|
IFUSE-TORQ IMPLANT 10MMX50MM
|
Facility
|
OP
|
$16,125.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270702634
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$388.61 |
| Max. Negotiated Rate |
$8,062.50 |
| Rate for Payer: Aetna Commercial |
$6,127.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,837.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,111.88
|
| Rate for Payer: Cigna Commercial |
$8,062.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,547.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$388.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$427.31
|
|
|
IFUSE-TORQ IMPLANT 11.5X50MM
|
Facility
|
OP
|
$16,125.00
|
|
| Hospital Charge Code |
270702633
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$388.61 |
| Max. Negotiated Rate |
$8,062.50 |
| Rate for Payer: Aetna Commercial |
$6,127.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,837.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,111.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,111.88
|
| Rate for Payer: Cigna Commercial |
$8,062.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,547.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$388.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$427.31
|
|
|
IFUSE-TORQ IMPLANT 11.5X50MM
|
Facility
|
IP
|
$16,125.00
|
|
| Hospital Charge Code |
270702633
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,418.75 |
| Max. Negotiated Rate |
$3,902.25 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,225.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,902.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,547.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,418.75
|
|
|
IgA
|
Facility
|
OP
|
$379.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38472407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.44 |
| Max. Negotiated Rate |
$189.50 |
| Rate for Payer: Aetna Commercial |
$25.30
|
| Rate for Payer: Aetna Medicare Advantage |
$30.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.57
|
| Rate for Payer: Cigna Commercial |
$189.50
|
| Rate for Payer: Cigna Medicare Advantage |
$9.30
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.04
|
|
|
IgA
|
Facility
|
IP
|
$379.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38472407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.85 |
| Max. Negotiated Rate |
$56.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.85
|
|
|
IGA
|
Facility
|
IP
|
$379.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38479415
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.85 |
| Max. Negotiated Rate |
$56.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.85
|
|
|
IGA
|
Facility
|
OP
|
$379.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38479415
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.44 |
| Max. Negotiated Rate |
$189.50 |
| Rate for Payer: Aetna Commercial |
$25.30
|
| Rate for Payer: Aetna Medicare Advantage |
$30.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.57
|
| Rate for Payer: Cigna Commercial |
$189.50
|
| Rate for Payer: Cigna Medicare Advantage |
$9.30
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.04
|
|
|
IGA
|
Facility
|
IP
|
$379.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38479496
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.85 |
| Max. Negotiated Rate |
$56.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.85
|
|
|
IGA
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
HCPCS 86671
|
| Hospital Charge Code |
3035174B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
|
|
IGA
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86671
|
| Hospital Charge Code |
3035174B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$33.32
|
| Rate for Payer: Aetna Medicare Advantage |
$39.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.22
|
| Rate for Payer: Cigna Commercial |
$49.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.25
|
| Rate for Payer: Clover Medicare Advantage |
$11.64
|
| Rate for Payer: EmblemHealth Commercial |
$36.75
|
| Rate for Payer: Humana Medicare Advantage |
$12.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.60
|
|
|
IGA
|
Facility
|
OP
|
$379.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38479496
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.44 |
| Max. Negotiated Rate |
$189.50 |
| Rate for Payer: Aetna Commercial |
$25.30
|
| Rate for Payer: Aetna Medicare Advantage |
$30.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.57
|
| Rate for Payer: Cigna Commercial |
$189.50
|
| Rate for Payer: Cigna Medicare Advantage |
$9.30
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.04
|
|
|
IGA FIBRONECTION
|
Facility
|
IP
|
$187.25
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
3038089
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.09 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.09
|
|
|
IGA FIBRONECTION
|
Facility
|
OP
|
$187.25
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
3038089
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.96 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$31.36
|
| Rate for Payer: Aetna Medicare Advantage |
$37.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.62
|
