|
ASPERIGILLUS AB
|
Facility
|
OP
|
$139.25
|
|
|
Service Code
|
HCPCS 8660691
|
| Hospital Charge Code |
3004082A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$41.77
|
| Rate for Payer: Aetna Medicare Advantage |
$41.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.51
|
| Rate for Payer: Cigna Commercial |
$69.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
ASPERIGILLUS AB
|
Facility
|
IP
|
$139.25
|
|
|
Service Code
|
HCPCS 8660691
|
| Hospital Charge Code |
3004082A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
ASPERIGILLUS AB
|
Facility
|
IP
|
$139.25
|
|
|
Service Code
|
HCPCS 86606
|
| Hospital Charge Code |
3004082C
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
ASPIRATE/INJ GANGLION CYST
|
Facility
|
IP
|
$1,434.65
|
|
|
Service Code
|
HCPCS 20612
|
| Hospital Charge Code |
412320612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.20 |
| Max. Negotiated Rate |
$215.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$215.20
|
|
|
ASPIRATE/INJ GANGLION CYST
|
Facility
|
OP
|
$1,434.65
|
|
|
Service Code
|
HCPCS 20612
|
| Hospital Charge Code |
412320612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$186.50 |
| Max. Negotiated Rate |
$1,864.00 |
| Rate for Payer: Aetna Commercial |
$430.39
|
| Rate for Payer: Aetna Medicare Advantage |
$430.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$365.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$365.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$365.84
|
| Rate for Payer: Cigna Commercial |
$730.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$186.50
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$215.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,686.00
|
|
|
ASPIRATE MAXX CELL MARROW 11CM
|
Facility
|
IP
|
$11,250.00
|
|
| Hospital Charge Code |
270686055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,687.50 |
| Max. Negotiated Rate |
$1,687.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,687.50
|
|
|
ASPIRATE MAXX CELL MARROW 11CM
|
Facility
|
OP
|
$11,250.00
|
|
| Hospital Charge Code |
270686055
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,462.50 |
| Max. Negotiated Rate |
$5,625.00 |
| Rate for Payer: Aetna Commercial |
$3,375.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,375.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,868.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,868.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,868.75
|
| Rate for Payer: Cigna Commercial |
$5,625.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,462.50
|
| Rate for Payer: Oxford Commercial |
$5,625.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,687.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,625.00
|
|
|
ASPIRATE PLEURA W IMAGING
|
Facility
|
IP
|
$2,429.50
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2011457
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.43 |
| Max. Negotiated Rate |
$364.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$364.43
|
|
|
ASPIRATE PLEURA W IMAGING
|
Facility
|
OP
|
$2,429.50
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2011457
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$315.83 |
| Max. Negotiated Rate |
$2,575.00 |
| Rate for Payer: Aetna Commercial |
$728.85
|
| Rate for Payer: Aetna Medicare Advantage |
$728.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$619.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$619.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$619.52
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$315.83
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$364.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,575.00
|
|
|
ASPIRATE PLEURA W/IMAGING
|
Facility
|
IP
|
$2,873.16
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
1600000468
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$430.97 |
| Max. Negotiated Rate |
$430.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$430.97
|
|
|
ASPIRATE PLEURA W/IMAGING
|
Facility
|
OP
|
$2,873.16
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
1600000468
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$373.51 |
| Max. Negotiated Rate |
$2,575.00 |
| Rate for Payer: Aetna Commercial |
$861.95
|
| Rate for Payer: Aetna Medicare Advantage |
$861.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$732.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$732.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$732.66
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$373.51
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$430.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,575.00
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2250419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,235.00 |
| Max. Negotiated Rate |
$2,850.00 |
| Rate for Payer: Aetna Commercial |
$2,850.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,850.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,422.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,422.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,422.50
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,235.00
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,575.00
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
OP
|
$2,429.50
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
7411381
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$315.83 |
| Max. Negotiated Rate |
$2,575.00 |
| Rate for Payer: Aetna Commercial |
$728.85
|
| Rate for Payer: Aetna Medicare Advantage |
$728.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$619.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$619.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$619.52
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$315.83
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$364.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,575.00
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
IP
|
$2,429.50
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
7411381
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.43 |
| Max. Negotiated Rate |
$364.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$364.43
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
IP
|
$2,429.51
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2301103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.43 |
| Max. Negotiated Rate |
$364.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$364.43
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
OP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
5700314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$471.99 |
| Max. Negotiated Rate |
$2,575.00 |
| Rate for Payer: Aetna Commercial |
$1,089.21
|
| Rate for Payer: Aetna Medicare Advantage |
$1,089.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$925.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$925.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$925.83
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$471.99
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,575.00
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
IP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
5700314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$544.61 |
| Max. Negotiated Rate |
$544.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
OP
|
$2,429.50
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
366832555
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$315.83 |
| Max. Negotiated Rate |
$2,575.00 |
| Rate for Payer: Aetna Commercial |
$728.85
|
| Rate for Payer: Aetna Medicare Advantage |
$728.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$619.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$619.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$619.52
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$315.83
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$364.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,575.00
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
OP
|
$2,429.51
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2301103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$315.84 |
| Max. Negotiated Rate |
$2,575.00 |
| Rate for Payer: Aetna Commercial |
$728.85
|
| Rate for Payer: Aetna Medicare Advantage |
$728.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$619.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$619.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$619.53
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$315.84
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$364.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,575.00
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2250419
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
OP
|
$2,429.51
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
5701001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$315.84 |
| Max. Negotiated Rate |
$1,493.86 |
| Rate for Payer: Aetna Commercial |
$728.85
|
| Rate for Payer: Aetna Medicare Advantage |
$728.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$619.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$619.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$619.53
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$315.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$364.43
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
IP
|
$2,429.50
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
366832555
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.43 |
| Max. Negotiated Rate |
$364.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$364.43
|
|
|
ASPIRATE PLEURA W IMAGINIG
|
Facility
|
IP
|
$2,429.51
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
5701001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$364.43 |
| Max. Negotiated Rate |
$364.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$364.43
|
|
|
ASPIRATE PLEURA W/O IMAGING
|
Facility
|
OP
|
$2,873.16
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
16000639
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$373.51 |
| Max. Negotiated Rate |
$2,575.00 |
| Rate for Payer: Aetna Commercial |
$861.95
|
| Rate for Payer: Aetna Medicare Advantage |
$861.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$732.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$732.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$732.66
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$373.51
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$430.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,575.00
|
|
|
ASPIRATE PLEURA W/O IMAGING
|
Facility
|
IP
|
$2,873.16
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
16000639
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$430.97 |
| Max. Negotiated Rate |
$430.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$430.97
|
|