|
LH
|
Facility
|
IP
|
$192.85
|
|
|
Service Code
|
HCPCS 83002
|
| Hospital Charge Code |
39900415
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.93 |
| Max. Negotiated Rate |
$28.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.93
|
|
|
LH
|
Facility
|
OP
|
$192.85
|
|
|
Service Code
|
HCPCS 83002
|
| Hospital Charge Code |
39900415
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$50.37
|
| Rate for Payer: Aetna Medicare Advantage |
$60.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$66.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$66.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$66.85
|
| Rate for Payer: Cigna Commercial |
$96.42
|
| Rate for Payer: Cigna Medicare Advantage |
$18.52
|
| Rate for Payer: Clover Medicare Advantage |
$17.59
|
| Rate for Payer: EmblemHealth Commercial |
$55.56
|
| Rate for Payer: Humana Medicare Advantage |
$19.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$18.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.85
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.11
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
OP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93457
|
| Hospital Charge Code |
7411231
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$289.83 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,607.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$289.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$318.69
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
OP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93456
|
| Hospital Charge Code |
7411227
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$289.83 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,607.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$289.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$318.69
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
IP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93455
|
| Hospital Charge Code |
7411223
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,803.90 |
| Max. Negotiated Rate |
$1,803.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
OP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93455
|
| Hospital Charge Code |
7411223
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$289.83 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,607.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$289.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$318.69
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
IP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93459
|
| Hospital Charge Code |
366893459
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,803.90 |
| Max. Negotiated Rate |
$1,803.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
OP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93461
|
| Hospital Charge Code |
7411243
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$289.83 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,607.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$289.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$318.69
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
IP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93456
|
| Hospital Charge Code |
7411227
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,803.90 |
| Max. Negotiated Rate |
$1,803.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
OP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93454
|
| Hospital Charge Code |
7411219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$289.83 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,607.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$289.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$318.69
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
IP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93461
|
| Hospital Charge Code |
7411243
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,803.90 |
| Max. Negotiated Rate |
$1,803.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
OP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93459
|
| Hospital Charge Code |
366893459
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$289.83 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,607.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$289.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$318.69
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
OP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93459
|
| Hospital Charge Code |
7411239
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$289.83 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,607.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$289.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$318.69
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
IP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93459
|
| Hospital Charge Code |
7411239
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,803.90 |
| Max. Negotiated Rate |
$1,803.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
IP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93457
|
| Hospital Charge Code |
7411231
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,803.90 |
| Max. Negotiated Rate |
$1,803.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
|
|
LH0 LV CORONARY SVG ANGIO
|
Facility
|
IP
|
$12,026.00
|
|
|
Service Code
|
HCPCS 93454
|
| Hospital Charge Code |
7411219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,803.90 |
| Max. Negotiated Rate |
$1,803.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,803.90
|
|
|
L HRT ARTERY/VENTRICLE ANGIO
|
Facility
|
OP
|
$25,737.16
|
|
|
Service Code
|
HCPCS 93458
|
| Hospital Charge Code |
5100666
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$620.27 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,721.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,860.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$620.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$682.03
|
|
|
L HRT ARTERY/VENTRICLE ANGIO
|
Facility
|
OP
|
$25,737.16
|
|
|
Service Code
|
HCPCS 93458
|
| Hospital Charge Code |
74110067
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$620.27 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,721.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,860.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$620.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$682.03
|
|
|
L HRT ARTERY/VENTRICLE ANGIO
|
Facility
|
IP
|
$25,737.16
|
|
|
Service Code
|
HCPCS 93458
|
| Hospital Charge Code |
5100666
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,860.57 |
| Max. Negotiated Rate |
$3,860.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,860.57
|
|
|
L HRT ARTERY/VENTRICLE ANGIO
|
Facility
|
IP
|
$25,737.16
|
|
|
Service Code
|
HCPCS 93458
|
| Hospital Charge Code |
74110067
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,860.57 |
| Max. Negotiated Rate |
$3,860.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,860.57
|
|
|
L HRT ART/GRFT ANGIO
|
Facility
|
OP
|
$25,737.16
|
|
|
Service Code
|
HCPCS 93459
|
| Hospital Charge Code |
5100667
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$620.27 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,721.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,860.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$620.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$682.03
|
|
|
L HRT ART/GRFT ANGIO
|
Facility
|
OP
|
$25,737.16
|
|
|
Service Code
|
HCPCS 93459
|
| Hospital Charge Code |
74110068
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$620.27 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,721.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,860.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$620.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$682.03
|
|
|
L HRT ART/GRFT ANGIO
|
Facility
|
IP
|
$25,737.16
|
|
|
Service Code
|
HCPCS 93459
|
| Hospital Charge Code |
74110068
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,860.57 |
| Max. Negotiated Rate |
$3,860.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,860.57
|
|
|
L HRT ART/GRFT ANGIO
|
Facility
|
IP
|
$25,737.16
|
|
|
Service Code
|
HCPCS 93459
|
| Hospital Charge Code |
5100667
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,860.57 |
| Max. Negotiated Rate |
$3,860.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,860.57
|
|
|
L HRT CATH CHD NM/ABN NT CNJ
|
Facility
|
OP
|
$25,737.16
|
|
|
Service Code
|
HCPCS 93595
|
| Hospital Charge Code |
411093595
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$620.27 |
| Max. Negotiated Rate |
$13,902.76 |
| Rate for Payer: Aetna Commercial |
$10,476.08
|
| Rate for Payer: Aetna Medicare Advantage |
$12,478.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,902.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,851.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,902.76
|
| Rate for Payer: Cigna Commercial |
$7,720.31
|
| Rate for Payer: Cigna Medicare Advantage |
$3,851.50
|
| Rate for Payer: Clover Medicare Advantage |
$3,658.93
|
| Rate for Payer: EmblemHealth Commercial |
$11,554.50
|
| Rate for Payer: Humana Medicare Advantage |
$3,967.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,851.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,721.15
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,860.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$620.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,851.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$682.03
|
|
