|
ARTERIAL LINE INSERTION
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
83080005
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$157.32
|
| Rate for Payer: Aetna Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.57
|
| Rate for Payer: Cigna Commercial |
$207.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.20
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.97
|
|
|
ARTERIAL LINE INSERTION
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
83092005
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$157.32
|
| Rate for Payer: Aetna Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.57
|
| Rate for Payer: Cigna Commercial |
$207.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.20
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.97
|
|
|
ARTERIAL LINE INSERTION
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
83091005
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.10 |
| Max. Negotiated Rate |
$62.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.10
|
|
|
ARTERIAL LINE INSERTION
|
Facility
|
IP
|
$414.00
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
83092005
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.10 |
| Max. Negotiated Rate |
$62.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.10
|
|
|
ARTERIAL LINE INSERTION
|
Facility
|
OP
|
$414.00
|
|
|
Service Code
|
HCPCS 36140
|
| Hospital Charge Code |
83091005
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9.98 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$157.32
|
| Rate for Payer: Aetna Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.57
|
| Rate for Payer: Cigna Commercial |
$207.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$124.20
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.97
|
|
|
ARTERIAL LINE KIT 20G 3
|
Facility
|
OP
|
$88.68
|
|
| Hospital Charge Code |
270650554
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$44.34 |
| Rate for Payer: Aetna Commercial |
$33.70
|
| Rate for Payer: Aetna Medicare Advantage |
$26.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.61
|
| Rate for Payer: Cigna Commercial |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.60
|
| Rate for Payer: Oxford Commercial |
$17.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$17.74
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.35
|
|
|
ARTERIAL LINE KIT 20G 3
|
Facility
|
IP
|
$88.68
|
|
| Hospital Charge Code |
270650554
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.30 |
| Max. Negotiated Rate |
$13.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.30
|
|
|
ARTERIAL LINE KIT 20G 6
|
Facility
|
IP
|
$78.02
|
|
| Hospital Charge Code |
270649796
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.70 |
| Max. Negotiated Rate |
$11.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.70
|
|
|
ARTERIAL LINE KIT 20G 6
|
Facility
|
OP
|
$78.02
|
|
| Hospital Charge Code |
270649796
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.88 |
| Max. Negotiated Rate |
$39.01 |
| Rate for Payer: Aetna Commercial |
$29.65
|
| Rate for Payer: Aetna Medicare Advantage |
$23.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.90
|
| Rate for Payer: Cigna Commercial |
$39.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.41
|
| Rate for Payer: Oxford Commercial |
$15.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.07
|
|
|
ARTERIAL LINE KIT 20GA 12CM
|
Facility
|
OP
|
$303.42
|
|
| Hospital Charge Code |
270663684S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.31 |
| Max. Negotiated Rate |
$151.71 |
| Rate for Payer: Aetna Commercial |
$115.30
|
| Rate for Payer: Aetna Medicare Advantage |
$91.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77.37
|
| Rate for Payer: Cigna Commercial |
$151.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$91.03
|
| Rate for Payer: Oxford Commercial |
$60.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$60.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.04
|
|
|
ARTERIAL LINE KIT 20GA 12CM
|
Facility
|
IP
|
$303.42
|
|
| Hospital Charge Code |
270663684S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.51 |
| Max. Negotiated Rate |
$45.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.51
|
|
|
ARTERIAL PVR DOPPLER UP EXT BI
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
2692145
|
|
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 PVR DOPPLER UP EXT BI
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
74115033
|
|
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 PVR DOPPLER UP EXT BI
|
Facility
|
OP
|
$1,440.90
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
94053245
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$34.73 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$697.73
|
| Rate for Payer: Aetna Medicare Advantage |
$831.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$256.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$530.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$925.96
|
| Rate for Payer: Cigna Commercial |
$514.20
|
| Rate for Payer: Cigna Medicare Advantage |
$256.52
|
| Rate for Payer: Clover Medicare Advantage |
$243.69
|
| Rate for Payer: EmblemHealth Commercial |
$769.56
|
| Rate for Payer: Humana Medicare Advantage |
$264.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$256.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$432.27
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$216.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.73
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$38.18
|
|
|
ARTERIAL PVR DOPPLER UP EXT BI
|
Facility
|
IP
|
$1,440.90
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
94053245
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$216.13 |
| Max. Negotiated Rate |
$216.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$216.13
|
|
|
ARTERIAL PVR DOPPLER UP EXT BI
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
74115033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$243.69 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$697.73
|
| Rate for Payer: Aetna Medicare Advantage |
