|
IV PUSH FIRST DRUG
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
94053140
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$61.47 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$840.00
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$67.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$74.20
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
1500104
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
73092060
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
OP
|
$440.91
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
2400612
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$132.27
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.68
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$1,080.95
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
5790895
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$162.14 |
| Max. Negotiated Rate |
$162.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$162.14
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
5300145
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
321796374
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
73092060
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$61.47 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$840.00
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$67.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$74.20
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
OP
|
$440.91
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
74115057
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$132.27
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.68
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$440.91
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
74116057
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$66.14 |
| Max. Negotiated Rate |
$66.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.14
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
321796374
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$61.47 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$840.00
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$67.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$74.20
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
OP
|
$394.88
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
73050980
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$9.52 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$118.46
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.46
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$394.88
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
93500065
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$59.23 |
| Max. Negotiated Rate |
$59.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.23
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
94053140
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
5300145
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$61.47 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$840.00
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$67.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$74.20
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
73092070
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$440.91
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
5700256
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$66.14 |
| Max. Negotiated Rate |
$66.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.14
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
100113
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$440.91
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
74115057
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$66.14 |
| Max. Negotiated Rate |
$66.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.14
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$440.91
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
4501032
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$66.14 |
| Max. Negotiated Rate |
$66.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.14
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$1,076.70
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
395096374
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$161.50 |
| Max. Negotiated Rate |
$161.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.50
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
OP
|
$440.91
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
74117057
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$132.27
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.68
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
IP
|
$394.88
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
93082030
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$59.23 |
| Max. Negotiated Rate |
$59.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.23
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
485096374
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$61.47 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$840.00
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$67.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$74.20
|
|
|
IV PUSH FIRST DRUG
|
Facility
|
OP
|
$440.91
|
|
|
Service Code
|
HCPCS 96374
|
| Hospital Charge Code |
5700256
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$919.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$912.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$912.17
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$132.27
|
| Rate for Payer: Oxford Commercial |
$707.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$919.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.68
|
|
