|
IR VENTRICULOGRAPHY
|
Facility
|
IP
|
$3,646.49
|
|
|
Service Code
|
HCPCS 78635
|
| Hospital Charge Code |
7411760
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$546.97 |
| Max. Negotiated Rate |
$546.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$546.97
|
|
|
IR VENTRICULOGRAPHY
|
Facility
|
OP
|
$3,646.49
|
|
|
Service Code
|
HCPCS 78635
|
| Hospital Charge Code |
2680365
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$87.88 |
| Max. Negotiated Rate |
$5,021.00 |
| Rate for Payer: Aetna Commercial |
$1,754.56
|
| Rate for Payer: Aetna Medicare Advantage |
$2,089.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,328.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,328.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$645.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$181.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,328.47
|
| Rate for Payer: Cigna Commercial |
$1,293.03
|
| Rate for Payer: Cigna Medicare Advantage |
$451.54
|
| Rate for Payer: Clover Medicare Advantage |
$612.81
|
| Rate for Payer: EmblemHealth Commercial |
$1,935.18
|
| Rate for Payer: Humana Medicare Advantage |
$664.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$645.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,093.95
|
| Rate for Payer: Oxford Commercial |
$3,120.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$546.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,021.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$87.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.63
|
|
|
IR VESICULOGRAPHY
|
Facility
|
IP
|
$906.25
|
|
|
Service Code
|
HCPCS 74440
|
| Hospital Charge Code |
2600139
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$135.94 |
| Max. Negotiated Rate |
$135.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.94
|
|
|
IR VESICULOGRAPHY
|
Facility
|
OP
|
$906.25
|
|
|
Service Code
|
HCPCS 74440
|
| Hospital Charge Code |
2600139
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$21.84 |
| Max. Negotiated Rate |
$1,975.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,023.24
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$198.43
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.88
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.84
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.02
|
|
|
IR VNGRM SUPEROR SAGITAL SINUS
|
Facility
|
IP
|
$2,237.55
|
|
|
Service Code
|
HCPCS 75870
|
| Hospital Charge Code |
2600138
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$335.63 |
| Max. Negotiated Rate |
$335.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$335.63
|
|
|
IR VNGRM SUPEROR SAGITAL SINUS
|
Facility
|
IP
|
$2,237.55
|
|
|
Service Code
|
HCPCS 75870
|
| Hospital Charge Code |
7411720
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$335.63 |
| Max. Negotiated Rate |
$335.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$335.63
|
|
|
IR VNGRM SUPEROR SAGITAL SINUS
|
Facility
|
OP
|
$2,237.55
|
|
|
Service Code
|
HCPCS 75870
|
| Hospital Charge Code |
2600138
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.92 |
| 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 |
$316.25
|
| 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 |
$671.26
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$335.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$53.92
|
| 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 |
$59.30
|
|
|
IR VNGRM SUPEROR SAGITAL SINUS
|
Facility
|
OP
|
$2,237.55
|
|
|
Service Code
|
HCPCS 75870
|
| Hospital Charge Code |
7411720
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.92 |
| 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 |
$316.25
|
| 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 |
$671.26
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$335.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$53.92
|
| 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 |
$59.30
|
|
|
IR-WITHDRAW ART BLD
|
Facility
|
IP
|
$623.55
|
|
|
Service Code
|
HCPCS 36600
|
| Hospital Charge Code |
321036600
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.53 |
| Max. Negotiated Rate |
$93.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.53
|
|
|
IR-WITHDRAW ART BLD
|
Facility
|
OP
|
$623.55
|
|
|
Service Code
|
HCPCS 36600
|
| Hospital Charge Code |
2690060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.03 |
| Max. Negotiated Rate |
$570.55 |
| 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 |
$31.31
|
| 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 |
$124.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.71
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$197.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.52
|
|
|
IR-WITHDRAW ART BLD
|
Facility
|
IP
|
$525.15
|
|
|
Service Code
|
HCPCS 36600
|
| Hospital Charge Code |
366836600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$78.77 |
| Max. Negotiated Rate |
$78.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.77
|
|
|
IR-WITHDRAW ART BLD
|
Facility
|
IP
|
$623.55
|
|
|
Service Code
|
HCPCS 36600
|
| Hospital Charge Code |
2690060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.53 |
| Max. Negotiated Rate |
$93.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.53
|
|
|
IR-WITHDRAW ART BLD
|
Facility
|
OP
|
$525.15
|
|
|
Service Code
|
HCPCS 36600
|
| Hospital Charge Code |
411036600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12.66 |
| 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 |
$862.00
|
| 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 |
$157.54
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.66
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$197.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$193.50
|
|
|
IR-WITHDRAW ART BLD
|
Facility
|
IP
|
$525.15
|
|
|
Service Code
|
HCPCS 36600
|
| Hospital Charge Code |
411036600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$78.77 |
| Max. Negotiated Rate |
$78.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.77
|
|
|
IR-WITHDRAW ART BLD
|
Facility
|
IP
|
$111.83
|
|
|
Service Code
|
HCPCS 36600
|
| Hospital Charge Code |
7411479
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$16.77 |
| Max. Negotiated Rate |
$16.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.77
|
