|
DUPLEX SCAN ABD PELVIS RETR
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74115048
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$118.35 |
| Max. Negotiated Rate |
$118.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
|
|
DUPLEX SCAN ABD PELVIS RETR
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74116048
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$118.35 |
| Max. Negotiated Rate |
$118.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
|
|
DUPLEX SCAN ABD PELVIS RETR
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74116048
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$844.10
|
| 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 |
$124.20
|
| 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 |
$236.70
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.91
|
|
|
DUPLEX SCAN ABD PELVIS RETR
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74117048
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$844.10
|
| 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 |
$124.20
|
| 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 |
$236.70
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.91
|
|
|
DUPLEX SCAN ABD PELVIS RETR
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74115048
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$844.10
|
| 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 |
$124.20
|
| 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 |
$236.70
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.91
|
|
|
DUPLEX SCAN ABD PELVIS RETR
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
2692155
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
DUPLEX SCAN ABD PELVIS RETR
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
2692155
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$117.99 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$844.10
|
| 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 |
$124.20
|
| 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 |
$5,160.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$414.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
DUPLEX SCAN ABD PELVIS RETR
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74117048
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$118.35 |
| Max. Negotiated Rate |
$118.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
|
|
DUPLEX SCAN EXTREMITY UNI LTD
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
421593971
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
DUPLEX SCAN EXTREMITY UNI LTD
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
421593971
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$117.99 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$844.10
|
| 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 |
$124.20
|
| 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 |
$5,160.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$414.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
DUPLEX SCAN EXTREM VEINS COMPL
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93970
|
| Hospital Charge Code |
411093970
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$873.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,023.24
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,160.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$414.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
DUPLEX SCAN EXTREM VEINS COMPL
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93970
|
| Hospital Charge Code |
411093970
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
DUPLEX SCAN FL ABD PEL ORGANS
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93976
|
| Hospital Charge Code |
411093976
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$117.99 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$551.76
|
| 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 |
$124.20
|
| 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 |
$5,160.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$414.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
DUPLEX SCAN FL ABD PEL ORGANS
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93976
|
| Hospital Charge Code |
411093976
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
DUPLEX SCAN HEMO ACCESS
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93990
|
| Hospital Charge Code |
2692100
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$117.99 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$607.90
|
| 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 |
$124.20
|
| 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 |
$5,160.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$414.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
DUPLEX SCAN HEMO ACCESS
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93990
|
| Hospital Charge Code |
2692100
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
DUPLEX SCAN HEMO ACCESS
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
HCPCS 93990
|
| Hospital Charge Code |
74116056
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$118.35 |
| Max. Negotiated Rate |
$118.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
|
|
DUPLEX SCAN HEMO ACCESS
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93990
|
| Hospital Charge Code |
74117056
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$607.90
|
| 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 |
$124.20
|
| 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 |
$236.70
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.91
|
|
|
DUPLEX SCAN HEMO ACCESS
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
HCPCS 93990
|
| Hospital Charge Code |
74117056
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$118.35 |
| Max. Negotiated Rate |
$118.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
|
|
DUPLEX SCAN HEMO ACCESS
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93990
|
| Hospital Charge Code |
74116056
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$607.90
|
| 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 |
$124.20
|
| 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 |
$236.70
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.91
|
|
|
DUPLEX SCAN HEMO ACCESS
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
HCPCS 93990
|
| Hospital Charge Code |
74115056
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$118.35 |
| Max. Negotiated Rate |
$118.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
|
|
DUPLEX SCAN HEMO ACCESS
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93990
|
| Hospital Charge Code |
74115056
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$607.90
|
| 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 |
$124.20
|
| 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 |
$236.70
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.91
|
|
|
DUPLEX SCAN HEMO COMP BIL
|
Facility
|
OP
|
$1,364.48
|
|
|
Service Code
|
HCPCS 93985
|
| Hospital Charge Code |
404293985
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$32.88 |
| Max. Negotiated Rate |
$2,301.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$307.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,023.24
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$409.34
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$36.16
|
|
|
DUPLEX SCAN HEMO COMP BIL
|
Facility
|
IP
|
$1,364.48
|
|
|
Service Code
|
HCPCS 93985
|
| Hospital Charge Code |
404293985
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$204.67 |
| Max. Negotiated Rate |
$204.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$204.67
|
|
|
DUPLEX SCAN HEMO COMP UNI
|
Facility
|
OP
|
$656.27
|
|
|
Service Code
|
HCPCS 93986
|
| Hospital Charge Code |
404293986
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$15.82 |
| Max. Negotiated Rate |
$2,301.00 |
| 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 |
$178.31
|
| 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 |
$124.20
|
| 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 |
$196.88
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$98.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.39
|
|
