|
XP EXPANDABLE LUMBAR INTERBODY
|
Facility
|
OP
|
$20,000.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
270704667
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$482.00 |
| Max. Negotiated Rate |
$10,000.00 |
| Rate for Payer: Aetna Commercial |
$7,600.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6,000.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,000.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,100.00
|
| Rate for Payer: Cigna Commercial |
$10,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,840.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$4,400.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,000.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$482.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$530.00
|
|
|
X-PLATE VA LCKG 2.4/2.7MM MED
|
Facility
|
IP
|
$4,347.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$652.14 |
| Max. Negotiated Rate |
$1,052.12 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$869.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,052.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$956.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$652.14
|
|
|
X-PLATE VA LCKG 2.4/2.7MM MED
|
Facility
|
OP
|
$4,347.60
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$104.78 |
| Max. Negotiated Rate |
$2,173.80 |
| Rate for Payer: Aetna Commercial |
$1,652.09
|
| Rate for Payer: Aetna Medicare Advantage |
$1,304.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,108.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,108.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$869.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,108.64
|
| Rate for Payer: Cigna Commercial |
$2,173.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,052.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$956.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$652.14
|
| Rate for Payer: UnitedHealthcare Community & State |
$104.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$115.21
|
|
|
X-PLATE VA LCKG 3.7MM MED
|
Facility
|
OP
|
$670.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270689594
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.17 |
| Max. Negotiated Rate |
$335.40 |
| Rate for Payer: Aetna Commercial |
$254.90
|
| Rate for Payer: Aetna Medicare Advantage |
$201.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$171.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$171.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$134.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$171.05
|
| Rate for Payer: Cigna Commercial |
$335.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$162.33
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$147.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.62
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.78
|
|
|
X-PLATE VA LCKG 3.7MM MED
|
Facility
|
IP
|
$670.80
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270689594
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$100.62 |
| Max. Negotiated Rate |
$162.33 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$134.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$162.33
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$147.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.62
|
|
|
XR ABDMEN AP OBLIQUE CONE VIEW
|
Facility
|
OP
|
$258.70
|
|
|
Service Code
|
HCPCS 74010
|
| Hospital Charge Code |
2011304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$1,975.00 |
| Rate for Payer: Aetna Commercial |
$98.31
|
| Rate for Payer: Aetna Medicare Advantage |
$77.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$65.97
|
| Rate for Payer: Cigna Commercial |
$129.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$77.61
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.23
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$247.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.86
|
|
|
XR ABDMEN AP OBLIQUE CONE VIEW
|
Facility
|
IP
|
$258.70
|
|
|
Service Code
|
HCPCS 74010
|
| Hospital Charge Code |
2011304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$38.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.80
|
|
|
XR ABDMEN SERIES W/CHEST 1VIEW
|
Facility
|
OP
|
$440.25
|
|
|
Service Code
|
HCPCS 74022
|
| Hospital Charge Code |
2011305
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$1,975.00 |
| 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 |
$53.24
|
| 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 |
$86.94
|
| 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 |
$132.07
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.61
|
| 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 |
$11.67
|
|
|
XR ABDMEN SERIES W/CHEST 1VIEW
|
Facility
|
IP
|
$440.25
|
|
|
Service Code
|
HCPCS 74022
|
| Hospital Charge Code |
2011305
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$66.04 |
| Max. Negotiated Rate |
$66.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.04
|
|
|
XR ABDOMEN 1 VIEW PORTABLE
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 74018
|
| Hospital Charge Code |
2002780
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
XR ABDOMEN 1 VIEW PORTABLE
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 74018
|
| Hospital Charge Code |
2002780
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$1,975.00 |
| Rate for Payer: Aetna Commercial |
$281.22
|
| Rate for Payer: Aetna Medicare Advantage |
$334.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$103.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.21
|
| Rate for Payer: Cigna Commercial |
$207.24
|
| Rate for Payer: Cigna Medicare Advantage |
$72.37
|
| Rate for Payer: Clover Medicare Advantage |
$98.22
|
| Rate for Payer: EmblemHealth Commercial |
$310.17
|
| Rate for Payer: Humana Medicare Advantage |
$106.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$103.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,530.00
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$122.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.15
|
|
|
XR ABDOMEN 2 VWS W DECUB ERECT
|
Facility
|
IP
|
$204.00
|
|
|
Service Code
|
HCPCS 74020
|
| Hospital Charge Code |
2000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.60
|
|
|
XR ABDOMEN 2 VWS W DECUB ERECT
|
Facility
|
OP
|
$204.00
|
|
|
Service Code
|
HCPCS 74020
|
| Hospital Charge Code |
2000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$4.92 |
| Max. Negotiated Rate |
$1,975.00 |
| Rate for Payer: Aetna Commercial |
$77.52
|
| Rate for Payer: Aetna Medicare Advantage |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.02
|
| Rate for Payer: Cigna Commercial |
$102.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.20
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.92
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$216.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.41
|
|
|
XR ABDOMEN MULT VIEWS
|
Facility
|
IP
|
$6,601.19
|
|
|
Service Code
|
HCPCS 74022
|
| Hospital Charge Code |
2000214
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$990.18 |
| Max. Negotiated Rate |
