|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4504507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.75
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4518507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.75
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4832507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.75
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4527507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4527507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.75
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4510507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.75
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4515507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4832507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4515507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.75
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4535507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.75
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4517507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4510507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4824507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4546507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4517507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.75
|
|
|
IND PSYCHOTX NONMD 45MIN CHILD
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90834
|
| Hospital Charge Code |
4546507
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$130.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$450.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$94.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.75
|
|
|
IND PSYCHOTX NONMD 60MIN ADULT
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
4822508
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$117.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$600.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$300.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$48.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$53.00
|
|
|
IND PSYCHOTX NONMD 60MIN ADULT
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
4822508
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$300.00
|
|
|
IND PSYCHOTX NONMD 60MIN ADULT
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
4818508
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$300.00
|
|
|
IND PSYCHOTX NONMD 60MIN ADULT
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
4832508
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$117.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$600.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$300.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$48.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$53.00
|
|
|
IND PSYCHOTX NONMD 60MIN ADULT
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
4511508
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$300.00
|
|
|
IND PSYCHOTX NONMD 60MIN ADULT
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
4504508
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$300.00
|
|
|
IND PSYCHOTX NONMD 60MIN ADULT
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
4511508
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$761.18 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$117.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$600.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$300.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$48.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$53.00
|
|
|
IND PSYCHOTX NONMD 60MIN ADULT
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
4502508
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$300.00
|
|
|
IND PSYCHOTX NONMD 60MIN ADULT
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 90837
|
| Hospital Charge Code |
4832508
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$300.00
|
|
