|
XR REPLACE DUOD/JEJ TUBE PERC
|
Facility
|
OP
|
$4,459.55
|
|
|
Service Code
|
HCPCS 49451
|
| Hospital Charge Code |
321049451
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$107.48 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| 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 |
$3,889.52
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,337.87
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$668.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$107.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$118.18
|
|
|
XR REPLACE DUOD/JEJ TUBE PERC
|
Facility
|
IP
|
$4,459.55
|
|
|
Service Code
|
HCPCS 49451
|
| Hospital Charge Code |
5600164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$668.93 |
| Max. Negotiated Rate |
$668.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$668.93
|
|
|
XR REPLACE DUOD/JEJ TUBE PERC
|
Facility
|
OP
|
$4,459.55
|
|
|
Service Code
|
HCPCS 49451
|
| Hospital Charge Code |
5600164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$107.48 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| 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 |
$3,889.52
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,337.87
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$668.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$107.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$118.18
|
|
|
XR REPLACE DUOD/JEJ TUBE PERC
|
Facility
|
IP
|
$4,459.55
|
|
|
Service Code
|
HCPCS 49451
|
| Hospital Charge Code |
321049451
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$668.93 |
| Max. Negotiated Rate |
$668.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$668.93
|
|
|
XR REPLACE G/C TUBE PERC
|
Facility
|
OP
|
$2,087.20
|
|
|
Service Code
|
HCPCS 49450
|
| Hospital Charge Code |
5600163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$50.30 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| 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 |
$3,889.52
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$626.16
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$313.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$55.31
|
|
|
XR REPLACE G/C TUBE PERC
|
Facility
|
IP
|
$2,087.20
|
|
|
Service Code
|
HCPCS 49450
|
| Hospital Charge Code |
5600163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$313.08 |
| Max. Negotiated Rate |
$313.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$313.08
|
|
|
XR REPLACE G-J TUBE
|
Facility
|
IP
|
$2,087.20
|
|
|
Service Code
|
HCPCS 49452
|
| Hospital Charge Code |
5600165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$313.08 |
| Max. Negotiated Rate |
$313.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$313.08
|
|
|
XR REPLACE G-J TUBE
|
Facility
|
OP
|
$2,087.20
|
|
|
Service Code
|
HCPCS 49452
|
| Hospital Charge Code |
5600165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$50.30 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,889.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| 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 |
$3,889.52
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$626.16
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$313.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$55.31
|
|
|
XR REPLACE PICVAD CATH
|
Facility
|
OP
|
$11,315.45
|
|
|
Service Code
|
HCPCS 36585
|
| Hospital Charge Code |
7411470
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$272.70 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,355.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,394.64
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,697.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$272.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$299.86
|
|
|
XR REPLACE PICVAD CATH
|
Facility
|
IP
|
$11,315.45
|
|
|
Service Code
|
HCPCS 36585
|
| Hospital Charge Code |
7411470
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,697.32 |
| Max. Negotiated Rate |
$1,697.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,697.32
|
|
|
XR REPLACE PICVAD CATH
|
Facility
|
OP
|
$11,315.45
|
|
|
Service Code
|
HCPCS 36585
|
| Hospital Charge Code |
5600134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$272.70 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,355.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,394.64
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,697.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$272.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$299.86
|
|
|
XR REPLACE PICVAD CATH
|
Facility
|
IP
|
$11,315.45
|
|
|
Service Code
|
HCPCS 36585
|
| Hospital Charge Code |
5600134
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,697.32 |
| Max. Negotiated Rate |
$1,697.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,697.32
|
|
|
XR REPLACE TUN CV CATH SAME AC
|
Facility
|
OP
|
$13,510.10
|
|
|
Service Code
|
HCPCS 36583
|
| Hospital Charge Code |
5600133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$325.59 |
| Max. Negotiated Rate |
$23,862.86 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,355.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,862.86
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$6,610.76
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,053.03
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,026.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$325.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$358.02
|
|
|
XR REPLACE TUN CV CATH SAME AC
|
Facility
|
OP
|
$13,510.10
|
|
|
Service Code
|
HCPCS 36583
|
| Hospital Charge Code |
7411468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$325.59 |
| Max. Negotiated Rate |
$23,862.86 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,355.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,862.86
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$6,610.76
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,053.03
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,026.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$325.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$358.02
|
|
|
XR REPLACE TUN CV CATH SAME AC
|
Facility
|
IP
|
$13,510.10
|
|
|
Service Code
|
HCPCS 36583
|
| Hospital Charge Code |
7411468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,026.52 |
| Max. Negotiated Rate |
$2,026.52 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,026.52
|
|
|
XR REPLACE TUN CV CATH SAME AC
|
Facility
|
IP
|
$13,510.10
|
|
|
Service Code
|
HCPCS 36583
|
| Hospital Charge Code |
5600133
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,026.52 |
| Max. Negotiated Rate |
$2,026.52 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,026.52
|
|
|
XR REP OF PREV CATH UN FLUORO
|
Facility
|
IP
|
$6,404.20
|
|
|
Service Code
|
HCPCS 36597
|
| Hospital Charge Code |
5100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$960.63 |
| Max. Negotiated Rate |
$960.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$960.63
|
|
|
XR REP OF PREV CATH UN FLUORO
|
Facility
|
IP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 36597
|
| Hospital Charge Code |
366836597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$737.17 |
| Max. Negotiated Rate |
$737.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$737.17
|
|
|
XR REP OF PREV CATH UN FLUORO
|
Facility
|
OP
|
$6,404.20
|
|
|
Service Code
|
HCPCS 36597
|
| Hospital Charge Code |
321036597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.34 |
| 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 |
$1,626.00
|
| 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 |
$1,921.26
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$960.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$154.34
|
| 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 |
$169.71
|
|
|
XR REP OF PREV CATH UN FLUORO
|
Facility
|
OP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 36597
|
| Hospital Charge Code |
366836597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$118.44 |
| 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 |
$1,626.00
|
| 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 |
$1,474.35
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$737.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$118.44
|
| 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 |
$130.23
|
|
|
XR REP OF PREV CATH UN FLUORO
|
Facility
|
OP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 36597
|
| Hospital Charge Code |
411036597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$118.44 |
| 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 |
$1,626.00
|
| 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 |
$1,474.35
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$737.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$118.44
|
| 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 |
$130.23
|
|
|
XR REP OF PREV CATH UN FLUORO
|
Facility
|
IP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 36597
|
| Hospital Charge Code |
411036597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$737.17 |
| Max. Negotiated Rate |
$737.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$737.17
|
|
|
XR REP OF PREV CATH UN FLUORO
|
Facility
|
IP
|
$6,404.20
|
|
|
Service Code
|
HCPCS 36597
|
| Hospital Charge Code |
321036597
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$960.63 |
| Max. Negotiated Rate |
$960.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$960.63
|
|
|
XR REP OF PREV CATH UN FLUORO
|
Facility
|
IP
|
$2,024.90
|
|
|
Service Code
|
HCPCS 36597
|
| Hospital Charge Code |
7411477
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$303.74 |
| Max. Negotiated Rate |
$303.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.74
|
|
|
XR REP OF PREV CATH UN FLUORO
|
Facility
|
OP
|
$2,024.90
|
|
|
Service Code
|
HCPCS 36597
|
| Hospital Charge Code |
7411477
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$48.80 |
| 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 |
$1,626.00
|
| 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 |
$607.47
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$48.80
|
| 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 |
$53.66
|
|