$990.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$990.18
|
|
|
XR ABDOMEN MULT VIEWS
|
Facility
|
OP
|
$6,601.19
|
|
|
Service Code
|
HCPCS 74022
|
| Hospital Charge Code |
2000214
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.24 |
| Max. Negotiated Rate |
$1,980.36 |
| 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 |
$53.24
|
| 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 |
$86.94
|
| 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 |
$1,980.36
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$990.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$159.09
|
| 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 |
$174.93
|
|
|
XR ABDOMEN ONE VIEW
|
Facility
|
IP
|
$6,601.19
|
|
|
Service Code
|
HCPCS 74018
|
| Hospital Charge Code |
2000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$990.18 |
| Max. Negotiated Rate |
$990.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$990.18
|
|
|
XR ABDOMEN ONE VIEW
|
Facility
|
OP
|
$6,601.19
|
|
|
Service Code
|
HCPCS 74018
|
| Hospital Charge Code |
2000198
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$1,980.36 |
| Rate for Payer: Aetna Commercial |
$281.22
|
| Rate for Payer: Aetna Medicare Advantage |
$334.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$373.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$373.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$103.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$373.21
|
| Rate for Payer: Cigna Commercial |
$207.24
|
| Rate for Payer: Cigna Medicare Advantage |
$72.37
|
| Rate for Payer: Clover Medicare Advantage |
$98.22
|
| Rate for Payer: EmblemHealth Commercial |
$310.17
|
| Rate for Payer: Humana Medicare Advantage |
$106.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$103.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,980.36
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$990.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$159.09
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$174.93
|
|
|
XR ABDOMEN TWO VIEWS PORTABLE
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 74019
|
| Hospital Charge Code |
2003051
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
XR ABDOMEN TWO VIEWS PORTABLE
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 74019
|
| Hospital Charge Code |
2003051
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$38.57 |
| Max. Negotiated Rate |
$1,975.00 |
| 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 |
$38.57
|
| 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 |
$86.94
|
| 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 |
$1,530.00
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$122.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.15
|
|
|
XR ABLATE BONE TUMOR(S) PERQ
|
Facility
|
IP
|
$33,376.25
|
|
|
Service Code
|
HCPCS 20982
|
| Hospital Charge Code |
5600102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,006.44 |
| Max. Negotiated Rate |
$5,006.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,006.44
|
|
|
XR ABLATE BONE TUMOR(S) PERQ
|
Facility
|
OP
|
$20,597.50
|
|
|
Service Code
|
HCPCS 20982
|
| Hospital Charge Code |
7411348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$496.40 |
| Max. Negotiated Rate |
$75,192.36 |
| Rate for Payer: Aetna Commercial |
$56,659.34
|
| Rate for Payer: Aetna Medicare Advantage |
$67,491.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75,192.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75,192.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20,830.64
|
| 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 |
$75,192.36
|
| Rate for Payer: Cigna Commercial |
$41,754.94
|
| Rate for Payer: Cigna Medicare Advantage |
$20,830.64
|
| Rate for Payer: Clover Medicare Advantage |
$19,789.11
|
| Rate for Payer: EmblemHealth Commercial |
$62,491.92
|
| Rate for Payer: Humana Medicare Advantage |
$21,455.56
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20,830.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,179.25
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,089.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$496.40
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$545.83
|
|
|
XR ABLATE BONE TUMOR(S) PERQ
|
Facility
|
IP
|
$33,376.25
|
|
|
Service Code
|
HCPCS 20982
|
| Hospital Charge Code |
321020982
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,006.44 |
| Max. Negotiated Rate |
$5,006.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,006.44
|
|
|
XR ABLATE BONE TUMOR(S) PERQ
|
Facility
|
IP
|
$20,597.50
|
|
|
Service Code
|
HCPCS 20982
|
| Hospital Charge Code |
7411348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,089.62 |
| Max. Negotiated Rate |
$3,089.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,089.62
|
|
|
XR ABLATE BONE TUMOR(S) PERQ
|
Facility
|
OP
|
$33,376.25
|
|
|
Service Code
|
HCPCS 20982
|
| Hospital Charge Code |
321020982
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$804.37 |
| Max. Negotiated Rate |
$75,192.36 |
| Rate for Payer: Aetna Commercial |
$56,659.34
|
| Rate for Payer: Aetna Medicare Advantage |
$67,491.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75,192.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75,192.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20,830.64
|
| 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 |
$75,192.36
|
| Rate for Payer: Cigna Commercial |
$41,754.94
|
| Rate for Payer: Cigna Medicare Advantage |
$20,830.64
|
| Rate for Payer: Clover Medicare Advantage |
$19,789.11
|
| Rate for Payer: EmblemHealth Commercial |
$62,491.92
|
| Rate for Payer: Humana Medicare Advantage |
$21,455.56
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20,830.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10,012.88
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,006.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$804.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$884.47
|
|
|
XR ABLATE BONE TUMOR(S) PERQ
|
Facility
|
OP
|
$33,376.25
|
|
|
Service Code
|
HCPCS 20982
|
| Hospital Charge Code |
5600102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$804.37 |
| Max. Negotiated Rate |
$75,192.36 |
| Rate for Payer: Aetna Commercial |
$56,659.34
|
| Rate for Payer: Aetna Medicare Advantage |
$67,491.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75,192.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75,192.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20,830.64
|
| 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 |
$75,192.36
|
| Rate for Payer: Cigna Commercial |
$41,754.94
|
| Rate for Payer: Cigna Medicare Advantage |
$20,830.64
|
| Rate for Payer: Clover Medicare Advantage |
$19,789.11
|
| Rate for Payer: EmblemHealth Commercial |
$62,491.92
|
| Rate for Payer: Humana Medicare Advantage |
$21,455.56
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20,830.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10,012.88
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,006.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$804.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$884.47
|
|
