|
US NEEDLE BIOPSY ABD/RETROPER
|
Facility
|
IP
|
$4,709.90
|
|
|
Service Code
|
HCPCS 49180
|
| Hospital Charge Code |
2101079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$706.49 |
| Max. Negotiated Rate |
$706.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$706.49
|
|
|
US NEEDLE BIOPSY ABD/RETROPER
|
Facility
|
OP
|
$4,709.90
|
|
|
Service Code
|
HCPCS 49180
|
| Hospital Charge Code |
2101079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$113.51 |
| 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 |
$1,412.97
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$706.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$113.51
|
| 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 |
$124.81
|
|
|
US NEEDLE BIOPSY LIVER
|
Facility
|
OP
|
$4,709.90
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
2101038
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$113.51 |
| 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 |
$1,412.97
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$706.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$113.51
|
| 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 |
$124.81
|
|
|
US NEEDLE BIOPSY LIVER
|
Facility
|
IP
|
$4,709.90
|
|
|
Service Code
|
HCPCS 47000
|
| Hospital Charge Code |
2101038
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$706.49 |
| Max. Negotiated Rate |
$706.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$706.49
|
|
|
US NEEDLE BIOPSY LUNG/MEDIAST
|
Facility
|
IP
|
$4,709.90
|
|
|
Service Code
|
HCPCS 32405
|
| Hospital Charge Code |
2101046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$706.49 |
| Max. Negotiated Rate |
$706.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$706.49
|
|
|
US NEEDLE BIOPSY LUNG/MEDIAST
|
Facility
|
OP
|
$4,709.90
|
|
|
Service Code
|
HCPCS 32405
|
| Hospital Charge Code |
2101046
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$113.51 |
| Max. Negotiated Rate |
$2,354.95 |
| Rate for Payer: Aetna Commercial |
$1,789.76
|
| Rate for Payer: Aetna Medicare Advantage |
$1,412.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,201.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,201.02
|
| 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 |
$1,201.02
|
| Rate for Payer: Cigna Commercial |
$2,354.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,412.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$706.49
|
| Rate for Payer: UnitedHealthcare Community & State |
$113.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$124.81
|
|
|
US NEEDLE BIOPSY MUSCLE PERC
|
Facility
|
OP
|
$4,709.90
|
|
|
Service Code
|
HCPCS 20206
|
| Hospital Charge Code |
2101020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$113.51 |
| 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 |
$1,412.97
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$706.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$113.51
|
| 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 |
$124.81
|
|
|
US NEEDLE BIOPSY MUSCLE PERC
|
Facility
|
IP
|
$4,709.90
|
|
|
Service Code
|
HCPCS 20206
|
| Hospital Charge Code |
2101020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$706.49 |
| Max. Negotiated Rate |
$706.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$706.49
|
|
|
US NEEDLE BIOPSY PANCREAS
|
Facility
|
OP
|
$4,350.20
|
|
|
Service Code
|
HCPCS 48102
|
| Hospital Charge Code |
2101012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.84 |
| 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 |
$1,305.06
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$652.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$104.84
|
| 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 |
$115.28
|
|
|
US NEEDLE BIOPSY PANCREAS
|
Facility
|
IP
|
$4,350.20
|
|
|
Service Code
|
HCPCS 48102
|
| Hospital Charge Code |
2101012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$652.53 |
| Max. Negotiated Rate |
$652.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$652.53
|
|
|
US NEEDLE BIOPSY PLEURA
|
Facility
|
IP
|
$4,350.20
|
|
|
Service Code
|
HCPCS 32400
|
| Hospital Charge Code |
2101004
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$652.53 |
| Max. Negotiated Rate |
$652.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$652.53
|
|
|
US NEEDLE BIOPSY PLEURA
|
Facility
|
OP
|
$4,350.20
|
|
|
Service Code
|
HCPCS 32400
|
| Hospital Charge Code |
2101004
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.84 |
| 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 |
$1,305.06
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$652.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$104.84
|
| 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 |
$115.28
|
|
|
US NEEDLE BIOPSY PROSTATE
|
Facility
|
OP
|
$5,244.50
|
|
|
Service Code
|
HCPCS 55700
|
| Hospital Charge Code |
2101087
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$126.39 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$1,992.91
|
| Rate for Payer: Aetna Medicare Advantage |
$1,573.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,337.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,337.35
|
| 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 |
$1,337.35
|
| Rate for Payer: Cigna Commercial |
$2,622.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,573.35
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$786.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$126.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$138.98
|
|
|
US NEEDLE BIOPSY PROSTATE
|
Facility
|
IP
|
$5,244.50
|
|
|
Service Code
|
HCPCS 55700
|
| Hospital Charge Code |
2101087
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$786.67 |
| Max. Negotiated Rate |
$786.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$786.67
|
|
|
US NEEDLE PLACEMENT RENAL BLTL
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301033
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$26.45 |
| Max. Negotiated Rate |
$2,517.00 |
| Rate for Payer: Aetna Commercial |
$417.09
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$71.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$548.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$329.28
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,517.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.09
|
|
|
US NEEDLE PLACEMENT RENAL BLTL
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301033
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US NEEDLE PLACEMENT RENAL LEFT
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301034
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US NEEDLE PLACEMENT RENAL LEFT
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301034
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$26.45 |
| Max. Negotiated Rate |
$2,517.00 |
| Rate for Payer: Aetna Commercial |
$417.09
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$71.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$548.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$329.28
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,517.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.09
|
|
|
US NEEDLE PLACEMENT RENAL RGHT
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301035
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US NEEDLE PLACEMENT RENAL RGHT
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301035
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$26.45 |
| Max. Negotiated Rate |
$2,517.00 |
| Rate for Payer: Aetna Commercial |
$417.09
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$71.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$548.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$329.28
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,517.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.09
|
|
|
US NI LO EXT ANKLE BRAC IND
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93922
|
| Hospital Charge Code |
405393922
|
|
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 NI LO EXT ANKLE BRAC IND
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93922
|
| Hospital Charge Code |
2101100
|
|
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 NI LO EXT ANKLE BRAC IND
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93922
|
| Hospital Charge Code |
2101100
|
|
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 NI LO EXT ANKLE BRAC IND
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93922
|
| Hospital Charge Code |
405393922
|
|
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 NI LO EXT ART MULTI BILAT
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93923
|
| Hospital Charge Code |
2101098
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$243.69 |
| Max. Negotiated Rate |
$6,760.00 |
| Rate for Payer: Aetna Commercial |
$697.73
|
| Rate for Payer: Aetna Medicare Advantage |
$831.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$925.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$256.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$530.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$925.96
|
| Rate for Payer: Cigna Commercial |
$514.20
|
| Rate for Payer: Cigna Medicare Advantage |
$256.52
|
| Rate for Payer: Clover Medicare Advantage |
$243.69
|
| Rate for Payer: EmblemHealth Commercial |
$769.56
|
| Rate for Payer: Humana Medicare Advantage |
$264.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$256.52
|
| 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 |
$256.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.80
|
|