|
|
IR-WITHDRAW ART BLD
|
Facility
|
OP
|
$111.83
|
|
|
Service Code
|
HCPCS 36600
|
| Hospital Charge Code |
7411479
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$570.55 |
| 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 |
$31.31
|
| 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 |
$33.55
|
| Rate for Payer: Oxford Commercial |
$22.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$197.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.96
|
|
|
IR-WITHDRAW ART BLD
|
Facility
|
OP
|
$623.55
|
|
|
Service Code
|
HCPCS 36600
|
| Hospital Charge Code |
321036600
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.03 |
| Max. Negotiated Rate |
$570.55 |
| 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 |
$31.31
|
| 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 |
$124.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.71
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$197.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.52
|
|
|
IR-WITHDRAW ART BLD
|
Facility
|
OP
|
$525.15
|
|
|
Service Code
|
HCPCS 36600
|
| Hospital Charge Code |
366836600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12.66 |
| 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 |
$862.00
|
| 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 |
$157.54
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.66
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$197.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$193.50
|
|
|
IR WRIST,ARTHROGRAPHY,RAD S &I
|
Facility
|
IP
|
$1,667.37
|
|
|
Service Code
|
HCPCS 73115
|
| Hospital Charge Code |
2680275
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$250.11 |
| Max. Negotiated Rate |
$250.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$250.11
|
|
|
IR WRIST,ARTHROGRAPHY,RAD S &I
|
Facility
|
OP
|
$1,667.37
|
|
|
Service Code
|
HCPCS 73115
|
| Hospital Charge Code |
7411666
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$40.18 |
| Max. Negotiated Rate |
$1,975.00 |
| Rate for Payer: Aetna Commercial |
$1,127.36
|
| Rate for Payer: Aetna Medicare Advantage |
$1,342.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,496.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,496.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$414.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,496.11
|
| Rate for Payer: Cigna Commercial |
$830.80
|
| Rate for Payer: Cigna Medicare Advantage |
$290.13
|
| Rate for Payer: Clover Medicare Advantage |
$393.75
|
| Rate for Payer: EmblemHealth Commercial |
$1,243.41
|
| Rate for Payer: Humana Medicare Advantage |
$426.90
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$414.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$500.21
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$250.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$40.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$414.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$414.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$44.19
|
|
|
IR WRIST,ARTHROGRAPHY,RAD S &I
|
Facility
|
OP
|
$1,667.37
|
|
|
Service Code
|
HCPCS 73115
|
| Hospital Charge Code |
2680275
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$40.18 |
| Max. Negotiated Rate |
$1,975.00 |
| Rate for Payer: Aetna Commercial |
$1,127.36
|
| Rate for Payer: Aetna Medicare Advantage |
$1,342.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,496.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,496.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$414.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,496.11
|
| Rate for Payer: Cigna Commercial |
$830.80
|
| Rate for Payer: Cigna Medicare Advantage |
$290.13
|
| Rate for Payer: Clover Medicare Advantage |
$393.75
|
| Rate for Payer: EmblemHealth Commercial |
$1,243.41
|
| Rate for Payer: Humana Medicare Advantage |
$426.90
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$414.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$500.21
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$250.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$40.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$414.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$414.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$44.19
|
|
|
IR WRIST,ARTHROGRAPHY,RAD S &I
|
Facility
|
IP
|
$1,667.37
|
|
|
Service Code
|
HCPCS 73115
|
| Hospital Charge Code |
7411666
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$250.11 |
| Max. Negotiated Rate |
$250.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$250.11
|
|
|
IR XPOSE FOR ENDOPROSTH FEM
|
Facility
|
IP
|
$1,600.00
|
|
|
Service Code
|
HCPCS 34812
|
| Hospital Charge Code |
2011290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$240.00 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.00
|
|
|
IR XPOSE FOR ENDOPROSTH FEM
|
Facility
|
OP
|
$1,600.00
|
|
|
Service Code
|
HCPCS 34812
|
| Hospital Charge Code |
2011290
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$38.56 |
| Max. Negotiated Rate |
$10,232.00 |
| Rate for Payer: Aetna Commercial |
$608.00
|
| Rate for Payer: Aetna Medicare Advantage |
$480.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$408.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$408.00
|
| 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 |
$408.00
|
| Rate for Payer: Cigna Commercial |
$800.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$480.00
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$38.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.40
|
|
|
IR XPOSE FOR ENDOPROSTH FEM
|
Facility
|
OP
|
$1,600.00
|
|
|
Service Code
|
HCPCS 34812
|
| Hospital Charge Code |
7411398
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$38.56 |
| Max. Negotiated Rate |
$10,232.00 |
| Rate for Payer: Aetna Commercial |
$608.00
|
| Rate for Payer: Aetna Medicare Advantage |
$480.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$408.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$408.00
|
| 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 |
$408.00
|
| Rate for Payer: Cigna Commercial |
$800.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$480.00
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$38.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.40
|
|
