|
REGEN ANU RHEOE
|
Facility
|
OP
|
$13,875.00
|
|
| Hospital Charge Code |
270679813
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,081.25 |
| Max. Negotiated Rate |
$6,937.50 |
| Rate for Payer: Aetna Commercial |
$4,162.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,162.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,538.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,538.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,775.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,538.12
|
| Rate for Payer: Cigna Commercial |
$6,937.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,357.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,081.25
|
|
|
REGEN(CAS+IMD) EUA 600MG INJ
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS Q0240
|
| Hospital Charge Code |
606390438
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
REGEN(CAS+IMD) EUA 600MG INJ
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS Q0240
|
| Hospital Charge Code |
606390438
|
|
Hospital Revenue Code
|
636
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
OP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3237M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.00
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3234M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
OP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3234M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.00
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3047M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
4201M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
OP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3080M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.00
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
OP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3240M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.00
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3049M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
OP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3034M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.00
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3080M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3046M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
OP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3046M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.00
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3037M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
OP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3043M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.00
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
OP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3050M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.00
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3043M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3120M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3020M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
OP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3120M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.00
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
3042M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
IP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
4229M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$337.50 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
|
|
REGEN(CAS+IMD)INJ REPEAT DOSE
|
Facility
|
OP
|
$2,250.00
|
|
|
Service Code
|
HCPCS M0240
|
| Hospital Charge Code |
4201M0240
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Aetna Commercial |
$675.00
|
| Rate for Payer: Aetna Medicare Advantage |
$675.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.75
|
| Rate for Payer: Cigna Commercial |
$1,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$292.50
|
| Rate for Payer: Oxford Commercial |
$91.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$337.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.00
|
|