|
RPLC GTUBE NO REVJ TRC
|
Facility
|
OP
|
$1,286.08
|
|
|
Service Code
|
HCPCS 43762
|
| Hospital Charge Code |
16000344
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$30.99 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$807.38
|
| Rate for Payer: Aetna Medicare Advantage |
$961.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,071.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,071.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$296.83
|
| 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 |
$1,071.47
|
| Rate for Payer: Cigna Commercial |
$594.98
|
| Rate for Payer: Cigna Medicare Advantage |
$296.83
|
| Rate for Payer: Clover Medicare Advantage |
$281.99
|
| Rate for Payer: EmblemHealth Commercial |
$890.49
|
| Rate for Payer: Humana Medicare Advantage |
$305.73
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$296.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$385.82
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$192.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$30.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$34.08
|
|
|
RP LOCALTUM 2+AREA 1+D IMG
|
Facility
|
IP
|
$2,155.44
|
|
|
Service Code
|
HCPCS 78801
|
| Hospital Charge Code |
406078801
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$323.32 |
| Max. Negotiated Rate |
$323.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$323.32
|
|
|
RP LOCALTUM 2+AREA 1+D IMG
|
Facility
|
OP
|
$2,155.44
|
|
|
Service Code
|
HCPCS 78801
|
| Hospital Charge Code |
406078801
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$51.95 |
| Max. Negotiated Rate |
$5,021.00 |
| Rate for Payer: Aetna Commercial |
$1,291.84
|
| Rate for Payer: Aetna Medicare Advantage |
$1,538.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,714.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,714.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$474.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$291.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,714.39
|
| Rate for Payer: Cigna Commercial |
$952.02
|
| Rate for Payer: Cigna Medicare Advantage |
$332.46
|
| Rate for Payer: Clover Medicare Advantage |
$451.19
|
| Rate for Payer: EmblemHealth Commercial |
$1,424.82
|
| Rate for Payer: Humana Medicare Advantage |
$489.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$474.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$646.63
|
| Rate for Payer: Oxford Commercial |
$3,120.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$323.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,021.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$51.95
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$57.12
|
|
|
RP LOCAL TUM SPECT 2 AREAS
|
Facility
|
OP
|
$7,449.00
|
|
|
Service Code
|
HCPCS 78831
|
| Hospital Charge Code |
406078831
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$179.52 |
| Max. Negotiated Rate |
$5,552.01 |
| Rate for Payer: Aetna Commercial |
$4,183.58
|
| Rate for Payer: Aetna Medicare Advantage |
$4,983.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,552.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,552.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,538.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$637.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,552.01
|
| Rate for Payer: Cigna Commercial |
$3,083.08
|
| Rate for Payer: Cigna Medicare Advantage |
$1,076.66
|
| Rate for Payer: Clover Medicare Advantage |
$1,461.18
|
| Rate for Payer: EmblemHealth Commercial |
$4,614.24
|
| Rate for Payer: Humana Medicare Advantage |
$1,584.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,538.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,234.70
|
| Rate for Payer: Oxford Commercial |
$3,120.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,117.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,021.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$179.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,538.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,538.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$197.40
|
|
|
RP LOCAL TUM SPECT 2 AREAS
|
Facility
|
IP
|
$7,449.00
|
|
|
Service Code
|
HCPCS 78831
|
| Hospital Charge Code |
406078831
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,117.35 |
| Max. Negotiated Rate |
$1,117.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,117.35
|
|
|
RP LOCAL TUM SPECT W/CT 1
|
Facility
|
IP
|
$7,449.00
|
|
|
Service Code
|
HCPCS 78830
|
| Hospital Charge Code |
406078830
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,117.35 |
| Max. Negotiated Rate |
$1,117.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,117.35
|
|
|
RP LOCAL TUM SPECT W/CT 1
|
Facility
|
OP
|
$7,449.00
|
|
|
Service Code
|
HCPCS 78830
|
| Hospital Charge Code |
406078830
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$179.52 |
| Max. Negotiated Rate |
$5,552.01 |
| Rate for Payer: Aetna Commercial |
$4,183.58
|
| Rate for Payer: Aetna Medicare Advantage |
$4,983.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,552.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,552.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,538.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$440.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,552.01
|
| Rate for Payer: Cigna Commercial |
$3,083.08
|
| Rate for Payer: Cigna Medicare Advantage |
$1,076.66
|
| Rate for Payer: Clover Medicare Advantage |
$1,461.18
|
| Rate for Payer: EmblemHealth Commercial |
$4,614.24
|
| Rate for Payer: Humana Medicare Advantage |
$1,584.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,538.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,234.70
|
| Rate for Payer: Oxford Commercial |
