|
RENAL ANG-SUPSEL W/AOR-RT
|
Facility
|
OP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 25628RT
|
| Hospital Charge Code |
321036253R
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$617.65 |
| Max. Negotiated Rate |
$12,814.23 |
| Rate for Payer: Aetna Commercial |
$9,738.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,688.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,535.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,535.25
|
| 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 |
$6,535.25
|
| Rate for Payer: Cigna Commercial |
$12,814.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,688.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$617.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$679.15
|
|
|
RENAL ANG-SUPSEL W/AOR-RT
|
Facility
|
OP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 36253RT
|
| Hospital Charge Code |
2691295
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$617.65 |
| Max. Negotiated Rate |
$12,814.23 |
| Rate for Payer: Aetna Commercial |
$9,738.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,688.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,535.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,535.25
|
| 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 |
$6,535.25
|
| Rate for Payer: Cigna Commercial |
$12,814.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,688.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$617.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$679.15
|
|
|
RENAL ANG-SUPSEL W/AOR-RT
|
Facility
|
IP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 36253RT
|
| Hospital Charge Code |
2691295
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,844.27 |
| Max. Negotiated Rate |
$3,844.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
|
|
RENAL ANG-SUPSEL W/AOR-RT
|
Facility
|
IP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 36253RT
|
| Hospital Charge Code |
7411915
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,844.27 |
| Max. Negotiated Rate |
$3,844.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
|
|
RENAL ANG-SUPSEL W/AOR-RT
|
Facility
|
IP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 25628RT
|
| Hospital Charge Code |
321036253R
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,844.27 |
| Max. Negotiated Rate |
$3,844.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
|
|
RENAL ANG-SUPSEL W/AOR-RT
|
Facility
|
OP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 36253RT
|
| Hospital Charge Code |
7411915
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$617.65 |
| Max. Negotiated Rate |
$12,814.23 |
| Rate for Payer: Aetna Commercial |
$9,738.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,688.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,535.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,535.25
|
| 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 |
$6,535.25
|
| Rate for Payer: Cigna Commercial |
$12,814.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,688.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$617.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$679.15
|
|
|
RENAL ARTERIO-BIL
|
Facility
|
OP
|
$7,281.00
|
|
| Hospital Charge Code |
2009010
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$175.47 |
| Max. Negotiated Rate |
$3,640.50 |
| Rate for Payer: Aetna Commercial |
$2,766.78
|
| Rate for Payer: Aetna Medicare Advantage |
$2,184.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,856.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,856.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,856.65
|
| Rate for Payer: Cigna Commercial |
$3,640.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,184.30
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,092.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$175.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$192.95
|
|
|
RENAL ARTERIO-BIL
|
Facility
|
IP
|
$7,281.00
|
|
| Hospital Charge Code |
2009010
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,092.15 |
| Max. Negotiated Rate |
$1,092.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,092.15
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
2101111
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$627.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,023.24
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$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 |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
74115050
|
|
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
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
74117050
|
|
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
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
74117050
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$627.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,023.24
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$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 |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
OP
|
$1,680.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
94053260
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$40.49 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$627.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,023.24
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$504.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$252.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$40.49
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$44.52
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
74115050
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$627.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,023.24
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$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 |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
2101111
|
|
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
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
74116050
|
|
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
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
IP
|
$1,680.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
94053260
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$252.00 |
| Max. Negotiated Rate |
$252.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$252.00
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
74116050
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$627.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,023.24
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$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 |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
2692165
|
|
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
|
|
|
RENAL ARTERY DUPLEX SCAN
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93975
|
| Hospital Charge Code |
2692165
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,023.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$627.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,023.24
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$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 |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
RENAL ARTERY DUPLEX SCAN LTD
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93976
|
| Hospital Charge Code |
2692170
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$117.99 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$551.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$124.20
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| 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 |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
RENAL ARTERY DUPLEX SCAN LTD
|
Facility
|
IP
|
$1,555.25
|
|
|
Service Code
|
HCPCS 93976
|
| Hospital Charge Code |
94053265
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$233.29 |
| Max. Negotiated Rate |
$233.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$233.29
|
|
|
RENAL ARTERY DUPLEX SCAN LTD
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93976
|
| Hospital Charge Code |
74115051
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$117.99 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$551.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$124.20
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| 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 |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
RENAL ARTERY DUPLEX SCAN LTD
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93976
|
| Hospital Charge Code |
421593976
|
|
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
|
|
|
RENAL ARTERY DUPLEX SCAN LTD
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93976
|
| Hospital Charge Code |
74117051
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$19.01 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$551.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$124.20
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$236.70
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.91
|
|