|
US INFERIOR VENA CAVA DPLX LMT
|
Facility
|
OP
|
$563.15
|
|
|
Service Code
|
HCPCS 93979
|
| Hospital Charge Code |
2301027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$13.57 |
| 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 |
$371.71
|
| 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 |
$168.94
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,760.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.92
|
|
|
US INSERT CV CATH W/O PORT>5YR
|
Facility
|
IP
|
$7,852.40
|
|
|
Service Code
|
HCPCS 36569
|
| Hospital Charge Code |
2301100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,177.86 |
| Max. Negotiated Rate |
$1,177.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,177.86
|
|
|
US INSERT CV CATH W/O PORT>5YR
|
Facility
|
OP
|
$7,852.40
|
|
|
Service Code
|
HCPCS 36569
|
| Hospital Charge Code |
2301100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$189.24 |
| Max. Negotiated Rate |
$6,750.64 |
| Rate for Payer: Aetna Commercial |
$5,086.78
|
| Rate for Payer: Aetna Medicare Advantage |
$6,059.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,750.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,750.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,870.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,750.64
|
| Rate for Payer: Cigna Commercial |
$3,748.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,870.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,776.63
|
| Rate for Payer: EmblemHealth Commercial |
$5,610.42
|
| Rate for Payer: Humana Medicare Advantage |
$1,926.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,870.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,355.72
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,177.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$189.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$208.09
|
|
|
US INTRAVASCULAR INITIAL VESSL
|
Facility
|
OP
|
$905.70
|
|
|
Service Code
|
HCPCS 75945
|
| Hospital Charge Code |
2301028
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$21.83 |
| Max. Negotiated Rate |
$1,975.00 |
| Rate for Payer: Aetna Commercial |
$344.17
|
| Rate for Payer: Aetna Medicare Advantage |
$271.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$230.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$230.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$230.95
|
| Rate for Payer: Cigna Commercial |
$452.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$271.71
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.00
|
|
|
US INTRAVASCULAR INITIAL VESSL
|
Facility
|
IP
|
$905.70
|
|
|
Service Code
|
HCPCS 75945
|
| Hospital Charge Code |
2301028
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$135.85 |
| Max. Negotiated Rate |
$135.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$135.85
|
|
|
US-KIDNEY TRANSPLANT
|
Facility
|
IP
|
$517.00
|
|
| Hospital Charge Code |
2309001
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$77.55 |
| Max. Negotiated Rate |
$77.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.55
|
|
|
US-KIDNEY TRANSPLANT
|
Facility
|
OP
|
$517.00
|
|
| Hospital Charge Code |
2309001
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$12.46 |
| Max. Negotiated Rate |
$2,517.00 |
| Rate for Payer: Aetna Commercial |
$196.46
|
| Rate for Payer: Aetna Medicare Advantage |
$155.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$131.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$131.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$131.84
|
| Rate for Payer: Cigna Commercial |
$258.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$155.10
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,517.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.70
|
|
|
US KIDNEY TRANSPLANT BILATERAL
|
Facility
|
OP
|
$6,700.00
|
|
|
Service Code
|
HCPCS 76776
|
| Hospital Charge Code |
2301029
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.12 |
| Max. Negotiated Rate |
$2,517.00 |
| 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 |
$76.12
|
| 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 |
$2,010.00
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,517.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$407.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$177.55
|
|
|
US KIDNEY TRANSPLANT BILATERAL
|
Facility
|
IP
|
$6,700.00
|
|
|
Service Code
|
HCPCS 76776
|
| Hospital Charge Code |
2301029
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,005.00 |
| Max. Negotiated Rate |
$1,005.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.00
|
|
|
US KIDNEY TRANSPLANT BILATERAL
|
Facility
|
IP
|
$6,700.00
|
|
|
Service Code
|
HCPCS 76776
|
| Hospital Charge Code |
94061506
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,005.00 |
| Max. Negotiated Rate |
$1,005.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.00
|
|
|
US KIDNEY TRANSPLANT BILATERAL
|
Facility
|
OP
|
$6,700.00
|
|
|
Service Code
|
HCPCS 76776
|
| Hospital Charge Code |
94061506
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$76.12 |
| Max. Negotiated Rate |
$2,517.00 |
| 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 |
$76.12
|
| 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 |
$2,010.00
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,517.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$407.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$177.55
|
|
|
US KIDNEY TRANSPLANT LEFT
|
Facility
|
OP
|
$571.55
|
|
|
Service Code
|
HCPCS 76776
|
| Hospital Charge Code |
2301030
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$13.77 |
