|
FAMILY EDUCATION/CONF 1/4 HR.
|
Facility
|
IP
|
$63.00
|
|
| Hospital Charge Code |
1008400
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$9.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.45
|
|
|
FAMILY EDUCATION/CONF 1/4 HR.
|
Facility
|
OP
|
$63.00
|
|
| Hospital Charge Code |
1008400
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$23.94
|
| Rate for Payer: Aetna Medicare Advantage |
$18.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.07
|
| Rate for Payer: Cigna Commercial |
$31.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.38
|
| Rate for Payer: Oxford Commercial |
$933.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.79
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84511021
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$31.07 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$284.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
OP
|
$1,047.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84310100
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$29.73 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$272.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$157.05
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.09
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.73
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84509021
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$31.07 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$284.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
IP
|
$1,047.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84310100
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$157.05 |
| Max. Negotiated Rate |
$157.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$157.05
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84509021
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$164.10 |
| Max. Negotiated Rate |
$164.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84517021
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$164.10 |
| Max. Negotiated Rate |
$164.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84504055
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$31.07 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$284.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84517021
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$31.07 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$284.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
IP
|
$725.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
94810035
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$108.75 |
| Max. Negotiated Rate |
$108.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$108.75
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
OP
|
$725.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
94810035
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$20.59 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$188.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$108.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.59
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84504055
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$164.10 |
| Max. Negotiated Rate |
$164.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84511021
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$164.10 |
| Max. Negotiated Rate |
$164.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
87506005
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$164.10 |
| Max. Negotiated Rate |
$164.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
87506005
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$31.07 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$284.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84518021
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$31.07 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$284.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
OP
|
$640.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
83246185
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$18.18 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$166.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.18
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
IP
|
$640.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
83246185
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$96.00 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.00
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
OP
|
$640.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
87504055
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$18.18 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$166.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.18
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
84518021
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$164.10 |
| Max. Negotiated Rate |
$164.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.10
|
|
|
FAMILY TX WO PATIENT 50 MIN
|
Facility
|
IP
|
$640.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
87504055
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$96.00 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.00
|
|
|
FAMILY TX WO PT 50 MIN ADULT
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
4504514
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$390.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.40
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.60
|
|
|
FAMILY TX WO PT 50 MIN ADULT
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
4511514
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
|
FAMILY TX WO PT 50 MIN ADULT
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90846
|
| Hospital Charge Code |
4822514
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$136.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$390.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.40
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.60
|
|
