|
VENOUS DUPLEX SCAN UP EXT BI
|
Facility
|
OP
|
$2,906.28
|
|
|
Service Code
|
HCPCS 93970
|
| Hospital Charge Code |
74117045
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$377.82 |
| Max. Negotiated Rate |
$5,061.00 |
| Rate for Payer: Aetna Commercial |
$871.88
|
| Rate for Payer: Aetna Medicare Advantage |
$871.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$741.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$741.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$518.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$741.10
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$377.82
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$435.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT BI
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93970
|
| Hospital Charge Code |
2692200
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$518.65 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Aetna Commercial |
$5,160.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$518.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,386.00
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,236.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT BI
|
Facility
|
IP
|
$2,906.28
|
|
|
Service Code
|
HCPCS 93970
|
| Hospital Charge Code |
94053290
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$435.94 |
| Max. Negotiated Rate |
$435.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$435.94
|
|
|
VENOUS DUPLEX SCAN UP EXT BI
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93970
|
| Hospital Charge Code |
2692200
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
VENOUS DUPLEX SCAN UP EXT BI
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93970
|
| Hospital Charge Code |
74115045
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
VENOUS DUPLEX SCAN UP EXT BI
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93970
|
| Hospital Charge Code |
74115045
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$518.65 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Aetna Commercial |
$5,160.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$518.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,386.00
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,236.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT BI
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93970
|
| Hospital Charge Code |
74116045
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$518.65 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Aetna Commercial |
$5,160.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$518.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,386.00
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,236.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT LT
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74116060
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$118.35 |
| Max. Negotiated Rate |
$118.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
|
|
VENOUS DUPLEX SCAN UP EXT LT
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74116060
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$102.57 |
| Max. Negotiated Rate |
$5,061.00 |
| Rate for Payer: Aetna Commercial |
$236.70
|
| Rate for Payer: Aetna Medicare Advantage |
$236.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$201.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$201.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$501.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$201.19
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.57
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT LT
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74117060
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
VENOUS DUPLEX SCAN UP EXT LT
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74115060
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$248.96 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Aetna Commercial |
$5,160.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$501.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,386.00
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,236.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT LT
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74115060
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
VENOUS DUPLEX SCAN UP EXT LT
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
2692205
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
VENOUS DUPLEX SCAN UP EXT LT
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74117060
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$248.96 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Aetna Commercial |
$5,160.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$501.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,386.00
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,236.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT LT
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
2692205
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$248.96 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Aetna Commercial |
$5,160.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$501.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,386.00
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,236.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT LT
|
Facility
|
OP
|
$2,497.57
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
94053295
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$248.96 |
| Max. Negotiated Rate |
$5,061.00 |
| Rate for Payer: Aetna Commercial |
$749.27
|
| Rate for Payer: Aetna Medicare Advantage |
$749.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$636.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$636.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$501.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$636.88
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$324.68
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$374.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT LT
|
Facility
|
IP
|
$2,497.57
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
94053295
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$374.64 |
| Max. Negotiated Rate |
$374.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$374.64
|
|
|
VENOUS DUPLEX SCAN UP EXT RT
|
Facility
|
IP
|
$789.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74116063
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$118.35 |
| Max. Negotiated Rate |
$118.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
|
|
VENOUS DUPLEX SCAN UP EXT RT
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
2692210
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$248.96 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Aetna Commercial |
$5,160.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$501.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,386.00
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,236.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT RT
|
Facility
|
OP
|
$2,497.57
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
94053300
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$248.96 |
| Max. Negotiated Rate |
$5,061.00 |
| Rate for Payer: Aetna Commercial |
$749.27
|
| Rate for Payer: Aetna Medicare Advantage |
$749.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$636.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$636.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$501.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$636.88
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$324.68
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$374.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT RT
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74115063
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
VENOUS DUPLEX SCAN UP EXT RT
|
Facility
|
IP
|
$2,497.57
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
94053300
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$374.64 |
| Max. Negotiated Rate |
$374.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$374.64
|
|
|
VENOUS DUPLEX SCAN UP EXT RT
|
Facility
|
OP
|
$789.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74116063
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$102.57 |
| Max. Negotiated Rate |
$5,061.00 |
| Rate for Payer: Aetna Commercial |
$236.70
|
| Rate for Payer: Aetna Medicare Advantage |
$236.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$201.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$201.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$501.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$201.19
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.57
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT RT
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74115063
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$248.96 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Aetna Commercial |
$5,160.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$501.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,386.00
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,236.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|
|
VENOUS DUPLEX SCAN UP EXT RT
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93971
|
| Hospital Charge Code |
74117063
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$248.96 |
| Max. Negotiated Rate |
$5,160.00 |
| Rate for Payer: Aetna Commercial |
$5,160.00
|
| Rate for Payer: Aetna Medicare Advantage |
$5,160.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,386.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$501.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,386.00
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,236.00
|
| Rate for Payer: Oxford Commercial |
$4,459.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,061.00
|
|