| Max. Negotiated Rate |
$2,517.00 |
| 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 |
$76.12
|
| 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 |
$171.47
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,517.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$407.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.15
|
|
|
US KIDNEY TRANSPLANT LEFT
|
Facility
|
IP
|
$571.55
|
|
|
Service Code
|
HCPCS 76776
|
| Hospital Charge Code |
2301030
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$85.73 |
| Max. Negotiated Rate |
$85.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.73
|
|
|
US KIDNEY TRANSPLANT RIGHT
|
Facility
|
OP
|
$571.55
|
|
|
Service Code
|
HCPCS 76776
|
| Hospital Charge Code |
2301031
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$13.77 |
| Max. Negotiated Rate |
$2,517.00 |
| 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 |
$76.12
|
| 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 |
$171.47
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,517.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$407.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.15
|
|
|
US KIDNEY TRANSPLANT RIGHT
|
Facility
|
IP
|
$571.55
|
|
|
Service Code
|
HCPCS 76776
|
| Hospital Charge Code |
2301031
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$85.73 |
| Max. Negotiated Rate |
$85.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.73
|
|
|
US LE ARTERIAL DUPLEX RIGHT
|
Facility
|
IP
|
$1,079.25
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
2301032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$161.89 |
| Max. Negotiated Rate |
$161.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.89
|
|
|
US LE ARTERIAL DUPLEX RIGHT
|
Facility
|
OP
|
$1,079.25
|
|
|
Service Code
|
HCPCS 93926
|
| Hospital Charge Code |
2301032
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$26.01 |
| Max. Negotiated Rate |
$2,301.00 |
| 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 |
$423.98
|
| 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 |
$323.77
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,301.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.60
|
|
|
US LE ARTRAL DPPLR 1-2 LVL BL
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93922
|
| Hospital Charge Code |
2301065
|
|
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
|
|
|
US LE ARTRAL DPPLR 1-2 LVL BL
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93922
|
| Hospital Charge Code |
2301065
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$150.16 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: Aetna Medicare Advantage |
$512.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$158.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$425.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$570.55
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$158.06
|
| Rate for Payer: Clover Medicare Advantage |
$150.16
|
| Rate for Payer: EmblemHealth Commercial |
$474.18
|
| Rate for Payer: Humana Medicare Advantage |
$162.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$158.06
|
| 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 |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|
|
US NDL BIOPSY BONE DEEP PERC
|
Facility
|
IP
|
$7,219.95
|
|
|
Service Code
|
HCPCS 20225
|
| Hospital Charge Code |
2101061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,082.99 |
| Max. Negotiated Rate |
$1,082.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,082.99
|
|
|
US NDL BIOPSY BONE DEEP PERC
|
Facility
|
OP
|
$7,219.95
|
|
|
Service Code
|
HCPCS 20225
|
| Hospital Charge Code |
2101061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$7,082.74 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,016.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,082.74
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,165.99
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,082.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$174.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$191.33
|
|
|
US NDL BIOPSY BONE SUPERFIC
|
Facility
|
OP
|
$3,749.80
|
|
|
Service Code
|
HCPCS 20220
|
| Hospital Charge Code |
2101053
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$90.37 |
| Max. Negotiated Rate |
$7,082.74 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,082.74
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,124.94
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$90.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$99.37
|
|
|
US NDL BIOPSY BONE SUPERFIC
|
Facility
|
IP
|
$3,749.80
|
|
|
Service Code
|
HCPCS 20220
|
| Hospital Charge Code |
2101053
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$562.47 |
| Max. Negotiated Rate |
$562.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.47
|
|
|
US NECK/HEAD SOFT TISSUES
|
Facility
|
IP
|
$6,700.00
|
|
|
Service Code
|
HCPCS 76536
|
| Hospital Charge Code |
2100923
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,005.00 |
| Max. Negotiated Rate |
$1,005.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.00
|
|
|
US NECK/HEAD SOFT TISSUES
|
Facility
|
OP
|
$6,700.00
|
|
|
Service Code
|
HCPCS 76536
|
| Hospital Charge Code |
2100923
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$79.26 |
| Max. Negotiated Rate |
$2,517.00 |
| 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 |
$79.26
|
| 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 |
$2,010.00
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,517.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$177.55
|
|