$3,120.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,117.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,021.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$179.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,538.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,538.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$197.40
|
|
|
RP LOCAL TUM SPECT W/CT 2
|
Facility
|
OP
|
$8,450.06
|
|
|
Service Code
|
HCPCS 78832
|
| Hospital Charge Code |
406078832
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$203.65 |
| Max. Negotiated Rate |
$6,132.23 |
| Rate for Payer: Aetna Commercial |
$4,620.79
|
| Rate for Payer: Aetna Medicare Advantage |
$5,504.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,132.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,132.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,698.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$830.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,132.23
|
| Rate for Payer: Cigna Commercial |
$3,405.27
|
| Rate for Payer: Cigna Medicare Advantage |
$1,189.17
|
| Rate for Payer: Clover Medicare Advantage |
$1,613.88
|
| Rate for Payer: EmblemHealth Commercial |
$5,096.46
|
| Rate for Payer: Humana Medicare Advantage |
$1,749.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,698.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,535.02
|
| Rate for Payer: Oxford Commercial |
$3,120.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,267.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,021.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$203.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,698.82
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,698.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$223.93
|
|
|
RP LOCAL TUM SPECT W/CT 2
|
Facility
|
IP
|
$8,450.06
|
|
|
Service Code
|
HCPCS 78832
|
| Hospital Charge Code |
406078832
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,267.51 |
| Max. Negotiated Rate |
$1,267.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,267.51
|
|
|
RP LOC TUMOR, W B, 2 OR > DAYS
|
Facility
|
IP
|
$5,849.36
|
|
|
Service Code
|
HCPCS 78804
|
| Hospital Charge Code |
7411761
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$877.40 |
| Max. Negotiated Rate |
$877.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$877.40
|
|
|
RP LOC TUMOR, W B, 2 OR > DAYS
|
Facility
|
IP
|
$5,849.36
|
|
|
Service Code
|
HCPCS 78804
|
| Hospital Charge Code |
2680370
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$877.40 |
| Max. Negotiated Rate |
$877.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$877.40
|
|
|
RP LOC TUMOR, W B, 2 OR > DAYS
|
Facility
|
OP
|
$5,849.36
|
|
|
Service Code
|
HCPCS 78804
|
| Hospital Charge Code |
2680370
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$140.97 |
| Max. Negotiated Rate |
$5,021.00 |
| Rate for Payer: Aetna Commercial |
$1,754.56
|
| Rate for Payer: Aetna Medicare Advantage |
$2,089.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,328.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,328.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$645.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$380.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,328.47
|
| Rate for Payer: Cigna Commercial |
$1,293.03
|
| Rate for Payer: Cigna Medicare Advantage |
$451.54
|
| Rate for Payer: Clover Medicare Advantage |
$612.81
|
| Rate for Payer: EmblemHealth Commercial |
$1,935.18
|
| Rate for Payer: Humana Medicare Advantage |
$664.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$645.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,754.81
|
| Rate for Payer: Oxford Commercial |
$3,120.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$877.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,021.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$155.01
|
|
|
RP LOC TUMOR, W B, 2 OR > DAYS
|
Facility
|
OP
|
$5,849.36
|
|
|
Service Code
|
HCPCS 78804
|
| Hospital Charge Code |
7411761
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$140.97 |
| Max. Negotiated Rate |
$5,021.00 |
| Rate for Payer: Aetna Commercial |
$1,754.56
|
| Rate for Payer: Aetna Medicare Advantage |
$2,089.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,328.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,328.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$645.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$380.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,328.47
|
| Rate for Payer: Cigna Commercial |
$1,293.03
|
| Rate for Payer: Cigna Medicare Advantage |
$451.54
|
| Rate for Payer: Clover Medicare Advantage |
$612.81
|
| Rate for Payer: EmblemHealth Commercial |
$1,935.18
|
| Rate for Payer: Humana Medicare Advantage |
$664.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$645.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,754.81
|
| Rate for Payer: Oxford Commercial |
$3,120.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$877.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,021.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$155.01
|
|
|
RPR
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 86592
|
| Hospital Charge Code |
3004694
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
RPR
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 86592
|
| Hospital Charge Code |
3004694
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.90 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$11.61
|
| Rate for Payer: Aetna Medicare Advantage |
$13.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.41
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$4.27
|
| Rate for Payer: Clover Medicare Advantage |
$4.06
|
| Rate for Payer: EmblemHealth Commercial |
$12.81
|
| Rate for Payer: Humana Medicare Advantage |
$4.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$200.28
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.27
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.69
|
|
|
RPR AA HRN 1ST > 10 NCR/STRN
