|
IR-THORACENTESIS-LT
|
Facility
|
IP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2691040
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$544.61 |
| Max. Negotiated Rate |
$544.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
|
|
IR-THORACENTESIS-LT
|
Facility
|
OP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
321032555L
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.50 |
| Max. Negotiated Rate |
$3,593.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,690.13
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.21
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$87.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.21
|
|
|
IR-THORACENTESIS-LT
|
Facility
|
OP
|
$605.45
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
7411383
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14.59 |
| Max. Negotiated Rate |
$3,593.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,690.13
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.63
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.82
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.04
|
|
|
IR-THORACENTESIS/PUNT/PLEURAL
|
Facility
|
IP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2680130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$544.61 |
| Max. Negotiated Rate |
$544.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
|
|
IR-THORACENTESIS/PUNT/PLEURAL
|
Facility
|
OP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
321032555
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.50 |
| Max. Negotiated Rate |
$3,593.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,690.13
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.21
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$87.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.21
|
|
|
IR-THORACENTESIS/PUNT/PLEURAL
|
Facility
|
IP
|
$2,289.68
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
7411382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$343.45 |
| Max. Negotiated Rate |
$343.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$343.45
|
|
|
IR-THORACENTESIS/PUNT/PLEURAL
|
Facility
|
IP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
321032555
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$544.61 |
| Max. Negotiated Rate |
$544.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
|
|
IR-THORACENTESIS/PUNT/PLEURAL
|
Facility
|
OP
|
$2,289.68
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
7411382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$55.18 |
| Max. Negotiated Rate |
$3,593.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,690.13
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$686.90
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$343.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$55.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60.68
|
|
|
IR-THORACENTESIS/PUNT/PLEURAL
|
Facility
|
OP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2680130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.50 |
| Max. Negotiated Rate |
$3,593.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,690.13
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.21
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$87.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.21
|
|
|
IR-THORACENTESIS-RT
|
Facility
|
OP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2691045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.50 |
| Max. Negotiated Rate |
$3,593.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,690.13
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.21
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$87.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.21
|
|
|
IR-THORACENTESIS-RT
|
Facility
|
OP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
321032555R
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.50 |
| Max. Negotiated Rate |
$3,593.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,690.13
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.21
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$87.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.21
|
|
|
IR-THORACENTESIS-RT
|
Facility
|
IP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2691045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$544.61 |
| Max. Negotiated Rate |
$544.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
|
|
IR-THORACENTESIS-RT
|
Facility
|
IP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
321032555R
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$544.61 |
| Max. Negotiated Rate |
$544.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
|
|
IR-THORACENTESIS-RT
|
Facility
|
OP
|
$605.45
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
7411384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14.59 |
| Max. Negotiated Rate |
$3,593.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,690.13
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.63
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.82
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.04
|
|
|
IR-THORACENTESIS-RT
|
Facility
|
IP
|
$605.45
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
7411384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$90.82 |
| Max. Negotiated Rate |
$90.82 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.82
|
|
|
IR THORACENTESIS W INSERT OF T
|
Facility
|
IP
|
$2,289.68
|
|
|
Service Code
|
HCPCS 32422
|
| Hospital Charge Code |
2670060
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$343.45 |
| Max. Negotiated Rate |
$343.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$343.45
|
|
|
IR THORACENTESIS W INSERT OF T
|
Facility
|
OP
|
$2,289.68
|
|
|
Service Code
|
HCPCS 32422
|
| Hospital Charge Code |
2670060
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$55.18 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$870.08
|
| Rate for Payer: Aetna Medicare Advantage |
$686.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$583.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$583.87
|
| 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 |
$583.87
|
| Rate for Payer: Cigna Commercial |
$1,144.84
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$686.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$343.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$55.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60.68
|
|
|
IR THORACIC VASC SEL CATH ADDL
|
Facility
|
OP
|
$414.45
|
|
|
Service Code
|
HCPCS 36218
|
| Hospital Charge Code |
2004240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$157.49
|
| Rate for Payer: Aetna Medicare Advantage |
$124.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.68
|
| 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 |
$105.68
|
| Rate for Payer: Cigna Commercial |
$207.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.33
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.98
|
|
|
IR THORACIC VASC SEL CATH ADDL
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36218
|
| Hospital Charge Code |
2004240
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR THORACIC VASC SEL CATH ADDL
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36218
|
| Hospital Charge Code |
74110044
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR THORACIC VASC SEL CATH ADDL
|
Facility
|
OP
|
$414.45
|
|
|
Service Code
|
HCPCS 36218
|
| Hospital Charge Code |
74110044
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$157.49
|
| Rate for Payer: Aetna Medicare Advantage |
$124.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.68
|
| 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 |
$105.68
|
| Rate for Payer: Cigna Commercial |
$207.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.33
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.98
|
|
|
IR THORACIC VASC SEL CATH ADDL
|
Facility
|
OP
|
$414.45
|
|
|
Service Code
|
HCPCS 36218
|
| Hospital Charge Code |
5100360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$157.49
|
| Rate for Payer: Aetna Medicare Advantage |
$124.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.68
|
| 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 |
$105.68
|
| Rate for Payer: Cigna Commercial |
$207.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.33
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.98
|
|
|
IR THORACIC VASC SEL CATH ADDL
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36218
|
| Hospital Charge Code |
5100360
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR-THORACOST(ABCE,HTX)-BI
|
Facility
|
IP
|
$1,650.00
|
|
|
Service Code
|
HCPCS 3255150
|
| Hospital Charge Code |
7411784
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$247.50 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$247.50
|
|
|
IR-THORACOST(ABCE,HTX)-BI
|
Facility
|
OP
|
$1,650.00
|
|
|
Service Code
|
HCPCS 3255150
|
| Hospital Charge Code |
7411784
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$39.77 |
| Max. Negotiated Rate |
$1,626.00 |
| Rate for Payer: Aetna Commercial |
$627.00
|
| Rate for Payer: Aetna Medicare Advantage |
$495.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$420.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$420.75
|
| 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 |
$420.75
|
| Rate for Payer: Cigna Commercial |
$825.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$495.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$247.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$43.73
|
|