|
ESOPHAGEAL DILATION****
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
HCPCS 43450
|
| Hospital Charge Code |
1001130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,889.52
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$81.00
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.16
|
|
|
ESOPHAGEAL MOTILITY (MANOMETRIC STUDY OF THE ESOPHAGUS AND/OR GASTROESOPHAGEAL JUNCTION) STUDY WITH INTERPRETATION AND REPORT;
|
Facility
|
OP
|
$2,348.37
|
|
|
Service Code
|
CPT 91010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$421.15 |
| Max. Negotiated Rate |
$2,348.37 |
| Rate for Payer: Aetna Commercial |
$1,205.83
|
| Rate for Payer: Aetna Medicare Advantage |
$1,436.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,600.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,600.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$443.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,348.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,600.25
|
| Rate for Payer: Cigna Commercial |
$888.63
|
| Rate for Payer: Cigna Medicare Advantage |
$443.32
|
| Rate for Payer: Clover Medicare Advantage |
$421.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,329.96
|
| Rate for Payer: Humana Medicare Advantage |
$456.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$443.32
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$443.32
|
|
|
ESOPHAGEAL MOTILITY STUDIES***
|
Facility
|
IP
|
$829.40
|
|
|
Service Code
|
HCPCS 91010
|
| Hospital Charge Code |
2300739
|
|
Hospital Revenue Code
|
759
|
| Min. Negotiated Rate |
$124.41 |
| Max. Negotiated Rate |
$124.41 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$124.41
|
|
|
ESOPHAGEAL MOTILITY STUDIES***
|
Facility
|
OP
|
$829.40
|
|
|
Service Code
|
HCPCS 91010
|
| Hospital Charge Code |
2300739
|
|
Hospital Revenue Code
|
759
|
| Min. Negotiated Rate |
$19.99 |
| Max. Negotiated Rate |
$2,348.37 |
| Rate for Payer: Aetna Commercial |
$1,205.83
|
| Rate for Payer: Aetna Medicare Advantage |
$1,436.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,600.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,600.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$443.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,348.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,600.25
|
| Rate for Payer: Cigna Commercial |
$888.63
|
| Rate for Payer: Cigna Medicare Advantage |
$443.32
|
| Rate for Payer: Clover Medicare Advantage |
$421.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,329.96
|
| Rate for Payer: Humana Medicare Advantage |
$456.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$443.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$248.82
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$124.41
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.98
|
|
|
ESOPHAGEAL OBTURATOR*****
|
Facility
|
IP
|
$126.00
|
|
| Hospital Charge Code |
8000630
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$18.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.90
|
|
|
ESOPHAGEAL OBTURATOR*****
|
Facility
|
OP
|
$126.00
|
|
| Hospital Charge Code |
8000630
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$47.88
|
| Rate for Payer: Aetna Medicare Advantage |
$37.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.13
|
| Rate for Payer: Cigna Commercial |
$63.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.80
|
| Rate for Payer: Oxford Commercial |
$25.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$25.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.34
|
|
|
ESOPHAGEAL WALL STENT
|
Facility
|
OP
|
$590.00
|
|
| Hospital Charge Code |
270335511
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.22 |
| Max. Negotiated Rate |
$295.00 |
| Rate for Payer: Aetna Commercial |
$224.20
|
| Rate for Payer: Aetna Medicare Advantage |
$177.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$150.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$150.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$118.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$150.45
|
| Rate for Payer: Cigna Commercial |
$295.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.78
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$129.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$88.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.63
|
|
|
ESOPHAGEAL WALL STENT
|
Facility
|
IP
|
$590.00
|
|
| Hospital Charge Code |
270335511
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.50 |
| Max. Negotiated Rate |
$142.78 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$118.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.78
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$129.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$88.50
|
|
|
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC
|
Facility
|
IP
|
$43,127.60
|
|
|
Service Code
|
MSDRG 391
|
| Min. Negotiated Rate |
$13,131.80 |
| Max. Negotiated Rate |
$43,127.60 |
| Rate for Payer: Aetna Commercial |
$29,890.90
|
| Rate for Payer: Aetna Medicare Advantage |
$43,127.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29,774.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29,774.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,822.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29,774.08
|
| Rate for Payer: Cigna Commercial |
$23,734.97
|
| Rate for Payer: Cigna Medicare Advantage |
$13,822.95
|
| Rate for Payer: Clover Medicare Advantage |
$13,131.80
|
| Rate for Payer: EmblemHealth Commercial |
$41,468.85
|
| Rate for Payer: Humana Medicare Advantage |
$14,237.64
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,822.95
|
| Rate for Payer: Oxford Commercial |
$17,058.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$29,912.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,822.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,822.95
|
|
|
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$27,332.01
|
|
|
Service Code
|
MSDRG 392
|
| Min. Negotiated Rate |
$8,322.25 |
| Max. Negotiated Rate |
$27,332.01 |
| Rate for Payer: Aetna Commercial |