|
Facility
|
IP
|
$11,151.60
|
|
|
Service Code
|
HCPCS 49596
|
| Hospital Charge Code |
16000754
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,672.74 |
| Max. Negotiated Rate |
$1,672.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,672.74
|
|
|
RPR AA HRN 1ST > 10 NCR/STRN
|
Facility
|
OP
|
$11,151.60
|
|
|
Service Code
|
HCPCS 49596
|
| Hospital Charge Code |
16000754
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$268.75 |
| Max. Negotiated Rate |
$14,834.00 |
| Rate for Payer: Aetna Commercial |
$4,237.61
|
| Rate for Payer: Aetna Medicare Advantage |
$3,345.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,843.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,843.66
|
| 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 |
$2,843.66
|
| Rate for Payer: Cigna Commercial |
$5,575.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,345.48
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,672.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$268.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$295.52
|
|
|
RPR AA HRN 1ST 3-10 NCR/STRN
|
Facility
|
IP
|
$25,013.88
|
|
|
Service Code
|
HCPCS 49594
|
| Hospital Charge Code |
160000184
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,752.08 |
| Max. Negotiated Rate |
$3,752.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,752.08
|
|
|
RPR AA HRN 1ST 3-10 NCR/STRN
|
Facility
|
OP
|
$25,013.88
|
|
|
Service Code
|
HCPCS 49594
|
| Hospital Charge Code |
160000184
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$602.83 |
| 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 |
$7,504.16
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,752.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$602.83
|
| 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 |
$662.87
|
|
|
RPR AA HRN 1ST 3-10 RDC
|
Facility
|
IP
|
$16,997.00
|
|
|
Service Code
|
HCPCS 49593
|
| Hospital Charge Code |
1600000265
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,549.55 |
| Max. Negotiated Rate |
$2,549.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,549.55
|
|
|
RPR AA HRN 1ST 3-10 RDC
|
Facility
|
OP
|
$16,997.60
|
|
|
Service Code
|
HCPCS 49593
|
| Hospital Charge Code |
1600000382
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$409.64 |
| Max. Negotiated Rate |
$27,762.46 |
| Rate for Payer: Aetna Commercial |
$20,919.71
|
| Rate for Payer: Aetna Medicare Advantage |
$24,919.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27,762.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27,762.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,691.07
|
| 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 |
$27,762.46
|
| Rate for Payer: Cigna Commercial |
$15,416.72
|
| Rate for Payer: Cigna Medicare Advantage |
$7,691.07
|
| Rate for Payer: Clover Medicare Advantage |
$7,306.52
|
| Rate for Payer: EmblemHealth Commercial |
$23,073.21
|
| Rate for Payer: Humana Medicare Advantage |
$7,921.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,691.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,099.28
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,549.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$409.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,691.07
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,691.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$450.44
|
|
|
RPR AA HRN 1ST 3-10 RDC
|
Facility
|
IP
|
$16,997.60
|
|
|
Service Code
|
HCPCS 49593
|
| Hospital Charge Code |
1600000382
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,549.64 |
| Max. Negotiated Rate |
$2,549.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,549.64
|
|
|
RPR AA HRN 1ST 3-10 RDC
|
Facility
|
OP
|
$16,997.00
|
|
|
Service Code
|
HCPCS 49593
|
| Hospital Charge Code |
1600000265
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$409.63 |
| Max. Negotiated Rate |
$27,762.46 |
| Rate for Payer: Aetna Commercial |
$20,919.71
|
| Rate for Payer: Aetna Medicare Advantage |
$24,919.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27,762.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27,762.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,691.07
|
| 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 |
$27,762.46
|
| Rate for Payer: Cigna Commercial |
$15,416.72
|
| Rate for Payer: Cigna Medicare Advantage |
$7,691.07
|
| Rate for Payer: Clover Medicare Advantage |
$7,306.52
|
| Rate for Payer: EmblemHealth Commercial |
$23,073.21
|
| Rate for Payer: Humana Medicare Advantage |
$7,921.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,691.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,099.10
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,549.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$409.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,691.07
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,691.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$450.42
|
|
|
RPR AA HRN 1ST < 3 CM RDC
|
Facility
|
OP
|
$16,997.60
|
|
|
Service Code
|
HCPCS 49591
|
| Hospital Charge Code |
16000992
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$409.64 |
| Max. Negotiated Rate |
$15,354.26 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,354.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,354.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,354.26
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,099.28
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,549.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$409.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$450.44
|
|
|
RPR AA HRN 1ST < 3 CM RDC
|
Facility
|
IP
|
$16,997.60
|
|
|
Service Code
|
HCPCS 49591
|
| Hospital Charge Code |
16000992
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,549.64 |
| Max. Negotiated Rate |
$2,549.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,549.64
|
|