| Rate for Payer: Cigna Commercial |
$93.62
|
| Rate for Payer: Cigna Medicare Advantage |
$11.53
|
| Rate for Payer: Clover Medicare Advantage |
$10.95
|
| Rate for Payer: EmblemHealth Commercial |
$34.59
|
| Rate for Payer: Humana Medicare Advantage |
$11.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.17
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.96
|
|
|
IGA SUBCLASSES I
|
Facility
|
OP
|
$81.25
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
3000368A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.15 |
| Max. Negotiated Rate |
$131.65 |
| Rate for Payer: Aetna Commercial |
$21.81
|
| Rate for Payer: Aetna Medicare Advantage |
$25.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$131.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.95
|
| Rate for Payer: Cigna Commercial |
$40.62
|
| Rate for Payer: Cigna Medicare Advantage |
$8.02
|
| Rate for Payer: Clover Medicare Advantage |
$7.62
|
| Rate for Payer: EmblemHealth Commercial |
$24.06
|
| Rate for Payer: Humana Medicare Advantage |
$8.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.38
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.15
|
|
|
IGA SUBCLASSES I
|
Facility
|
IP
|
$81.25
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
3000368A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.19 |
| Max. Negotiated Rate |
$12.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.19
|
|
|
IGA SUBCLASSES II
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
HCPCS 83883
|
| Hospital Charge Code |
3000368B
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$171.49 |
| Rate for Payer: Aetna Commercial |
$36.99
|
| Rate for Payer: Aetna Medicare Advantage |
$44.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$171.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.09
|
| Rate for Payer: Cigna Commercial |
$75.00
|
| Rate for Payer: Cigna Medicare Advantage |
$13.60
|
| Rate for Payer: Clover Medicare Advantage |
$12.92
|
| Rate for Payer: EmblemHealth Commercial |
$40.80
|
| Rate for Payer: Humana Medicare Advantage |
$14.01
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.98
|
|
|
IGA SUBCLASSES II
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
HCPCS 83883
|
| Hospital Charge Code |
3000368B
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.50 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
|
|
IGA SUBCLASSES III
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
HCPCS 83883
|
| Hospital Charge Code |
3000368C
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.50 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
|
|
IGA SUBCLASSES III
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
HCPCS 83883
|
| Hospital Charge Code |
3000368C
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$171.49 |
| Rate for Payer: Aetna Commercial |
$36.99
|
| Rate for Payer: Aetna Medicare Advantage |
$44.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$171.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.09
|
| Rate for Payer: Cigna Commercial |
$75.00
|
| Rate for Payer: Cigna Medicare Advantage |
$13.60
|
| Rate for Payer: Clover Medicare Advantage |
$12.92
|
| Rate for Payer: EmblemHealth Commercial |
$40.80
|
| Rate for Payer: Humana Medicare Advantage |
$14.01
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.98
|
|
|
IGD
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38472027
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.44 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$25.30
|
| Rate for Payer: Aetna Medicare Advantage |
$30.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.57
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$9.30
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
IGD
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38472027
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
IgE
|
Facility
|
OP
|
$574.00
|
|
|
Service Code
|
HCPCS 82785
|
| Hospital Charge Code |
38472416
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.17 |
| Max. Negotiated Rate |
$287.00 |
| Rate for Payer: Aetna Commercial |
$44.77
|
| Rate for Payer: Aetna Medicare Advantage |
$53.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.42
|
| Rate for Payer: Cigna Commercial |
$287.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.46
|
| Rate for Payer: Clover Medicare Advantage |
$15.64
|
| Rate for Payer: EmblemHealth Commercial |
$49.38
|
| Rate for Payer: Humana Medicare Advantage |
$16.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$172.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.46
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.21
|
|
|
IgE
|
Facility
|
IP
|
$574.00
|
|
|
Service Code
|
HCPCS 82785
|
| Hospital Charge Code |
38472416
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$86.10 |
| Max. Negotiated Rate |
$86.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.10
|
|
|
IGE LATEX SPECIFIC
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3035000
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$26.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.38
|
|
|
IGE LATEX SPECIFIC
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3035000
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
