payer: Humana Medicare Advantage |
$214.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$208.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$543.06
|
| Rate for Payer: Oxford Commercial |
$2,443.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$271.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,354.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$43.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$47.97
|
|
|
CT SINUS W/ & W/O CONTRAST
|
Facility
|
IP
|
$1,810.20
|
|
|
Service Code
|
HCPCS 70488
|
| Hospital Charge Code |
2205425
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$271.53 |
| Max. Negotiated Rate |
$271.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$271.53
|
|
|
CT SOFT TIISUE NECK W CONT
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70491
|
| Hospital Charge Code |
2205288
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT SOFT TIISUE NECK W CONT
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70491
|
| Hospital Charge Code |
2205288
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$145.87 |
| Max. Negotiated Rate |
$3,354.00 |
| Rate for Payer: Aetna Commercial |
$566.79
|
| Rate for Payer: Aetna Medicare Advantage |
$675.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$208.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$286.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$752.19
|
| Rate for Payer: Cigna Commercial |
$417.70
|
| Rate for Payer: Cigna Medicare Advantage |
$145.87
|
| Rate for Payer: Clover Medicare Advantage |
$197.96
|
| Rate for Payer: EmblemHealth Commercial |
$625.14
|
| Rate for Payer: Humana Medicare Advantage |
$214.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$208.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,850.00
|
| Rate for Payer: Oxford Commercial |
$2,443.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,354.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$228.95
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$251.75
|
|
|
CT SOFT TISSUE NECK W & WO CON
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70492
|
| Hospital Charge Code |
2205290
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT SOFT TISSUE NECK W & WO CON
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70492
|
| Hospital Charge Code |
2205290
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$145.87 |
| Max. Negotiated Rate |
$3,354.00 |
| Rate for Payer: Aetna Commercial |
$566.79
|
| Rate for Payer: Aetna Medicare Advantage |
$675.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$208.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$338.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$752.19
|
| Rate for Payer: Cigna Commercial |
$417.70
|
| Rate for Payer: Cigna Medicare Advantage |
$145.87
|
| Rate for Payer: Clover Medicare Advantage |
$197.96
|
| Rate for Payer: EmblemHealth Commercial |
$625.14
|
| Rate for Payer: Humana Medicare Advantage |
$214.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$208.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,850.00
|
| Rate for Payer: Oxford Commercial |
$2,443.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,354.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$228.95
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$251.75
|
|
|
CT THORACENTESIS FOR ASP INIT
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2205144
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$228.95 |
| Max. Negotiated Rate |
$3,593.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,690.13
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,850.00
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$228.95
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$251.75
|
|
|
CT THORACENTESIS FOR ASP INIT
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2205144
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT THORACENTESIS/TUBE INSERT
|
Facility
|
OP
|
$2,422.65
|
|
| Hospital Charge Code |
2205312
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$58.39 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$920.61
|
| Rate for Payer: Aetna Medicare Advantage |
$726.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$617.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$617.78
|
| 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 |
$617.78
|
| Rate for Payer: Cigna Commercial |
$1,211.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$726.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$58.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$64.20
|
|
|
CT THORACENTESIS/TUBE INSERT
|
Facility
|
IP
|
$2,422.65
|
|
| Hospital Charge Code |
2205312
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.40 |
| Max. Negotiated Rate |
$363.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.40
|
|
|
CT THORACIC SPINE W/CONTR
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 72129
|
| Hospital Charge Code |
2205151
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT THORACIC SPINE W/CONTR
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 72129
|
| Hospital Charge Code |
2205151
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$145.87 |
| Max. Negotiated Rate |
$3,354.00 |
| Rate for Payer: Aetna Commercial |
$566.79
|
| Rate for Payer: Aetna Medicare Advantage |
$675.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$752.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$208.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$329.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$752.19
|
| Rate for Payer: Cigna Commercial |
$417.70
|
| Rate for Payer: Cigna Medicare Advantage |
$145.87
|
| Rate for Payer: Clover Medicare Advantage |
$197.96
|
| Rate for Payer: EmblemHealth Commercial |
$625.14
|
| Rate for Payer: Humana Medicare Advantage |
$214.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$208.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,850.00
|
| Rate for Payer: Oxford Commercial |
$2,443.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,354.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$228.95
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$958.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$251.75
|
|
|
CT THORACIC SPINE W/O CONTR
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 72128
|
| Hospital Charge Code |
2200129
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT THORACIC SPINE W/O CONTR
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 72128
|
| Hospital Charge Code |
2200129
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$86.94 |
| Max. Negotiated Rate |
$3,354.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,850.00
|
| Rate for Payer: Oxford Commercial |
$2,443.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,354.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$228.95
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$407.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$251.75
|
|