|
XR CEPHALOGRAM ORTHODONTIC
|
Facility
|
OP
|
$258.70
|
|
|
Service Code
|
HCPCS 70350
|
| Hospital Charge Code |
2011317
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$6.23 |
| 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 |
$18.74
|
| 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 |
$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: UnitedHealthcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.86
|
|
|
XR CERVICAL SPINE 4 VWS W OBL
|
Facility
|
OP
|
$6,601.19
|
|
|
Service Code
|
HCPCS 72050
|
| Hospital Charge Code |
2002012
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$49.64 |
| 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 |
$49.64
|
| 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 |
$316.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$174.93
|
|
|
XR CERVICAL SPINE 4 VWS W OBL
|
Facility
|
IP
|
$6,601.19
|
|
|
Service Code
|
HCPCS 72050
|
| Hospital Charge Code |
2002012
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$990.18 |
| Max. Negotiated Rate |
$990.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$990.18
|
|
|
XR CERVICAL SPINE AP & LAT
|
Facility
|
OP
|
$6,601.19
|
|
|
Service Code
|
HCPCS 72040
|
| Hospital Charge Code |
2000651
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$34.36 |
| 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 |
$34.36
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$247.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$174.93
|
|
|
XR CERVICAL SPINE AP & LAT
|
Facility
|
IP
|
$6,601.19
|
|
|
Service Code
|
HCPCS 72040
|
| Hospital Charge Code |
2000651
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$990.18 |
| Max. Negotiated Rate |
$990.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$990.18
|
|
|
XR CERVICAL SPINE COMP W/ F&E
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72052
|
| Hospital Charge Code |
2002020
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$61.10 |
| 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 |
$61.10
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$316.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.15
|
|
|
XR CERVICAL SPINE COMP W/ F&E
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72052
|
| Hospital Charge Code |
2002020
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
XR CERVICAL SPINE PORTABLE
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72020
|
| Hospital Charge Code |
2002798
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$23.60 |
| 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 |
$23.60
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$216.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.15
|
|
|
XR CERVICAL SPINE PORTABLE
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72020
|
| Hospital Charge Code |
2002798
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
XR CHANGE G TUBE TO G-J PERC
|
Facility
|
IP
|
$3,929.65
|
|
|
Service Code
|
HCPCS 49446
|
| Hospital Charge Code |
5600162
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$589.45 |
| Max. Negotiated Rate |
$589.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$589.45
|
|
|
XR CHANGE G TUBE TO G-J PERC
|
Facility
|
OP
|
$3,929.65
|
|
|
Service Code
|
HCPCS 49446
|
| Hospital Charge Code |
5600162
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.70 |
| Max. Negotiated Rate |
$8,229.07 |
| Rate for Payer: Aetna Commercial |
$6,200.81
|
| Rate for Payer: Aetna Medicare Advantage |
$7,386.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,229.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,279.71
|
| 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 |
$8,229.07
|
| Rate for Payer: Cigna Commercial |
$4,569.67
|
| Rate for Payer: Cigna Medicare Advantage |
$2,279.71
|
| Rate for Payer: Clover Medicare Advantage |
$2,165.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,839.13
|
| Rate for Payer: Humana Medicare Advantage |
$2,348.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,279.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,178.89
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$589.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$94.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,279.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$104.14
|
|
|
XR CHANGE OF URETER TUBE/STENT
|
Facility
|
IP
|
$7,084.55
|
|
|
Service Code
|
HCPCS 50688
|
| Hospital Charge Code |
5600174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,062.68 |
| Max. Negotiated Rate |
$1,062.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,062.68
|
|
|
XR CHANGE OF URETER TUBE/STENT
|
Facility
|
OP
|
$7,084.55
|
|
|
Service Code
|
HCPCS 50688
|
| Hospital Charge Code |
5600174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$170.74 |
| Max. Negotiated Rate |
$8,964.44 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| 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 |
$8,964.44
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,125.36
