|
IR INS PEG TUBE
|
Facility
|
OP
|
$8,368.50
|
|
|
Service Code
|
HCPCS 49441
|
| Hospital Charge Code |
366849441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$201.68 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,510.55
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,255.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$201.68
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$221.77
|
|
|
IR INS PEG TUBE
|
Facility
|
IP
|
$7,136.45
|
|
|
Service Code
|
HCPCS 49441
|
| Hospital Charge Code |
411049441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,070.47 |
| Max. Negotiated Rate |
$1,070.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,070.47
|
|
|
IR INS PEG TUBE
|
Facility
|
OP
|
$7,136.45
|
|
|
Service Code
|
HCPCS 49441
|
| Hospital Charge Code |
411049441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$171.99 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,140.93
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,070.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$171.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$189.12
|
|
|
IR INS PEG TUBE
|
Facility
|
IP
|
$8,368.50
|
|
|
Service Code
|
HCPCS 49441
|
| Hospital Charge Code |
7411594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,255.28 |
| Max. Negotiated Rate |
$1,255.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,255.28
|
|
|
IR INS PEG TUBE
|
Facility
|
IP
|
$8,686.35
|
|
|
Service Code
|
HCPCS 49441
|
| Hospital Charge Code |
2670040
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,302.95 |
| Max. Negotiated Rate |
$1,302.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,302.95
|
|
|
IR INS PEG TUBE
|
Facility
|
OP
|
$8,368.50
|
|
|
Service Code
|
HCPCS 49441
|
| Hospital Charge Code |
7411594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$201.68 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,510.55
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,255.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$201.68
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$221.77
|
|
|
IR INS PEG TUBE
|
Facility
|
OP
|
$8,686.35
|
|
|
Service Code
|
HCPCS 49441
|
| Hospital Charge Code |
2670040
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$209.34 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,605.91
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,302.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$209.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$230.19
|
|
|
IR INS TEMP BLADDER CATH (FOLE
|
Facility
|
OP
|
$623.55
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
321051702
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15.03 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: Aetna Medicare Advantage |
$512.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$158.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$570.55
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$158.06
|
| Rate for Payer: Clover Medicare Advantage |
$150.16
|
| Rate for Payer: EmblemHealth Commercial |
$474.18
|
| Rate for Payer: Humana Medicare Advantage |
$162.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$158.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$187.06
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.52
|
|
|
IR INS TEMP BLADDER CATH (FOLE
|
Facility
|
IP
|
$623.55
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
321051702
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$93.53 |
| Max. Negotiated Rate |
$93.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.53
|
|
|
IR INS TEMP BLADDER CATH (FOLE
|
Facility
|
OP
|
$274.00
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
2680215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: Aetna Medicare Advantage |
$512.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$158.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$570.55
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$158.06
|
| Rate for Payer: Clover Medicare Advantage |
$150.16
|
| Rate for Payer: EmblemHealth Commercial |
$474.18
|
| Rate for Payer: Humana Medicare Advantage |
$162.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$158.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.20
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.26
|
|
|
IR INS TEMP BLADDER CATH (FOLE
|
Facility
|
IP
|
$274.00
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
2680215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$41.10 |
| Max. Negotiated Rate |
$41.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.10
|
|
|
IR INS.TEMP IN-DWEL-CATH/FOLEY
|
Facility
|
OP
|
$274.00
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
3408001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: Aetna Medicare Advantage |
$512.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$158.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$570.55
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$158.06
|
| Rate for Payer: Clover Medicare Advantage |
$150.16
|
| Rate for Payer: EmblemHealth Commercial |
$474.18
|
| Rate for Payer: Humana Medicare Advantage |
$162.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$158.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.20
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.26
|
|
|
IR INS.TEMP IN-DWEL-CATH/FOLEY
|
Facility
|
IP
|
$274.00
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
3408001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$41.10 |
| Max. Negotiated Rate |
$41.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.10
|
|
|
IR INS TUND CV CATH W/O PORT <
|
Facility
|
IP
|
$5,224.75
|
|
|
Service Code
|
HCPCS 36557
|
| Hospital Charge Code |
7411449
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$783.71 |
| Max. Negotiated Rate |
$783.71 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$783.71
|
|
|
IR INS TUND CV CATH W/O PORT <
|
Facility
|
OP
|
$5,224.75
|
|
|
Service Code
|
HCPCS 36557
|
| Hospital Charge Code |
7411449
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$125.92 |
| 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 |
$1,016.00
|
| 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 |
$6,610.76
|
| 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 |
$1,567.42
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$783.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$125.92
|
| 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 |
$138.46
|
|
|
IR INS TUND CV CATH W/O PORT <
|
Facility
|
OP
|
$5,224.75
|
|
|
Service Code
|
HCPCS 36557
|
| Hospital Charge Code |
2101164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$125.92 |
| 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 |
$1,016.00
|
| 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 |
$6,610.76
|
| 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 |
$1,567.42
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$783.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$125.92
|
| 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 |
$138.46
|
|
|
IR INS TUND CV CATH W/O PORT <
|
Facility
|
IP
|
$5,224.75
|
|
|
Service Code
|
HCPCS 36557
|
| Hospital Charge Code |
2101164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$783.71 |
| Max. Negotiated Rate |
$783.71 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$783.71
|
|
|
IR INS TUND CV CATH W/O PORT>5
|
Facility
|
IP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 36558
|
| Hospital Charge Code |
411036558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,869.43 |
| Max. Negotiated Rate |
$1,869.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
|
|
IR INS TUND CV CATH W/O PORT>5
|
Facility
|
IP
|
$14,614.45
|
|
|
Service Code
|
HCPCS 36558
|
| Hospital Charge Code |
366836558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,192.17 |
| Max. Negotiated Rate |
$2,192.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,192.17
|
|
|
IR INS TUND CV CATH W/O PORT>5
|
Facility
|
OP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 36558
|
| Hospital Charge Code |
411036558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$300.35 |
| 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 |
$1,016.00
|
| 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 |
$3,751.17
|
| 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 |
$3,738.86
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.35
|
| 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 |
$330.27
|
|
|
IR INS TUND CV CATH W/O PORT>5
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36558
|
| Hospital Charge Code |
321036558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$372.79 |
| 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 |
$1,016.00
|
| 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 |
$3,751.17
|
| 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 |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| 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 INS TUND CV CATH W/O PORT>5
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36558
|
| Hospital Charge Code |
2011097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
IR INS TUND CV CATH W/O PORT>5
|
Facility
|
OP
|
$14,614.45
|
|
|
Service Code
|
HCPCS 36558
|
| Hospital Charge Code |
366836558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$352.21 |
| 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 |
$1,016.00
|
| 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 |
$3,751.17
|
| 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 |
$4,384.34
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,192.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$352.21
|
| 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 |
$387.28
|
|
|
IR INS TUND CV CATH W/O PORT>5
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36558
|
| Hospital Charge Code |
2011097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$372.79 |
| 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 |
$1,016.00
|
| 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 |
$3,751.17
|
| 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 |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| 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 INS TUND CV CATH W/O PORT>5
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36558
|
| Hospital Charge Code |
321036558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
