|
ARTERIAL DOPPLER-LOWER LTD
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93922
|
| Hospital Charge Code |
74115031
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
ARTERIAL DOPPLER UPP LOW EXTR
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93922
|
| Hospital Charge Code |
2692035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
ARTERIAL DOPPLER UPP LOW EXTR
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93922
|
| Hospital Charge Code |
2692035
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$150.16 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$425.92
|
| 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 |
$5,160.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$414.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
ARTERIAL DOPPLER UPP LOW LTD
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93922
|
| Hospital Charge Code |
421593922
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$150.16 |
| Max. Negotiated Rate |
$6,760.00 |
| 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 |
$425.92
|
| 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 |
$5,160.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$414.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
ARTERIAL DOPPLER UPP LOW LTD
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93922
|
| Hospital Charge Code |
421593922
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
ARTERIAL DUPLEX LOWER EXT LTD
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
74115039
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$2,301.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$423.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$124.20
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$236.70
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.91
|
|
|
ARTERIAL DUPLEX LOWER EXT LTD
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
2692140
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$117.99 |
| Max. Negotiated Rate |
$2,301.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$423.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$124.20
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,530.00
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$122.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.15
|
|
|
ARTERIAL DUPLEX LOWER EXT LTD
|
Facility
|
IP
|
$1,079.25
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
94053240
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$161.89 |
| Max. Negotiated Rate |
$161.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.89
|
|
|
ARTERIAL DUPLEX LOWER EXT LTD
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
2692140
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
ARTERIAL DUPLEX LOWER EXT LTD
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
74116039
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$118.35 |
| Max. Negotiated Rate |
$118.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
|
|
ARTERIAL DUPLEX LOWER EXT LTD
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
74117039
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$118.35 |
| Max. Negotiated Rate |
$118.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
|
|
ARTERIAL DUPLEX LOWER EXT LTD
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
74116039
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$2,301.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$423.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$124.20
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$236.70
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.91
|
|
|
ARTERIAL DUPLEX LOWER EXT LTD
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
74117039
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$2,301.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$423.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$124.20
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$236.70
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.91
|
|
|
ARTERIAL DUPLEX LOWER EXT LTD
|
Facility
|
OP
|
$1,079.25
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
94053240
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$26.01 |
| Max. Negotiated Rate |
$2,301.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$423.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$124.20
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$323.77
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.60
|
|
|
ARTERIAL DUPLEX LOWER EXT LTD
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
74115039
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$118.35 |
| Max. Negotiated Rate |
$118.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
|
|
ARTERIAL DUPLEX SCAN
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
421593925
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
ARTERIAL DUPLEX SCAN
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
421593925
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$122.91 |
| Max. Negotiated Rate |
$2,301.00 |
| 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 |
$695.02
|
| 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 |
$283.47
|
| 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 |
$1,530.00
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$122.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.15
|
|
|
ARTERIAL DUPLEX SCAN LE
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
94053185
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$122.91 |
| Max. Negotiated Rate |
$2,301.00 |
| 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 |
$695.02
|
| 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 |
$283.47
|
| 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 |
$1,530.00
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$122.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.15
|
|
|
ARTERIAL DUPLEX SCAN LE
|
Facility
|
OP
|
$838.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
2692045
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$2,301.00 |
| 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 |
$695.02
|
| 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 |
$283.47
|
| 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 |
$251.40
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.21
|
|
|
ARTERIAL DUPLEX SCAN LE
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
94053185
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
ARTERIAL DUPLEX SCAN LE
|
Facility
|
OP
|
$838.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
7411763
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$2,301.00 |
| 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 |
$695.02
|
| 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 |
$283.47
|
| 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 |
$251.40
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.21
|
|
|
ARTERIAL DUPLEX SCAN LE
|
Facility
|
IP
|
$838.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
7411763
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$125.70 |
| Max. Negotiated Rate |
$125.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.70
|
|
|
ARTERIAL DUPLEX SCAN LE
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
74116036
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$122.91 |
| Max. Negotiated Rate |
$2,301.00 |
| 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 |
$695.02
|
| 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 |
$283.47
|
| 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 |
$1,530.00
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$122.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.15
|
|
|
ARTERIAL DUPLEX SCAN LE
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
74117036
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$122.91 |
| Max. Negotiated Rate |
$2,301.00 |
| 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 |
$695.02
|
| 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 |
$283.47
|
| 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 |
$1,530.00
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$122.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.15
|
|
|
ARTERIAL DUPLEX SCAN LE
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
74117036
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