$831.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$256.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$530.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$925.96
|
| Rate for Payer: Cigna Commercial |
$514.20
|
| Rate for Payer: Cigna Medicare Advantage |
$256.52
|
| Rate for Payer: Clover Medicare Advantage |
$243.69
|
| Rate for Payer: EmblemHealth Commercial |
$769.56
|
| Rate for Payer: Humana Medicare Advantage |
$264.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$256.52
|
| 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 |
$256.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
ARTERIAL PVR DOPPLER UP EXT BI
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
2692145
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$243.69 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$697.73
|
| Rate for Payer: Aetna Medicare Advantage |
$831.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$256.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$530.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$925.96
|
| Rate for Payer: Cigna Commercial |
$514.20
|
| Rate for Payer: Cigna Medicare Advantage |
$256.52
|
| Rate for Payer: Clover Medicare Advantage |
$243.69
|
| Rate for Payer: EmblemHealth Commercial |
$769.56
|
| Rate for Payer: Humana Medicare Advantage |
$264.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$256.52
|
| 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 |
$256.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
ARTERIAL PVR DOPPLER UP EXT BI
|
Facility
|
IP
|
$551.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
74117033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$82.65 |
| Max. Negotiated Rate |
$82.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.65
|
|
|
ARTERIAL PVR DOPPLER UP EXT BI
|
Facility
|
IP
|
$551.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
74116033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$82.65 |
| Max. Negotiated Rate |
$82.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.65
|
|
|
ARTERIAL PVR DOPPLER UP EXT BI
|
Facility
|
OP
|
$551.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
74117033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$697.73
|
| Rate for Payer: Aetna Medicare Advantage |
$831.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$256.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$530.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$925.96
|
| Rate for Payer: Cigna Commercial |
$514.20
|
| Rate for Payer: Cigna Medicare Advantage |
$256.52
|
| Rate for Payer: Clover Medicare Advantage |
$243.69
|
| Rate for Payer: EmblemHealth Commercial |
$769.56
|
| Rate for Payer: Humana Medicare Advantage |
$264.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$256.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$165.30
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.28
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.60
|
|
|
ARTERIAL PVR DOPPLER UP EXT BI
|
Facility
|
OP
|
$551.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
74116033
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$697.73
|
| Rate for Payer: Aetna Medicare Advantage |
$831.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$256.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$530.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$925.96
|
| Rate for Payer: Cigna Commercial |
$514.20
|
| Rate for Payer: Cigna Medicare Advantage |
$256.52
|
| Rate for Payer: Clover Medicare Advantage |
$243.69
|
| Rate for Payer: EmblemHealth Commercial |
$769.56
|
| Rate for Payer: Humana Medicare Advantage |
$264.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$256.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$165.30
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.28
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.60
|
|
|
ARTERIAL PVR/SEG LOW EXT BI
|
Facility
|
IP
|
$551.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
74116034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$82.65 |
| Max. Negotiated Rate |
$82.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.65
|
|
|
ARTERIAL PVR/SEG LOW EXT BI
|
Facility
|
IP
|
$1,440.90
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
94053250
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$216.13 |
| Max. Negotiated Rate |
$216.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$216.13
|
|
|
ARTERIAL PVR/SEG LOW EXT BI
|
Facility
|
OP
|
$551.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
74116034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$697.73
|
| Rate for Payer: Aetna Medicare Advantage |
$831.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$256.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$530.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$925.96
|
| Rate for Payer: Cigna Commercial |
$514.20
|
| Rate for Payer: Cigna Medicare Advantage |
$256.52
|
| Rate for Payer: Clover Medicare Advantage |
$243.69
|
| Rate for Payer: EmblemHealth Commercial |
$769.56
|
| Rate for Payer: Humana Medicare Advantage |
$264.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$256.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$165.30
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.28
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.60
|
|
|
ARTERIAL PVR/SEG LOW EXT BI
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
74115034
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$243.69 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$697.73
|
| Rate for Payer: Aetna Medicare Advantage |
$831.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$256.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$530.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$925.96
|
| Rate for Payer: Cigna Commercial |
$514.20
|
| Rate for Payer: Cigna Medicare Advantage |
$256.52
|
| Rate for Payer: Clover Medicare Advantage |
$243.69
|
| Rate for Payer: EmblemHealth Commercial |
$769.56
|
| Rate for Payer: Humana Medicare Advantage |
$264.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$256.52
|
| 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 |
$256.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
