|
IR ANGIOGRAM INTRACRANIAL
|
Facility
|
OP
|
$7,240.05
|
|
| Hospital Charge Code |
2600029
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$174.49 |
| Max. Negotiated Rate |
$3,620.03 |
| Rate for Payer: Aetna Commercial |
$2,751.22
|
| Rate for Payer: Aetna Medicare Advantage |
$2,172.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,846.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,846.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,846.21
|
| Rate for Payer: Cigna Commercial |
$3,620.03
|
| 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: Wellpoint Medicaid Managed Care |
$191.86
|
|
|
IR ANGIOGRAM INTRACRANIAL
|
Facility
|
IP
|
$7,240.05
|
|
| Hospital Charge Code |
2600029
|
|
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 PELVIS
|
Facility
|
OP
|
$25,004.60
|
|
|
Service Code
|
HCPCS 75736
|
| Hospital Charge Code |
2600030
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$292.72 |
| 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 |
$292.72
|
| 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 |
$7,501.38
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,750.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$602.61
|
| 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 |
$662.62
|
|
|
IR ANGIOGRAM PELVIS
|
Facility
|
IP
|
$7,240.05
|
|
|
Service Code
|
HCPCS 75736
|
| Hospital Charge Code |
7411697
|
|
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 PELVIS
|
Facility
|
IP
|
$25,004.60
|
|
|
Service Code
|
HCPCS 75736
|
| Hospital Charge Code |
2600030
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$3,750.69 |
| Max. Negotiated Rate |
$3,750.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,750.69
|
|
|
IR ANGIOGRAM PELVIS
|
Facility
|
OP
|
$7,240.05
|
|
|
Service Code
|
HCPCS 75736
|
| Hospital Charge Code |
7411697
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$174.49 |
| 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 |
$292.72
|
| 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 |
$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 |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$191.86
|
|
|
IR ANGIOGRAM PELVIS
|
Facility
|
IP
|
$25,004.60
|
|
|
Service Code
|
HCPCS 75736
|
| Hospital Charge Code |
366875736
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$3,750.69 |
| Max. Negotiated Rate |
$3,750.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,750.69
|
|
|
IR ANGIOGRAM PELVIS
|
Facility
|
OP
|
$25,004.60
|
|
|
Service Code
|
HCPCS 75736
|
| Hospital Charge Code |
366875736
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$292.72 |
| 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 |
$292.72
|
| 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 |
$7,501.38
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,750.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$602.61
|
| 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 |
$662.62
|
|
|
IR ANGIOGRAM PULMNRY NONSLCTVE
|
Facility
|
IP
|
$4,747.25
|
|
|
Service Code
|
HCPCS 75746
|
| Hospital Charge Code |
2600033
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$712.09 |
| Max. Negotiated Rate |
$712.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$712.09
|
|
|
IR ANGIOGRAM PULMNRY NONSLCTVE
|
Facility
|
OP
|
$4,747.25
|
|
|
Service Code
|
HCPCS 75746
|
| Hospital Charge Code |
2600033
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$104.54 |
| 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 |
$104.54
|
| 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 |
$1,424.17
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$712.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$114.41
|
| 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 |
$125.80
|
|
|
IR ANGIOGRAM PULMONARY BILTRAL
|
Facility
|
OP
|
$7,240.05
|
|
|
Service Code
|
HCPCS 75743
|
| Hospital Charge Code |
2600031
|
|
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 |
$338.78
|
| 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 PULMONARY BILTRAL
|
Facility
|
IP
|
$7,240.05
|
|
|
Service Code
|
HCPCS 75743
|
| Hospital Charge Code |
2600031
|
|
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 PULMONARY LEFT
|
Facility
|
OP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75741
|
| Hospital Charge Code |
2600032
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$271.04 |
| 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 |
$271.04
|
| 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 PULMONARY LEFT
|
Facility
|
IP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75741
|
| Hospital Charge Code |
2600032
|
|
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 PULMONARY RIGHT
|
Facility
|
IP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75741
|
| Hospital Charge Code |
2600034
|
|
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 PULMONARY RIGHT
|
Facility
|
OP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75741
|
| Hospital Charge Code |
2600034
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$271.04 |
| 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 |
$271.04
|
| 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 RENAL BILATERAL
|
Facility
|
OP
|
$7,240.05
|
|
| Hospital Charge Code |
2600035
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$174.49 |
| Max. Negotiated Rate |
$3,620.03 |
| Rate for Payer: Aetna Commercial |
$2,751.22
|
| Rate for Payer: Aetna Medicare Advantage |
$2,172.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,846.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,846.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,846.21
|
| Rate for Payer: Cigna Commercial |
$3,620.03
|
| 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: Wellpoint Medicaid Managed Care |
$191.86
|
|
|
IR ANGIOGRAM RENAL BILATERAL
|
Facility
|
IP
|
$7,240.05
|
|
| Hospital Charge Code |
2600035
|
|
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 RENAL LEFT
|
Facility
|
OP
|
$13,436.40
|
|
| Hospital Charge Code |
2600036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$323.82 |
| Max. Negotiated Rate |
$6,718.20 |
| Rate for Payer: Aetna Commercial |
$5,105.83
|
| Rate for Payer: Aetna Medicare Advantage |
$4,030.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,426.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,426.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,426.28
|
| Rate for Payer: Cigna Commercial |
$6,718.20
|
| 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: Wellpoint Medicaid Managed Care |
$356.06
|
|
|
IR ANGIOGRAM RENAL LEFT
|
Facility
|
IP
|
$13,436.40
|
|
| Hospital Charge Code |
2600036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,015.46 |
| Max. Negotiated Rate |
$2,015.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
|
|
IR ANGIOGRAM RENAL RIGHT
|
Facility
|
OP
|
$13,436.40
|
|
| Hospital Charge Code |
2600037
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$323.82 |
| Max. Negotiated Rate |
$6,718.20 |
| Rate for Payer: Aetna Commercial |
$5,105.83
|
| Rate for Payer: Aetna Medicare Advantage |
$4,030.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,426.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,426.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,426.28
|
| Rate for Payer: Cigna Commercial |
$6,718.20
|
| 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: Wellpoint Medicaid Managed Care |
$356.06
|
|
|
IR ANGIOGRAM RENAL RIGHT
|
Facility
|
IP
|
$13,436.40
|
|
| Hospital Charge Code |
2600037
|
|
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 SPINE SELECTIVE
|
Facility
|
IP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75705
|
| Hospital Charge Code |
7411689
|
|
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 SPINE SELECTIVE
|
Facility
|
OP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75705
|
| Hospital Charge Code |
2600038
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$323.82 |
| 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 |
$344.80
|
| 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 ANGIOGRAM SPINE SELECTIVE
|
Facility
|
IP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75705
|
| Hospital Charge Code |
2600038
|
|
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
|
|