|
IR-PLACE CATH SEGM ART-BI
|
Facility
|
OP
|
$268.00
|
|
|
Service Code
|
HCPCS 3601550
|
| Hospital Charge Code |
7411793
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$101.84
|
| Rate for Payer: Aetna Medicare Advantage |
$80.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.34
|
| 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 |
$68.34
|
| Rate for Payer: Cigna Commercial |
$134.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$80.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.10
|
|
|
IR-PLACE CATH SEGM ART-LT
|
Facility
|
OP
|
$268.00
|
|
|
Service Code
|
HCPCS 36015LT
|
| Hospital Charge Code |
7411904
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna Commercial |
$101.84
|
| Rate for Payer: Aetna Medicare Advantage |
$80.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.34
|
| Rate for Payer: Cigna Commercial |
$134.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$80.40
|
| Rate for Payer: Oxford Commercial |
$53.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$53.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.10
|
|
|
IR-PLACE CATH SEGM ART-LT
|
Facility
|
IP
|
$268.00
|
|
|
Service Code
|
HCPCS 36015LT
|
| Hospital Charge Code |
2691180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.20 |
| Max. Negotiated Rate |
$40.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.20
|
|
|
IR-PLACE CATH SEGM ART-LT
|
Facility
|
IP
|
$268.00
|
|
|
Service Code
|
HCPCS 36015LT
|
| Hospital Charge Code |
7411904
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.20 |
| Max. Negotiated Rate |
$40.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.20
|
|
|
IR-PLACE CATH SEGM ART-LT
|
Facility
|
OP
|
$268.00
|
|
|
Service Code
|
HCPCS 36015LT
|
| Hospital Charge Code |
2691180
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna Commercial |
$101.84
|
| Rate for Payer: Aetna Medicare Advantage |
$80.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.34
|
| Rate for Payer: Cigna Commercial |
$134.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$80.40
|
| Rate for Payer: Oxford Commercial |
$53.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$53.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.10
|
|
|
IR-PLACE CATH SEGM ART-RT
|
Facility
|
OP
|
$268.00
|
|
|
Service Code
|
HCPCS 36015RT
|
| Hospital Charge Code |
2691185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$101.84
|
| Rate for Payer: Aetna Medicare Advantage |
$80.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.34
|
| 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 |
$68.34
|
| Rate for Payer: Cigna Commercial |
$134.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$80.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.10
|
|
|
IR-PLACE CATH SEGM ART-RT
|
Facility
|
IP
|
$268.00
|
|
|
Service Code
|
HCPCS 36015RT
|
| Hospital Charge Code |
7411905
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.20 |
| Max. Negotiated Rate |
$40.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.20
|
|
|
IR-PLACE CATH SEGM ART-RT
|
Facility
|
IP
|
$268.00
|
|
|
Service Code
|
HCPCS 36015RT
|
| Hospital Charge Code |
2691185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$40.20 |
| Max. Negotiated Rate |
$40.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.20
|
|
|
IR-PLACE CATH SEGM ART-RT
|
Facility
|
OP
|
$268.00
|
|
|
Service Code
|
HCPCS 36015RT
|
| Hospital Charge Code |
7411905
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$134.00 |
| Rate for Payer: Aetna Commercial |
$101.84
|
| Rate for Payer: Aetna Medicare Advantage |
$80.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.34
|
| Rate for Payer: Cigna Commercial |
$134.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$80.40
|
| Rate for Payer: Oxford Commercial |
$53.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$53.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.10
|
|
|
IR-PLACE CTH PLM ARTRY-RT
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
HCPCS 36013RT
|
| Hospital Charge Code |
7411901
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$28.20 |
| Max. Negotiated Rate |
$28.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.20
|
|
|
IR-PLACE CTH PLM ARTRY-RT
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
HCPCS 36013RT
|
| Hospital Charge Code |
321036013R
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$28.20 |
| Max. Negotiated Rate |
$28.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.20
|
|
|
IR-PLACE CTH PLM ARTRY-RT
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
HCPCS 36013RT
|
| Hospital Charge Code |
321036013R
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$71.44
|
| Rate for Payer: Aetna Medicare Advantage |
$56.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.94
|