$19,037.52
|
| Rate for Payer: Aetna Medicare Advantage |
$27,332.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18,376.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18,376.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,760.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18,376.19
|
| Rate for Payer: Cigna Commercial |
$14,589.43
|
| Rate for Payer: Cigna Medicare Advantage |
$8,760.26
|
| Rate for Payer: Clover Medicare Advantage |
$8,322.25
|
| Rate for Payer: EmblemHealth Commercial |
$26,280.78
|
| Rate for Payer: Humana Medicare Advantage |
$9,023.07
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,760.26
|
| Rate for Payer: Oxford Commercial |
$10,485.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$18,386.87
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,760.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,760.26
|
|
|
ESOPHAGOGASTRDUODSPY W/POLYPEC
|
Facility
|
IP
|
$816.00
|
|
| Hospital Charge Code |
2300143
|
|
Hospital Revenue Code
|
759
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$122.40
|
|
|
ESOPHAGOGASTRDUODSPY W/POLYPEC
|
Facility
|
OP
|
$816.00
|
|
| Hospital Charge Code |
2300143
|
|
Hospital Revenue Code
|
759
|
| Min. Negotiated Rate |
$19.67 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna Commercial |
$310.08
|
| Rate for Payer: Aetna Medicare Advantage |
$244.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$208.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$208.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$208.08
|
| Rate for Payer: Cigna Commercial |
$408.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$244.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$122.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.62
|
|
|
ESOPHAGOGASTRODUODENOSCOPY***
|
Facility
|
IP
|
$286.00
|
|
| Hospital Charge Code |
2300101
|
|
Hospital Revenue Code
|
759
|
| Min. Negotiated Rate |
$42.90 |
| Max. Negotiated Rate |
$42.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.90
|
|
|
ESOPHAGOGASTRODUODENOSCOPY***
|
Facility
|
OP
|
$286.00
|
|
| Hospital Charge Code |
2300101
|
|
Hospital Revenue Code
|
759
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$143.00 |
| Rate for Payer: Aetna Commercial |
$108.68
|
| Rate for Payer: Aetna Medicare Advantage |
$85.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$72.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$72.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$72.93
|
| Rate for Payer: Cigna Commercial |
$143.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.58
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$5,311.00
|
|
|
Service Code
|
CPT 43235
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$292.34 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| 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 |
$3,889.52
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BAND LIGATION OF ESOPHAGEAL/GASTRIC VARICES
|
Facility
|
OP
|
$8,229.07
|
|
|
Service Code
|
CPT 43244
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$292.34 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| 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 |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$5,311.00
|
|
|
Service Code
|
CPT 43239
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$388.28 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$388.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,889.52
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH CONTROL OF BLEEDING, ANY METHOD
|
Facility
|
OP
|
$8,229.07
|
|
|
Service Code
|
CPT 43255
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$315.57 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$315.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH DILATION OF GASTRIC/DUODENAL STRICTURE(S) (EG, BALLOON, BOUGIE)
|
Facility
|
OP
|
$8,229.07
|
|
|
Service Code
|
CPT 43245
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$387.20 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$387.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE
|
Facility
|
OP
|
$5,311.00
|
|
|
Service Code
|
CPT 43236
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$271.04 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$271.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,889.52
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,531.95
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH ENDOSCOPIC MUCOSAL RESECTION
|
Facility
|
OP
|
$8,229.07
|
|
|
Service Code
|
CPT 43254
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$238.55 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$238.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH INSERTION OF GUIDE WIRE FOLLOWED BY PASSAGE OF DILATOR(S) THROUGH ESOPHAGUS OVER GUIDE WIRE
|
Facility
|
OP
|
$5,311.00
|
|
|
Service Code
|
CPT 43248
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$271.04 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$271.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,889.52
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,531.95
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF FOREIGN BODY(S)
|
Facility
|
OP
|
$5,311.00
|
|
|
Service Code
|
CPT 43247
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$292.34 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| 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 |
$3,889.52
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS
|
Facility
|
OP
|
$8,229.07
|
|
|
Service Code
|
CPT 43250
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$292.34 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| 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 |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
|
|
ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
|
Facility
|
OP
|
$8,229.07
|
|
|
Service Code
|
CPT 43251
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$292.34 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| 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 |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
|
