|
ARTERIAL DUPLEX SCAN LE
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
74115036
|
|
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 |
74115036
|
|
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
|
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
|
|
|
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 LOWER EXT
|
Facility
|
OP
|
$838.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
74117037
|
|
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 LOWER EXT
|
Facility
|
OP
|
$838.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
74115037
|
|
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 LOWER EXT
|
Facility
|
IP
|
$838.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
74117037
|
|
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 LOWER EXT
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
94053225
|
|
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 LOWER EXT
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
2692125
|
|
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 LOWER EXT
|
Facility
|
IP
|
$838.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
74116037
|
|
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 LOWER EXT
|
Facility
|
OP
|
$838.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
74116037
|
|
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 LOWER EXT
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
2692125
|
|
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 LOWER EXT
|
Facility
|
IP
|
$838.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
74115037
|
|
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 LOWER EXT
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 93925
|
| Hospital Charge Code |
94053225
|
|
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 UE
|
Facility
|
OP
|
$843.00
|
|
|
Service Code
|
HCPCS 93930
|
| Hospital Charge Code |
7411765
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$20.32 |
| 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 |
$2,001.82
|
| 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 |
$252.90
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.32
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.34
|
|
|
ARTERIAL DUPLEX SCAN UE
|
Facility
|
OP
|
$843.00
|
|
|
Service Code
|
HCPCS 93930
|
| Hospital Charge Code |
74117040
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$20.32 |
| 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 |
$2,001.82
|
| 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 |
$252.90
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.32
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.34
|
|
|
ARTERIAL DUPLEX SCAN UE
|
Facility
|
IP
|
$1,079.25
|
|
|
Service Code
|
HCPCS 93930
|
| Hospital Charge Code |
94053195
|
|
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 SCAN UE
|
Facility
|
IP
|
$843.00
|
|
|
Service Code
|
HCPCS 93930
|
| Hospital Charge Code |
74117040
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$126.45 |
| Max. Negotiated Rate |
$126.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.45
|
|
|
ARTERIAL DUPLEX SCAN UE
|
Facility
|
OP
|
$1,079.25
|
|
|
Service Code
|
HCPCS 93930
|
| Hospital Charge Code |
94053195
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$26.01 |
| 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 |
$2,001.82
|
| 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 |
$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 |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.60
|
|
|
ARTERIAL DUPLEX SCAN UE
|
Facility
|
OP
|
$843.00
|
|
|
Service Code
|
HCPCS 93930
|
| Hospital Charge Code |
74116040
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$20.32 |
| 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 |
$2,001.82
|
| 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 |
$252.90
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.32
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.34
|
|
|
ARTERIAL DUPLEX SCAN UE
|
Facility
|
OP
|
$843.00
|
|
|
Service Code
|
HCPCS 93930
|
| Hospital Charge Code |
74115040
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$20.32 |
| 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 |
$2,001.82
|
| 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 |
$252.90
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.32
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.34
|
|
|
ARTERIAL DUPLEX SCAN UE
|
Facility
|
IP
|
$843.00
|
|
|
Service Code
|
HCPCS 93930
|
| Hospital Charge Code |
74116040
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$126.45 |
| Max. Negotiated Rate |
$126.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.45
|
|
|
ARTERIAL DUPLEX SCAN UE
|
Facility
|
IP
|
$843.00
|
|
|
Service Code
|
HCPCS 93930
|
| Hospital Charge Code |
7411765
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$126.45 |
| Max. Negotiated Rate |
$126.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.45
|
|
|
ARTERIAL DUPLEX SCAN UE
|
Facility
|
IP
|
$843.00
|
|
|
Service Code
|
HCPCS 93930
|
| Hospital Charge Code |
2692055
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$126.45 |
| Max. Negotiated Rate |
$126.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.45
|
|
|
ARTERIAL DUPLEX SCAN UE
|
Facility
|
OP
|
$843.00
|
|
|
Service Code
|
HCPCS 93930
|
| Hospital Charge Code |
2692055
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$20.32 |
| 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 |
$2,001.82
|
| 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 |
$252.90
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.32
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.34
|
|
