|
IR ANGIO CAROTID EXTERNAL UNI
|
Facility
|
IP
|
$20,317.50
|
|
| Hospital Charge Code |
2004208
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$3,047.62 |
| Max. Negotiated Rate |
$3,047.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,047.62
|
|
|
IR ANGIO CAROTID EXTERNAL UNI
|
Facility
|
OP
|
$20,317.50
|
|
| Hospital Charge Code |
2004208
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$489.65 |
| Max. Negotiated Rate |
$10,158.75 |
| Rate for Payer: Aetna Commercial |
$7,720.65
|
| Rate for Payer: Aetna Medicare Advantage |
$6,095.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,180.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,180.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,180.96
|
| Rate for Payer: Cigna Commercial |
$10,158.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,095.25
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,047.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$489.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$538.41
|
|
|
IR ANGIO CAROTID EXTERNL BLTRL
|
Facility
|
IP
|
$20,317.50
|
|
|
Service Code
|
HCPCS 75662
|
| Hospital Charge Code |
2600020
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$3,047.62 |
| Max. Negotiated Rate |
$3,047.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,047.62
|
|
|
IR ANGIO CAROTID EXTERNL BLTRL
|
Facility
|
OP
|
$20,317.50
|
|
|
Service Code
|
HCPCS 75662
|
| Hospital Charge Code |
2600020
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$489.65 |
| Max. Negotiated Rate |
$10,158.75 |
| Rate for Payer: Aetna Commercial |
$7,720.65
|
| Rate for Payer: Aetna Medicare Advantage |
$6,095.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,180.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,180.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,180.96
|
| Rate for Payer: Cigna Commercial |
$10,158.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,095.25
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,047.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$489.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$538.41
|
|
|
IR ANGIO CELIAC
|
Facility
|
IP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 75726
|
| Hospital Charge Code |
2001253
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$3,844.27 |
| Max. Negotiated Rate |
$3,844.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
|
|
IR ANGIO CELIAC
|
Facility
|
OP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 75726
|
| Hospital Charge Code |
2001253
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$275.92 |
| Max. Negotiated Rate |
$23,862.86 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$275.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,862.86
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$4,627.53
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,688.53
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$617.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$679.15
|
|
|
IR ANGIO CELIAC
|
Facility
|
OP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75726
|
| Hospital Charge Code |
7411690
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$275.92 |
| Max. Negotiated Rate |
$23,862.86 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$275.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,862.86
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$4,627.53
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,030.92
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$323.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$356.06
|
|
|
IR ANGIO CELIAC
|
Facility
|
IP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75726
|
| Hospital Charge Code |
7411690
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,015.46 |
| Max. Negotiated Rate |
$2,015.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
|
|
IR ANGIO FEMORAL BILAT
|
Facility
|
OP
|
$21,359.77
|
|
|
Service Code
|
HCPCS 75716
|
| Hospital Charge Code |
2001139
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$243.94 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$243.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,407.93
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,203.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$514.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$566.03
|
|
|
IR ANGIO FEMORAL BILAT
|
Facility
|
IP
|
$21,359.77
|
|
|
Service Code
|
HCPCS 75716
|
| Hospital Charge Code |
2001139
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$3,203.97 |
| Max. Negotiated Rate |
$3,203.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,203.97
|
|
|
IR ANGIO FEMORAL UNI
|
Facility
|
IP
|
$13,882.22
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
741100110
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,082.33 |
| Max. Negotiated Rate |
$2,082.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,082.33
|
|
|
IR ANGIO FEMORAL UNI
|
Facility
|
OP
|
$13,882.22
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
741100110
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$146.36 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$146.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,164.67
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,082.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$334.56
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$367.88
|
|
|
IR ANGIO FEMORAL UNI
|
Facility
|
OP
|
$13,882.22
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
366875710
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$146.36 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$146.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,164.67
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,082.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$334.56
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$367.88
|
|
|
IR ANGIO FEMORAL UNI
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
321075710
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
IR ANGIO FEMORAL UNI
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
321075710
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$146.36 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$146.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,640.55
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$372.79
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$409.92
|
|
|
IR ANGIO FEMORAL UNI
|
Facility
|
IP
|
$13,882.22
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
366875710
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,082.33 |
| Max. Negotiated Rate |
$2,082.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,082.33
|
|
|
IR ANGIO FEMORAL UNI
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
2001121
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
IR ANGIO FEMORAL UNI
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75710
|
| Hospital Charge Code |
2001121
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$146.36 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$146.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,640.55
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$372.79
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$409.92
|
|
|
IR ANGIOGRAM ADRENAL BILATERAL
|
Facility
|
OP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75733
|
| Hospital Charge Code |
7411696
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$323.82 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$341.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,030.92
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$323.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$356.06
|
|
|
IR ANGIOGRAM ADRENAL BILATERAL
|
Facility
|
IP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75733
|
| Hospital Charge Code |
7411696
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,015.46 |
| Max. Negotiated Rate |
$2,015.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
|
|
IR ANGIOGRAM ADRENAL BILATERAL
|
Facility
|
IP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75733
|
| Hospital Charge Code |
2600009
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,015.46 |
| Max. Negotiated Rate |
$2,015.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
|
|
IR ANGIOGRAM ADRENAL BILATERAL
|
Facility
|
OP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75733
|
| Hospital Charge Code |
2600009
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$323.82 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$341.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,030.92
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$323.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$356.06
|
|
|
IR ANGIOGRAM ADRENAL LEFT
|
Facility
|
IP
|
$7,240.05
|
|
|
Service Code
|
HCPCS 75731
|
| Hospital Charge Code |
2600010
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,086.01 |
| Max. Negotiated Rate |
$1,086.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,086.01
|
|
|
IR ANGIOGRAM ADRENAL LEFT
|
Facility
|
OP
|
$7,240.05
|
|
|
Service Code
|
HCPCS 75731
|
| Hospital Charge Code |
7411694
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$174.49 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$253.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,172.01
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,086.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$174.49
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$191.86
|
|
|
IR ANGIOGRAM ADRENAL LEFT
|
Facility
|
OP
|
$7,240.05
|
|
|
Service Code
|
HCPCS 75731
|
| Hospital Charge Code |
2600010
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$174.49 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$253.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$2,625.82
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,172.01
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,086.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$174.49
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$191.86
|
|
