|
PACE INTERROGATION W/PROG DUAL
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93280
|
| Hospital Charge Code |
74115017
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
PACE INTERROGATION W/PROG DUAL
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
HCPCS 93280
|
| Hospital Charge Code |
5100279
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
|
|
PACE INTERROGATION W/PROG DUAL
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
HCPCS 93280
|
| Hospital Charge Code |
5100279
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$64.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$150.00
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.05
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.25
|
|
|
PACE INTERROGATION W/PROG DUAL
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93280
|
| Hospital Charge Code |
74116017
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
PACE INTERROGATION W/PROG DUAL
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93280
|
| Hospital Charge Code |
74117017
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$64.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
PACE INTERROGATION W/PROG DUAL
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93280
|
| Hospital Charge Code |
74117017
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
PACE INTERROGATION W/PROG DUAL
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93280
|
| Hospital Charge Code |
74115017
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$64.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
PACE INTERROGATION W/PROG DUAL
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93280
|
| Hospital Charge Code |
74116017
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$64.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
PACE INTERROGATION W/PROG DUAL
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
HCPCS 93280
|
| Hospital Charge Code |
94053065
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$64.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$150.00
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.05
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.25
|
|
|
PACE INTERROGATION W/PROG DUAL
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
HCPCS 93280
|
| Hospital Charge Code |
94053065
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
|
|
PACE INTERROGATION W/PROG S
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93279
|
| Hospital Charge Code |
74115016
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
PACE INTERROGATION W/PROG S
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93279
|
| Hospital Charge Code |
74116016
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
PACE INTERROGATION W/PROG S
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93279
|
| Hospital Charge Code |
74116016
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
PACE INTERROGATION W/PROG S
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93279
|
| Hospital Charge Code |
74115016
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
PACE INTERROGATION W/PROG S
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
HCPCS 93279
|
| Hospital Charge Code |
94053060
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
|
|
PACE INTERROGATION W/PROG S
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
HCPCS 93279
|
| Hospital Charge Code |
5100278
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$150.00
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.05
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.25
|
|
|
PACE INTERROGATION W/PROG S
|
Facility
|
OP
|
$214.68
|
|
|
Service Code
|
HCPCS 93279
|
| Hospital Charge Code |
74117016
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.69
|
|
|
PACE INTERROGATION W/PROG S
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
HCPCS 93279
|
| Hospital Charge Code |
5100278
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
|
|
PACE INTERROGATION W/PROG S
|
Facility
|
IP
|
$214.68
|
|
|
Service Code
|
HCPCS 93279
|
| Hospital Charge Code |
74117016
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.20
|
|
|
PACE INTERROGATION W/PROG S
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
HCPCS 93279
|
| Hospital Charge Code |
94053060
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$120.60
|
| Rate for Payer: Aetna Medicare Advantage |
$143.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.05
|
| Rate for Payer: Cigna Commercial |
$88.88
|
| Rate for Payer: Cigna Medicare Advantage |
$44.34
|
| Rate for Payer: Clover Medicare Advantage |
$42.12
|
| Rate for Payer: EmblemHealth Commercial |
$133.02
|
| Rate for Payer: Humana Medicare Advantage |
$45.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$150.00
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.05
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$44.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.25
|
|
|
PACEMAKER ACCENT DR PM2110
|
Facility
|
OP
|
$38,304.00
|
|
| Hospital Charge Code |
270648446C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$923.13 |
| Max. Negotiated Rate |
$19,152.00 |
| Rate for Payer: Aetna Commercial |
$14,555.52
|
| Rate for Payer: Aetna Medicare Advantage |
$11,491.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,767.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,767.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,660.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,767.52
|
| Rate for Payer: Cigna Commercial |
$19,152.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,269.57
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$8,426.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,745.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$923.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,015.06
|
|
|
PACEMAKER ACCENT DR PM2110
|
Facility
|
IP
|
$38,304.00
|
|
| Hospital Charge Code |
270648446C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,745.60 |
| Max. Negotiated Rate |
$9,269.57 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,660.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,269.57
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$8,426.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,745.60
|
|
|
PACEMAKER ACCENT DR U PR
|
Facility
|
IP
|
$31,920.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
270648446
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,788.00 |
| Max. Negotiated Rate |
$7,724.64 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6,384.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,724.64
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$7,022.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,788.00
|
|
|
PACEMAKER ACCENT DR U PR
|
Facility
|
OP
|
$31,920.00
|
|
| Hospital Charge Code |
27648446C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$769.27 |
| Max. Negotiated Rate |
$15,960.00 |
| Rate for Payer: Aetna Commercial |
$12,129.60
|
| Rate for Payer: Aetna Medicare Advantage |
$9,576.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,139.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,139.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6,384.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,139.60
|
| Rate for Payer: Cigna Commercial |
$15,960.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,724.64
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$7,022.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,788.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$769.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$845.88
|
|
|
PACEMAKER ACCENT DR U PR
|
Facility
|
IP
|
$31,920.00
|
|
| Hospital Charge Code |
27648446C
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,788.00 |
| Max. Negotiated Rate |
$7,724.64 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6,384.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,724.64
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$7,022.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,788.00
|
|
