|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
OP
|
$896.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
83246100
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$25.45 |
| 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 |
$151.74
|
| 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 |
$232.96
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$134.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.45
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
84511023
|
|
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 |
$151.74
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
84511023
|
|
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 W PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
83652357
|
|
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 |
$151.74
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
84504060
|
|
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 W PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
84206250
|
|
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 W PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
84504060
|
|
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 |
$151.74
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
IP
|
$896.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
83246265
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$134.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$134.40
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
IP
|
$800.80
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
87504060
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$120.12 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.12
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
83652357
|
|
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 W PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
84517023
|
|
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 |
$151.74
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
87502005
|
|
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 |
$151.74
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
IP
|
$896.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
83246100
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$134.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$134.40
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
94810080
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$5.77 |
| 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 |
$151.74
|
| 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 |
$52.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.41
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.77
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
IP
|
$284.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
94810040
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$42.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.60
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
87502005
|
|
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 W PATIENT 50 MIN
|
Facility
|
IP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
84518023
|
|
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 W PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
84206250
|
|
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 |
$151.74
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX W PATIENT 50 MIN
|
Facility
|
OP
|
$1,094.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
84518023
|
|
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 |
$151.74
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.07
|
|
|
FAMILY TX W PT 50 MIN ADULT
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
4822516
|
|
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 W PT 50 MIN ADULT
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
4822516
|
|
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 |
$151.74
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.60
|
|
|
FAMILY TX W PT 50 MIN ADULT
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
4504516
|
|
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 |
$151.74
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.60
|
|
|
FAMILY TX W PT 50 MIN ADULT
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
4504516
|
|
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 W PT 50 MIN ADULT
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
4502516
|
|
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 |
$151.74
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$113.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.60
|
|
|
FAMILY TX W PT 50 MIN ADULT
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS 90847
|
| Hospital Charge Code |
4502516
|
|
Hospital Revenue Code
|
916
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.00
|
|
