|
PERQ NJX ALGC FLUOR LMBR 1ST
|
Facility
|
OP
|
$59,508.84
|
|
|
Service Code
|
HCPCS 0627T
|
| Hospital Charge Code |
1600000770
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,434.16 |
| Max. Negotiated Rate |
$55,057.64 |
| Rate for Payer: Aetna Commercial |
$41,487.32
|
| Rate for Payer: Aetna Medicare Advantage |
$49,418.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55,057.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55,057.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15,252.69
|
| 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 |
$55,057.64
|
| Rate for Payer: Cigna Commercial |
$30,573.98
|
| Rate for Payer: Cigna Medicare Advantage |
$15,252.69
|
| Rate for Payer: Clover Medicare Advantage |
$14,490.06
|
| Rate for Payer: EmblemHealth Commercial |
$45,758.07
|
| Rate for Payer: Humana Medicare Advantage |
$15,710.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15,252.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17,852.65
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8,926.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,434.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,576.98
|
|
|
PERQ PLMT BILE DUCT STENT
|
Facility
|
IP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47538
|
| Hospital Charge Code |
404647538
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,639.63 |
| Max. Negotiated Rate |
$3,639.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
|
|
PERQ PLMT BILE DUCT STENT
|
Facility
|
IP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47540
|
| Hospital Charge Code |
7411569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,639.63 |
| Max. Negotiated Rate |
$3,639.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
|
|
PERQ PLMT BILE DUCT STENT
|
Facility
|
OP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47539
|
| Hospital Charge Code |
7411568
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,279.26
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$584.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$643.00
|
|
|
PERQ PLMT BILE DUCT STENT
|
Facility
|
IP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47539
|
| Hospital Charge Code |
7411568
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,639.63 |
| Max. Negotiated Rate |
$3,639.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
|
|
PERQ PLMT BILE DUCT STENT
|
Facility
|
OP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47538
|
| Hospital Charge Code |
404647538
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,279.26
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$584.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$643.00
|
|
|
PERQ PLMT BILE DUCT STENT
|
Facility
|
OP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47540
|
| Hospital Charge Code |
7411569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,279.26
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$584.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$643.00
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
IP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47540
|
| Hospital Charge Code |
366847540
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,639.63 |
| Max. Negotiated Rate |
$3,639.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
IP
|
$26,912.85
|
|
|
Service Code
|
HCPCS 47539
|
| Hospital Charge Code |
321047539
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,036.93 |
| Max. Negotiated Rate |
$4,036.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,036.93
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
OP
|
$26,912.85
|
|
|
Service Code
|
HCPCS 47540
|
| Hospital Charge Code |
2600234
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$648.60 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,073.85
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,036.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$648.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$713.19
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
IP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47538
|
| Hospital Charge Code |
366847538
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,639.63 |
| Max. Negotiated Rate |
$3,639.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
IP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47539
|
| Hospital Charge Code |
2011570
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,639.63 |
| Max. Negotiated Rate |
$3,639.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
IP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47538
|
| Hospital Charge Code |
2011569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,639.63 |
| Max. Negotiated Rate |
$3,639.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
OP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47538
|
| Hospital Charge Code |
2011569
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,279.26
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$584.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$643.00
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
OP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47540
|
| Hospital Charge Code |
2011571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,279.26
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$584.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$643.00
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
OP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47539
|
| Hospital Charge Code |
366847539
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,279.26
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$584.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$643.00
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
OP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47539
|
| Hospital Charge Code |
2011570
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,279.26
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$584.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$643.00
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
OP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47540
|
| Hospital Charge Code |
366847540
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,279.26
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$584.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$643.00
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
OP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47539
|
| Hospital Charge Code |
411047539
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,279.26
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$584.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$643.00
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
OP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47540
|
| Hospital Charge Code |
411047540
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,279.26
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$584.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$643.00
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
OP
|
$26,912.85
|
|
|
Service Code
|
HCPCS 47538
|
| Hospital Charge Code |
321047538
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$648.60 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,073.85
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,036.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$648.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$713.19
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
OP
|
$26,912.85
|
|
|
Service Code
|
HCPCS 47538
|
| Hospital Charge Code |
2600232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$648.60 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,073.85
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,036.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$648.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$713.19
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
IP
|
$26,912.85
|
|
|
Service Code
|
HCPCS 47538
|
| Hospital Charge Code |
2600232
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,036.93 |
| Max. Negotiated Rate |
$4,036.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,036.93
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
OP
|
$24,264.20
|
|
|
Service Code
|
HCPCS 47538
|
| Hospital Charge Code |
7411567
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$25,925.77 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,925.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$25,925.77
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,279.26
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,639.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$584.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$643.00
|
|
|
PERQ PLMT BILE DUCT STENT(S)
|
Facility
|
IP
|
$26,912.85
|
|
|
Service Code
|
HCPCS 47539
|
| Hospital Charge Code |
2600233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,036.93 |
| Max. Negotiated Rate |
$4,036.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,036.93
|
|
