|
IR REPOSITION GASTROSTOMY TUBE
|
Facility
|
OP
|
$3,929.65
|
|
|
Service Code
|
HCPCS 43761
|
| Hospital Charge Code |
2101178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.70 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$807.38
|
| Rate for Payer: Aetna Medicare Advantage |
$961.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,071.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,071.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$296.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,071.47
|
| Rate for Payer: Cigna Commercial |
$594.98
|
| Rate for Payer: Cigna Medicare Advantage |
$296.83
|
| Rate for Payer: Clover Medicare Advantage |
$281.99
|
| Rate for Payer: EmblemHealth Commercial |
$890.49
|
| Rate for Payer: Humana Medicare Advantage |
$305.73
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$296.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,178.89
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$589.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$94.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$104.14
|
|
|
IR REPOSITION GASTROSTOMY TUBE
|
Facility
|
IP
|
$3,929.65
|
|
|
Service Code
|
HCPCS 43761
|
| Hospital Charge Code |
2101178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$589.45 |
| Max. Negotiated Rate |
$589.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$589.45
|
|
|
IR REPOSITION GASTROSTOMY TUBE
|
Facility
|
OP
|
$3,929.65
|
|
|
Service Code
|
HCPCS 43761
|
| Hospital Charge Code |
7411548
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.70 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$807.38
|
| Rate for Payer: Aetna Medicare Advantage |
$961.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,071.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,071.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$296.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,071.47
|
| Rate for Payer: Cigna Commercial |
$594.98
|
| Rate for Payer: Cigna Medicare Advantage |
$296.83
|
| Rate for Payer: Clover Medicare Advantage |
$281.99
|
| Rate for Payer: EmblemHealth Commercial |
$890.49
|
| Rate for Payer: Humana Medicare Advantage |
$305.73
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$296.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,178.89
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$589.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$94.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$104.14
|
|
|
IR REP TUND CV CATH W/O PORT
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
321036581
|
|
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 REP TUND CV CATH W/O PORT
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
321036581
|
|
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 REP TUND CV CATH W/O PORT
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
2011276
|
|
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 REP TUND CV CATH W/O PORT
|
Facility
|
OP
|
$5,224.75
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
7411466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$125.92 |
| 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 |
$1,567.42
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$783.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$125.92
|
| 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 |
$138.46
|
|
|
IR REP TUND CV CATH W/O PORT
|
Facility
|
IP
|
$5,224.75
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
7411466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$783.71 |
| Max. Negotiated Rate |
$783.71 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$783.71
|
|
|
IR REP TUND CV CATH W/O PORT
|
Facility
|
OP
|
$5,224.75
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
366836581
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$125.92 |
| 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 |
$1,567.42
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$783.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$125.92
|
| 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 |
$138.46
|
|
|
IR REP TUND CV CATH W/O PORT
|
Facility
|
IP
|
$5,224.75
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
366836581
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$783.71 |
| Max. Negotiated Rate |
$783.71 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$783.71
|
|
|
IR REP TUND CV CATH W/O PORT
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
2011276
|
|
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 RETRIV INTRAVASC VENA CAVA
|
Facility
|
OP
|
$12,618.93
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
366837193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$304.12 |
| 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 |
$1,626.00
|
| 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 |
$3,785.68
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,892.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$304.12
|
| 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 |
$334.40
|
|
|
IR RETRIV INTRAVASC VENA CAVA
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
321037193
|
|
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 RETRIV INTRAVASC VENA CAVA
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
2670100
|
|
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 RETRIV INTRAVASC VENA CAVA
|
Facility
|
IP
|
$12,618.93
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
7411499
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,892.84 |
| Max. Negotiated Rate |
$1,892.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,892.84
|
|
|
IR RETRIV INTRAVASC VENA CAVA
|
Facility
|
IP
|
$12,618.93
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
366837193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,892.84 |
| Max. Negotiated Rate |
$1,892.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,892.84
|
|
|
IR RETRIV INTRAVASC VENA CAVA
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
2670100
|
|
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 |
$1,626.00
|
| 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 RETRIV INTRAVASC VENA CAVA
|
Facility
|
IP
|
$12,618.93
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
411037193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,892.84 |
| Max. Negotiated Rate |
$1,892.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,892.84
|
|
|
IR RETRIV INTRAVASC VENA CAVA
|
Facility
|
OP
|
$12,618.93
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
411037193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$304.12 |
| 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 |
$1,626.00
|
| 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 |
$3,785.68
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,892.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$304.12
|
| 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 |
$334.40
|
|
|
IR RETRIV INTRAVASC VENA CAVA
|
Facility
|
OP
|
$12,618.93
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
7411499
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$304.12 |
| 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 |
$1,626.00
|
| 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 |
$3,785.68
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,892.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$304.12
|
| 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 |
$334.40
|
|
|
IR RETRIV INTRAVASC VENA CAVA
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
321037193
|
|
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 |
$1,626.00
|
| 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 REVASC OPN/PRQ TIB/PER STN
|
Facility
|
OP
|
$22,441.40
|
|
|
Service Code
|
HCPCS 37234
|
| Hospital Charge Code |
366837234
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$540.84 |
| Max. Negotiated Rate |
$14,834.00 |
| Rate for Payer: Aetna Commercial |
$8,527.73
|
| Rate for Payer: Aetna Medicare Advantage |
$6,732.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,722.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,722.56
|
| 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 |
$5,722.56
|
| Rate for Payer: Cigna Commercial |
$11,220.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,732.42
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,366.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$540.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$594.70
|
|
|
IR REVASC OPN/PRQ TIB/PER STN
|
Facility
|
IP
|
$22,441.40
|
|
|
Service Code
|
HCPCS 37234
|
| Hospital Charge Code |
366837234
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,366.21 |
| Max. Negotiated Rate |
$3,366.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,366.21
|
|
|
IR REVASC OPN/PRQ TIB/PER STN
|
Facility
|
OP
|
$22,441.40
|
|
|
Service Code
|
HCPCS 37285
|
| Hospital Charge Code |
411037234
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$540.84 |
| Max. Negotiated Rate |
$11,220.70 |
| Rate for Payer: Aetna Commercial |
$8,527.73
|
| Rate for Payer: Aetna Medicare Advantage |
$6,732.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,722.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,722.56
|
| 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 |
$5,722.56
|
| Rate for Payer: Cigna Commercial |
$11,220.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,732.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,366.21
|
| Rate for Payer: UnitedHealthcare Community & State |
$540.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$594.70
|
|
|
IR REVASC OPN/PRQ TIB/PER STN
|
Facility
|
IP
|
$22,441.40
|
|
|
Service Code
|
HCPCS 37285
|
| Hospital Charge Code |
411037234
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,366.21 |
| Max. Negotiated Rate |
$3,366.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,366.21
|
|
