|
CLN DX PAT-FEMUR AP & LAT-RT
|
Facility
|
OP
|
$332.00
|
|
| Hospital Charge Code |
75190500
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$43.16 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$99.60
|
| Rate for Payer: Aetna Medicare Advantage |
$99.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.66
|
| Rate for Payer: Cigna Commercial |
$166.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.16
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FINGER-2ND DIGT-LT
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F1
|
| Hospital Charge Code |
75190435
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
CLN DX PAT-FINGER-2ND DIGT-LT
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F1
|
| Hospital Charge Code |
75190435
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FINGER-2ND DIGT-RT
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F6
|
| Hospital Charge Code |
75190460
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FINGER-2ND DIGT-RT
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F6
|
| Hospital Charge Code |
75190460
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
CLN DX PAT-FINGER-3RD DIGT-LT
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F2
|
| Hospital Charge Code |
75190440
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
CLN DX PAT-FINGER-3RD DIGT-LT
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F2
|
| Hospital Charge Code |
75190440
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FINGER-3RD DIGT-RT
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F7
|
| Hospital Charge Code |
75190465
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FINGER-3RD DIGT-RT
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F7
|
| Hospital Charge Code |
75190465
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
CLN DX PAT-FINGER-4TH DIGT-LT
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F3
|
| Hospital Charge Code |
75190445
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
CLN DX PAT-FINGER-4TH DIGT-LT
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F3
|
| Hospital Charge Code |
75190445
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FINGER-4TH DIGT-RT
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F8
|
| Hospital Charge Code |
75190470
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FINGER-4TH DIGT-RT
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F8
|
| Hospital Charge Code |
75190470
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
CLN DX PAT-FINGER-5TH DIGT-LT
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F4
|
| Hospital Charge Code |
75190450
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FINGER-5TH DIGT-LT
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F4
|
| Hospital Charge Code |
75190450
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
CLN DX PAT-FINGER-5TH DIGT-RT
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F9
|
| Hospital Charge Code |
75190475
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FINGER-5TH DIGT-RT
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F9
|
| Hospital Charge Code |
75190475
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
CLN DX PAT-FINGER-LT THUMB
|
Facility
|
OP
|
$251.00
|
|
|
Service Code
|
HCPCS 73140FA
|
| Hospital Charge Code |
75190480
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.63 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.30
|
| Rate for Payer: Aetna Medicare Advantage |
$75.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$64.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$64.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$64.00
|
| Rate for Payer: Cigna Commercial |
$125.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.63
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FINGER-LT THUMB
|
Facility
|
IP
|
$251.00
|
|
|
Service Code
|
HCPCS 73140FA
|
| Hospital Charge Code |
75190480
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.65 |
| Max. Negotiated Rate |
$37.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.65
|
|
|
CLN DX PAT-FINGERS-BILAT
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140
|
| Hospital Charge Code |
75190275
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
CLN DX PAT-FINGERS-BILAT
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140
|
| Hospital Charge Code |
75190275
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$207.24
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FINGER-THUMB-RT
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F5
|
| Hospital Charge Code |
75190455
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
CLN DX PAT-FINGER-THUMB-RT
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 73140F5
|
| Hospital Charge Code |
75190455
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FOOT 3 VIEWS-BILAT
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
HCPCS 7363050
|
| Hospital Charge Code |
75190365
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$1,489.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
|
|
CLN DX PAT-FOOT 3 VIEWS-BILAT
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
HCPCS 7363050
|
| Hospital Charge Code |
75190365
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|