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,062.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$170.74
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$187.74
|
|
|
XR CHANGE OF URETER TUBE/STENT
|
Facility
|
IP
|
$7,084.55
|
|
|
Service Code
|
HCPCS 50688
|
| Hospital Charge Code |
7411616
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,062.68 |
| Max. Negotiated Rate |
$1,062.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,062.68
|
|
|
XR CHANGE OF URETER TUBE/STENT
|
Facility
|
OP
|
$7,084.55
|
|
|
Service Code
|
HCPCS 50688
|
| Hospital Charge Code |
7411616
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$170.74 |
| Max. Negotiated Rate |
$8,964.44 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| 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 |
$8,964.44
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,125.36
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,062.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$170.74
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$187.74
|
|
|
XR CHANGE URETER STENT PERCUT
|
Facility
|
OP
|
$11,620.55
|
|
|
Service Code
|
HCPCS 50382
|
| Hospital Charge Code |
5600167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$280.06 |
| Max. Negotiated Rate |
$8,964.44 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| 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 |
$8,964.44
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,486.16
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,743.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$280.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$307.94
|
|
|
XR CHANGE URETER STENT PERCUT
|
Facility
|
IP
|
$11,620.55
|
|
|
Service Code
|
HCPCS 50382
|
| Hospital Charge Code |
5600167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,743.08 |
| Max. Negotiated Rate |
$1,743.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,743.08
|
|
|
XR CHEMICAL PLEURODESIS
|
Facility
|
OP
|
$2,422.50
|
|
|
Service Code
|
HCPCS 32560
|
| Hospital Charge Code |
5600107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$58.38 |
| Max. Negotiated Rate |
$3,593.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,690.13
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$726.75
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$58.38
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$64.20
|
|
|
XR CHEMICAL PLEURODESIS
|
Facility
|
IP
|
$2,422.50
|
|
|
Service Code
|
HCPCS 32560
|
| Hospital Charge Code |
5600107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$363.38 |
| Max. Negotiated Rate |
$363.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.38
|
|
|
XR CHEST 2 VIEWS W/FLUOROSCOPY
|
Facility
|
OP
|
$471.30
|
|
|
Service Code
|
HCPCS 71023
|
| Hospital Charge Code |
2011318
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$1,975.00 |
| Rate for Payer: Aetna Commercial |
$179.09
|
| Rate for Payer: Aetna Medicare Advantage |
$141.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$120.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$120.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$120.18
|
| Rate for Payer: Cigna Commercial |
$235.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$141.39
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.49
|
|
|
XR CHEST 2 VIEWS W/FLUOROSCOPY
|
Facility
|
IP
|
$471.30
|
|
|
Service Code
|
HCPCS 71023
|
| Hospital Charge Code |
2011318
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$70.69 |
| Max. Negotiated Rate |
$70.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.69
|
|
|
XR CHEST 4 OR > VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71048
|
| Hospital Charge Code |
2000552
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
XR CHEST 4 OR > VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71048
|
| Hospital Charge Code |
2000552
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$49.97 |
| 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 |
$49.97
|
| 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 CHEST DECUBITUS BILATERAL
|
Facility
|
OP
|
$517.40
|
|
|
Service Code
|
HCPCS 7103550
|
| Hospital Charge Code |
2011319
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$12.47 |
| Max. Negotiated Rate |
$1,975.00 |
| Rate for Payer: Aetna Commercial |
$196.61
|
| Rate for Payer: Aetna Medicare Advantage |
$155.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$131.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$131.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$131.94
|
| Rate for Payer: Cigna Commercial |
$258.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$155.22
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,975.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.71
|
|
|
XR CHEST DECUBITUS BILATERAL
|
Facility
|
IP
|
$517.40
|
|
|
Service Code
|
HCPCS 7103550
|
| Hospital Charge Code |
2011319
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$77.61 |
| Max. Negotiated Rate |
$77.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.61
|
|
