|
HYDRATION INF 1ST HR
|
Facility
|
IP
|
$1,334.09
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
2301097
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$200.11 |
| Max. Negotiated Rate |
$200.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$200.11
|
|
|
HYDRATION INF 1ST HR
|
Facility
|
OP
|
$1,334.09
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
2301097
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$32.15 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$272.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$400.23
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$200.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.35
|
|
|
HYDRATION INF 1ST HR
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
93500007
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
HYDRATION INF 1ST HR
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
73190085
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
HYDRATION INF 1ST HR
|
Facility
|
OP
|
$1,334.09
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
1500110
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$32.15 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$272.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$400.23
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$200.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.35
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
93500017
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
83653130
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
1600533
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
100137
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$151.31
|
| Rate for Payer: Aetna Medicare Advantage |
$180.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$55.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$200.81
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: Cigna Medicare Advantage |
$55.63
|
| Rate for Payer: Clover Medicare Advantage |
$52.85
|
| Rate for Payer: EmblemHealth Commercial |
$166.89
|
| Rate for Payer: Humana Medicare Advantage |
$57.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$55.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.56
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.79
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
1500111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
93500015
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$151.31
|
| Rate for Payer: Aetna Medicare Advantage |
$180.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$55.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$200.81
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: Cigna Medicare Advantage |
$55.63
|
| Rate for Payer: Clover Medicare Advantage |
$52.85
|
| Rate for Payer: EmblemHealth Commercial |
$166.89
|
| Rate for Payer: Humana Medicare Advantage |
$57.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$55.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.56
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.79
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
93500017
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$151.31
|
| Rate for Payer: Aetna Medicare Advantage |
$180.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$55.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$200.81
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: Cigna Medicare Advantage |
$55.63
|
| Rate for Payer: Clover Medicare Advantage |
$52.85
|
| Rate for Payer: EmblemHealth Commercial |
$166.89
|
| Rate for Payer: Humana Medicare Advantage |
$57.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$55.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.56
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.79
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
73050905
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
3401150
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
2250417
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$151.31
|
| Rate for Payer: Aetna Medicare Advantage |
$180.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$55.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$200.81
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: Cigna Medicare Advantage |
$55.63
|
| Rate for Payer: Clover Medicare Advantage |
$52.85
|
| Rate for Payer: EmblemHealth Commercial |
$166.89
|
| Rate for Payer: Humana Medicare Advantage |
$57.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$55.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.56
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.79
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
83653130
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$151.31
|
| Rate for Payer: Aetna Medicare Advantage |
$180.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$55.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$200.81
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: Cigna Medicare Advantage |
$55.63
|
| Rate for Payer: Clover Medicare Advantage |
$52.85
|
| Rate for Payer: EmblemHealth Commercial |
$166.89
|
| Rate for Payer: Humana Medicare Advantage |
$57.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$55.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.56
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.79
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
395096361
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$151.31
|
| Rate for Payer: Aetna Medicare Advantage |
$180.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$55.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$200.81
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: Cigna Medicare Advantage |
$55.63
|
| Rate for Payer: Clover Medicare Advantage |
$52.85
|
| Rate for Payer: EmblemHealth Commercial |
$166.89
|
| Rate for Payer: Humana Medicare Advantage |
$57.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$55.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.56
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.79
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
74308230
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$151.31
|
| Rate for Payer: Aetna Medicare Advantage |
$180.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$55.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$200.81
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: Cigna Medicare Advantage |
$55.63
|
| Rate for Payer: Clover Medicare Advantage |
$52.85
|
| Rate for Payer: EmblemHealth Commercial |
$166.89
|
| Rate for Payer: Humana Medicare Advantage |
$57.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$55.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.56
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.79
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
5700263
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$151.31
|
| Rate for Payer: Aetna Medicare Advantage |
$180.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$55.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$200.81
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: Cigna Medicare Advantage |
$55.63
|
| Rate for Payer: Clover Medicare Advantage |
$52.85
|
| Rate for Payer: EmblemHealth Commercial |
$166.89
|
| Rate for Payer: Humana Medicare Advantage |
$57.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$55.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.56
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.79
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
3401120
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
3401115
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$151.31
|
| Rate for Payer: Aetna Medicare Advantage |
$180.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$55.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$200.81
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: Cigna Medicare Advantage |
$55.63
|
| Rate for Payer: Clover Medicare Advantage |
$52.85
|
| Rate for Payer: EmblemHealth Commercial |
$166.89
|
| Rate for Payer: Humana Medicare Advantage |
$57.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$55.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.56
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.79
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
IP
|
$598.74
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
5700388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.81 |
| Max. Negotiated Rate |
$89.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.81
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
73050910
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$151.31
|
| Rate for Payer: Aetna Medicare Advantage |
$180.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$55.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$200.81
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: Cigna Medicare Advantage |
$55.63
|
| Rate for Payer: Clover Medicare Advantage |
$52.85
|
| Rate for Payer: EmblemHealth Commercial |
$166.89
|
| Rate for Payer: Humana Medicare Advantage |
$57.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$55.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.56
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.79
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
IP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
4501038
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$49.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
|
|
HYDRATION INF EA ADDL HR
|
Facility
|
OP
|
$331.87
|
|
|
Service Code
|
HCPCS 96361
|
| Hospital Charge Code |
4501038
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$151.31
|
| Rate for Payer: Aetna Medicare Advantage |
$180.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$200.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$55.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$112.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$200.81
|
| Rate for Payer: Cigna Commercial |
$111.50
|
| Rate for Payer: Cigna Medicare Advantage |
$55.63
|
| Rate for Payer: Clover Medicare Advantage |
$52.85
|
| Rate for Payer: EmblemHealth Commercial |
$166.89
|
| Rate for Payer: Humana Medicare Advantage |
$57.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$55.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.56
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$55.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.79
|
|
