|
EXCHANGE BILIARY DRG CATH
|
Facility
|
OP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47536
|
| Hospital Charge Code |
2011567
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.30 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,335.10
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$405.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$364.30
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
IP
|
$3,090.18
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
2101192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$463.53 |
| Max. Negotiated Rate |
$463.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$463.53
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
OP
|
$3,090.18
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
2101192
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.76 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$803.45
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$463.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$97.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$87.76
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
IP
|
$10,187.80
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
2600227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,528.17 |
| Max. Negotiated Rate |
$1,528.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,528.17
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
IP
|
$8,875.68
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
411050435
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,331.35 |
| Max. Negotiated Rate |
$1,331.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,331.35
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
OP
|
$8,875.68
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
411050435
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.07 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,307.68
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,331.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$280.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$252.07
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
IP
|
$8,875.68
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
366850435
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,331.35 |
| Max. Negotiated Rate |
$1,331.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,331.35
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
OP
|
$10,187.80
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
2600227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$289.33 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,648.83
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,528.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$321.93
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$289.33
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
OP
|
$8,875.68
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
366850435
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.07 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,307.68
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,331.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$280.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$252.07
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
OP
|
$10,187.80
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
321050435
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$289.33 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,648.83
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,528.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$321.93
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$289.33
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
IP
|
$10,187.80
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
321050435
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,528.17 |
| Max. Negotiated Rate |
$1,528.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,528.17
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
IP
|
$3,090.18
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
2709010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$463.53 |
| Max. Negotiated Rate |
$463.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$463.53
|
|
|
EXCHANGE NEPHROSTOMY CATH
|
Facility
|
OP
|
$3,090.18
|
|
|
Service Code
|
HCPCS 50435
|
| Hospital Charge Code |
2709010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.76 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$803.45
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$463.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$97.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$87.76
|
|
|
EXCHANGE NEPHROSTOMY CATH BI
|
Facility
|
OP
|
$3,933.60
|
|
|
Service Code
|
HCPCS 5043550
|
| Hospital Charge Code |
7411611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$111.71 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,494.77
|
| Rate for Payer: Aetna Medicare Advantage |
$1,180.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,003.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,003.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,003.07
|
| Rate for Payer: Cigna Commercial |
$1,966.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,022.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$590.04
|
| Rate for Payer: UnitedHealthcare Community & State |
$124.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$111.71
|
|
|
EXCHANGE NEPHROSTOMY CATH BI
|
Facility
|
IP
|
$3,933.60
|
|
|
Service Code
|
HCPCS 5043550
|
| Hospital Charge Code |
7411611
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.04 |
| Max. Negotiated Rate |
$590.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$590.04
|
|
|
EXCHANGE NEPHROSTOMY CATH BIL
|
Facility
|
IP
|
$3,933.60
|
|
|
Service Code
|
HCPCS 5043550
|
| Hospital Charge Code |
2011575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.04 |
| Max. Negotiated Rate |
$590.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$590.04
|
|
|
EXCHANGE NEPHROSTOMY CATH BIL
|
Facility
|
OP
|
$3,933.60
|
|
|
Service Code
|
HCPCS 5043550
|
| Hospital Charge Code |
2011575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$111.71 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,494.77
|
| Rate for Payer: Aetna Medicare Advantage |
$1,180.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,003.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,003.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,003.07
|
| Rate for Payer: Cigna Commercial |
$1,966.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,022.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$590.04
|
| Rate for Payer: UnitedHealthcare Community & State |
$124.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$111.71
|
|
|
EXCHANGE NEPHROSTOMY CATH BIL
|
Facility
|
IP
|
$3,933.60
|
|
|
Service Code
|
HCPCS 5043550
|
| Hospital Charge Code |
2101156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$590.04 |
| Max. Negotiated Rate |
$590.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$590.04
|
|
|
EXCHANGE NEPHROSTOMY CATH BIL
|
Facility
|
OP
|
$3,933.60
|
|
|
Service Code
|
HCPCS 5043550
|
| Hospital Charge Code |
2101156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$111.71 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,494.77
|
| Rate for Payer: Aetna Medicare Advantage |
$1,180.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,003.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,003.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,003.07
|
| Rate for Payer: Cigna Commercial |
$1,966.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,022.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$590.04
|
| Rate for Payer: UnitedHealthcare Community & State |
$124.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$111.71
|
|
|
EXCHANGE NEPHROSTOMY CATH LT
|
Facility
|
OP
|
$3,090.18
|
|
|
Service Code
|
HCPCS 50435LT
|
| Hospital Charge Code |
7412037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.76 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,174.27
|
| Rate for Payer: Aetna Medicare Advantage |
$927.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$788.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$788.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$788.00
|
| Rate for Payer: Cigna Commercial |
$1,545.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$803.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$463.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$97.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$87.76
|
|
|
EXCHANGE NEPHROSTOMY CATH LT
|
Facility
|
OP
|
$3,090.18
|
|
|
Service Code
|
HCPCS 50435LT
|
| Hospital Charge Code |
2011590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.76 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,174.27
|
| Rate for Payer: Aetna Medicare Advantage |
$927.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$788.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$788.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$788.00
|
| Rate for Payer: Cigna Commercial |
$1,545.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$803.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$463.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$97.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$87.76
|
|
|
EXCHANGE NEPHROSTOMY CATH LT
|
Facility
|
IP
|
$3,090.18
|
|
|
Service Code
|
HCPCS 50435LT
|
| Hospital Charge Code |
2011590
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$463.53 |
| Max. Negotiated Rate |
$463.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$463.53
|
|
|
EXCHANGE NEPHROSTOMY CATH LT
|
Facility
|
IP
|
$3,090.18
|
|
|
Service Code
|
HCPCS 50435LT
|
| Hospital Charge Code |
7412037
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$463.53 |
| Max. Negotiated Rate |
$463.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$463.53
|
|
|
EXCHANGE NEPHROSTOMY CATH LT
|
Facility
|
OP
|
$3,090.18
|
|
|
Service Code
|
HCPCS 50435LT
|
| Hospital Charge Code |
2101162
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.76 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,174.27
|
| Rate for Payer: Aetna Medicare Advantage |
$927.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$788.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$788.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$788.00
|
| Rate for Payer: Cigna Commercial |
$1,545.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$803.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$463.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$97.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$87.76
|
|
|
EXCHANGE NEPHROSTOMY CATH LT
|
Facility
|
IP
|
$3,090.18
|
|
|
Service Code
|
HCPCS 50435LT
|
| Hospital Charge Code |
2101162
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$463.53 |
| Max. Negotiated Rate |
$463.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$463.53
|
|