| 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 |
$47.94
|
| Rate for Payer: Cigna Commercial |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.98
|
|
|
IR-PLACE CTH PLM ARTRY-RT
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
HCPCS 36013RT
|
| Hospital Charge Code |
7411901
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$71.44
|
| Rate for Payer: Aetna Medicare Advantage |
$56.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.94
|
| 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 |
$47.94
|
| Rate for Payer: Cigna Commercial |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.98
|
|
|
IR-PLACE CTH PLM ARTRY-RT
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
HCPCS 36013RT
|
| Hospital Charge Code |
2691165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$71.44
|
| Rate for Payer: Aetna Medicare Advantage |
$56.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.94
|
| 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 |
$47.94
|
| Rate for Payer: Cigna Commercial |
$94.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.98
|
|
|
IR-PLACE CTH PLM ARTRY-RT
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
HCPCS 36013RT
|
| Hospital Charge Code |
2691165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$28.20 |
| Max. Negotiated Rate |
$28.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.20
|
|
|
IR PLACE GASTROSTOMY TUBE
|
Facility
|
OP
|
$3,929.65
|
|
|
Service Code
|
HCPCS 43246
|
| Hospital Charge Code |
5600187
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.70 |
| 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 |
$1,016.00
|
| 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 |
$1,178.89
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$589.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$94.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$4,829.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4,734.91
|
|
|
IR PLACE GASTROSTOMY TUBE
|
Facility
|
IP
|
$3,929.65
|
|
|
Service Code
|
HCPCS 43246
|
| Hospital Charge Code |
7411545
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$589.45 |
| Max. Negotiated Rate |
$589.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$589.45
|
|
|
IR PLACE GASTROSTOMY TUBE
|
Facility
|
IP
|
$3,929.65
|
|
|
Service Code
|
HCPCS 43246
|
| Hospital Charge Code |
5600187
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$589.45 |
| Max. Negotiated Rate |
$589.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$589.45
|
|
|
IR PLACE GASTROSTOMY TUBE
|
Facility
|
OP
|
$3,929.65
|
|
|
Service Code
|
HCPCS 43246
|
| Hospital Charge Code |
7411545
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.70 |
| 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 |
$1,016.00
|
| 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 |
$1,178.89
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$589.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$94.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$4,829.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4,734.91
|
|
|
IR PLACE GASTROSTOMY TUBE PERC
|
Facility
|
OP
|
$6,674.15
|
|
|
Service Code
|
HCPCS 49440
|
| Hospital Charge Code |
366849440
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$160.85 |
| 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 |
$2,002.24
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,001.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$160.85
|
| 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 |
$176.86
|
|
|
IR PLACE GASTROSTOMY TUBE PERC
|
Facility
|
IP
|
$8,686.35
|
|
|
Service Code
|
HCPCS 49440
|
| Hospital Charge Code |
321049440
|
|
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 PLACE GASTROSTOMY TUBE PERC
|
Facility
|
OP
|
$8,686.35
|
|
|
Service Code
|
HCPCS 49440
|
| Hospital Charge Code |
5600159
|
|
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 PLACE GASTROSTOMY TUBE PERC
|
Facility
|
OP
|
$8,686.35
|
|
|
Service Code
|
HCPCS 49440
|
| Hospital Charge Code |
321049440
|
|
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 PLACE GASTROSTOMY TUBE PERC
|
Facility
|
IP
|
$6,674.15
|
|
|
Service Code
|
HCPCS 49440
|
| Hospital Charge Code |
366849440
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,001.12 |
| Max. Negotiated Rate |
$1,001.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,001.12
|
|
|
IR PLACE GASTROSTOMY TUBE PERC
|
Facility
|
OP
|
$6,674.15
|
|
|
Service Code
|
HCPCS 49440
|
| Hospital Charge Code |
7411593
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$160.85 |
| 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 |
$2,002.24
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,001.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$160.85
|
| 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 |
$176.86
|
|