|
US ASPIRATION/INJ/BIOSPY BLTRL
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301064
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|
|
US ASPIRATION/INJ/BIOSPY BLTRL
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301064
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US ASPIRATION/INJ/BIOSPY RIGHT
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301066
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|
|
US ASPIRATION/INJ/BIOSPY RIGHT
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301066
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US BIOPSY ABDOMEN
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|
|
US BIOPSY ABDOMEN
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301069
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US BIOPSY BREAST BILATERAL
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301067
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US BIOPSY BREAST BILATERAL
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301067
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|
|
US BIOPSY BREAST LEFT
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|
|
US BIOPSY BREAST LEFT
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301068
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US BIOPSY BREAST NEEDLE CORE
|
Facility
|
OP
|
$3,355.30
|
|
|
Service Code
|
HCPCS 19083
|
| Hospital Charge Code |
2101144
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.19 |
| Max. Negotiated Rate |
$3,933.12 |
| Rate for Payer: Aetna Commercial |
$1,006.59
|
| Rate for Payer: Aetna Medicare Advantage |
$1,006.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$855.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$855.60
|
| 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 |
$855.60
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$436.19
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$503.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,687.00
|
|
|
US BIOPSY BREAST NEEDLE CORE
|
Facility
|
IP
|
$3,355.30
|
|
|
Service Code
|
HCPCS 19083
|
| Hospital Charge Code |
2101144
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$503.30 |
| Max. Negotiated Rate |
$503.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$503.30
|
|
|
US BIOPSY BREAST RIGHT
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301070
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US BIOPSY BREAST RIGHT
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301070
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|
|
US BIOPSY LIVER
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301071
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|
|
US BIOPSY LIVER
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301071
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US BIOPSY LUNG/MEDIASTINUM BLT
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301072
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|
|
US BIOPSY LUNG/MEDIASTINUM BLT
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301072
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US BIOPSY LUNG/MEDIASTINUM LFT
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|
|
US BIOPSY LUNG/MEDIASTINUM LFT
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US BIOPSY LUNG/MEDIASTINUM RGT
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|
|
US BIOPSY LUNG/MEDIASTINUM RGT
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301074
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US BIOPSY PLEURA BILATERAL
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|
|
US BIOPSY PLEURA BILATERAL
|
Facility
|
IP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301075
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.64 |
| Max. Negotiated Rate |
$164.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
|
|
US BIOPSY PLEURA LEFT
|
Facility
|
OP
|
$1,097.60
|
|
|
Service Code
|
HCPCS 76942
|
| Hospital Charge Code |
2301076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$69.19 |
| Max. Negotiated Rate |
$1,981.00 |
| Rate for Payer: Aetna Commercial |
$329.28
|
| Rate for Payer: Aetna Medicare Advantage |
$329.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.89
|
| Rate for Payer: Cigna Commercial |
$72.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.69
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,981.00
|
|