|
IBUPROFEN TAB 600MG
|
Facility
|
IP
|
$1.95
|
|
| Hospital Charge Code |
6022560
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$0.29 |
| Max. Negotiated Rate |
$0.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.29
|
|
|
ICD DEFIB INTERROGATION
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93289
|
| Hospital Charge Code |
74115023
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
ICD DEFIB INTERROGATION
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93289
|
| Hospital Charge Code |
74117023
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
ICD DEFIB INTERROGATION
|
Facility
|
IP
|
$6,070.00
|
|
|
Service Code
|
HCPCS 93289
|
| Hospital Charge Code |
94053095
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$910.50 |
| Max. Negotiated Rate |
$910.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$910.50
|
|
|
ICD DEFIB INTERROGATION
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93289
|
| Hospital Charge Code |
74116023
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
ICD DEFIB INTERROGATION
|
Facility
|
IP
|
$231.20
|
|
|
Service Code
|
HCPCS 93289
|
| Hospital Charge Code |
5300160
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$34.68 |
| Max. Negotiated Rate |
$34.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.68
|
|
|
ICD DEFIB INTERROGATION
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93289
|
| Hospital Charge Code |
74117023
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$72.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
ICD DEFIB INTERROGATION
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93289
|
| Hospital Charge Code |
74115023
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$72.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
ICD DEFIB INTERROGATION
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93289
|
| Hospital Charge Code |
74116023
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$72.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
ICD DEFIB INTERROGATION
|
Facility
|
OP
|
$6,070.00
|
|
|
Service Code
|
HCPCS 93289
|
| Hospital Charge Code |
94053095
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$42.12 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$72.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,821.00
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$910.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$146.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$160.85
|
|
|
ICD DEFIB INTERROGATION
|
Facility
|
OP
|
$231.20
|
|
|
Service Code
|
HCPCS 93289
|
| Hospital Charge Code |
5300160
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.57 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$72.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.36
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.13
|
|
|
ICD DEFIB INT W/PROG DUAL
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
74116019
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$91.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
ICD DEFIB INT W/PROG DUAL
|
Facility
|
IP
|
$231.20
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
94053075
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$34.68 |
| Max. Negotiated Rate |
$34.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.68
|
|
|
ICD DEFIB INT W/PROG DUAL
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
74117019
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
ICD DEFIB INT W/PROG DUAL
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
74115019
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$91.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
ICD DEFIB INT W/PROG DUAL
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
74116019
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
ICD DEFIB INT W/PROG DUAL
|
Facility
|
IP
|
$231.20
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
5300162
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$34.68 |
| Max. Negotiated Rate |
$34.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.68
|
|
|
ICD DEFIB INT W/PROG DUAL
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
74115019
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
ICD DEFIB INT W/PROG DUAL
|
Facility
|
OP
|
$231.20
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
94053075
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.57 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$91.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.36
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.13
|
|
|
ICD DEFIB INT W/PROG DUAL
|
Facility
|
OP
|
$231.20
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
5300162
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.57 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$91.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.36
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.13
|
|
|
ICD DEFIB INT W/PROG DUAL
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
74117019
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$91.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
ICD DEFIB INT W/PROG MULTIPLE
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
74116020
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
ICD DEFIB INT W/PROG MULTIPLE
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93284
|
| Hospital Charge Code |
74115020
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
ICD DEFIB INT W/PROG MULTIPLE
|
Facility
|
OP
|
$231.20
|
|
|
Service Code
|
HCPCS 93284
|
| Hospital Charge Code |
94053080
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.57 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$102.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.36
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.13
|
|
|
ICD DEFIB INT W/PROG MULTIPLE
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93283
|
| Hospital Charge Code |
74116020
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$91.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
