|
FP IMM.ADM@ADDTN'L INTNAS/ORL
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
HCPCS 90474
|
| Hospital Charge Code |
83652301
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
|
|
FP IMM.ADM@ADDTN'L INTNAS/ORL
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
HCPCS 90474
|
| Hospital Charge Code |
83652301
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Aetna Commercial |
$59.28
|
| Rate for Payer: Aetna Medicare Advantage |
$46.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.78
|
| Rate for Payer: Cigna Commercial |
$78.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.56
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.43
|
|
|
FP IND PSYCHTERAPHY 45-50MTS
|
Facility
|
OP
|
$576.00
|
|
|
Service Code
|
HCPCS 90806
|
| Hospital Charge Code |
83652349
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$288.00 |
| Rate for Payer: Aetna Commercial |
$218.88
|
| Rate for Payer: Aetna Medicare Advantage |
$172.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$146.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$146.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$146.88
|
| Rate for Payer: Cigna Commercial |
$288.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$149.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.36
|
|
|
FP IND PSYCHTERAPHY 45-50MTS
|
Facility
|
IP
|
$576.00
|
|
|
Service Code
|
HCPCS 90806
|
| Hospital Charge Code |
83652349
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$86.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.40
|
|
|
FP IND. PSYCH THERAPY 20-30 MT
|
Facility
|
IP
|
$476.00
|
|
|
Service Code
|
HCPCS 90804
|
| Hospital Charge Code |
83652345
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$71.40 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.40
|
|
|
FP IND. PSYCH THERAPY 20-30 MT
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
HCPCS 90804
|
| Hospital Charge Code |
83652345
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$13.52 |
| Max. Negotiated Rate |
$238.00 |
| Rate for Payer: Aetna Commercial |
$180.88
|
| Rate for Payer: Aetna Medicare Advantage |
$142.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$121.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$121.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$121.38
|
| Rate for Payer: Cigna Commercial |
$238.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$123.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.52
|
|
|
FP IND PSY-THRPY INTRACT 45-50
|
Facility
|
OP
|
$536.00
|
|
|
Service Code
|
HCPCS 90812
|
| Hospital Charge Code |
83652355
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$15.22 |
| Max. Negotiated Rate |
$268.00 |
| Rate for Payer: Aetna Commercial |
$203.68
|
| Rate for Payer: Aetna Medicare Advantage |
$160.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$136.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$136.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$136.68
|
| Rate for Payer: Cigna Commercial |
$268.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.36
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.22
|
|
|
FP IND PSY-THRPY INTRACT 45-50
|
Facility
|
IP
|
$536.00
|
|
|
Service Code
|
HCPCS 90812
|
| Hospital Charge Code |
83652355
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$80.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$80.40
|
|
|
FP INDV PSY-THPY-INTACT 20-30
|
Facility
|
OP
|
$399.00
|
|
|
Service Code
|
HCPCS 90810
|
| Hospital Charge Code |
83652353
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$11.33 |
| Max. Negotiated Rate |
$199.50 |
| Rate for Payer: Aetna Commercial |
$151.62
|
| Rate for Payer: Aetna Medicare Advantage |
$119.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$101.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$101.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$101.75
|
| Rate for Payer: Cigna Commercial |
$199.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.74
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.33
|
|
|
FP INDV PSY-THPY-INTACT 20-30
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
HCPCS 90810
|
| Hospital Charge Code |
83652353
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$59.85 |
| Max. Negotiated Rate |
$59.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.85
|
|
|
FP INJ SNGL TENDON LGMT APONE
|
Facility
|
IP
|
$185.05
|
|
|
Service Code
|
HCPCS 20550
|
| Hospital Charge Code |
87502555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$27.76 |
| Max. Negotiated Rate |
$27.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.76
|
|
|
FP INJ SNGL TENDON LGMT APONE
|
Facility
|
OP
|
$185.05
|
|
|
Service Code
|
HCPCS 20550
|
| Hospital Charge Code |
87502555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5.26 |
| Max. Negotiated Rate |
$1,322.84 |
| Rate for Payer: Aetna Commercial |
$991.90
|
| Rate for Payer: Aetna Medicare Advantage |
$1,181.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,322.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,322.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$364.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,322.84
|
| Rate for Payer: Cigna Commercial |
$730.97
|
| Rate for Payer: Cigna Medicare Advantage |
$364.67
|
| Rate for Payer: Clover Medicare Advantage |
$346.44
|
| Rate for Payer: EmblemHealth Commercial |
$1,094.01
|
| Rate for Payer: Humana Medicare Advantage |
$375.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$364.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.11
|
| Rate for Payer: Oxford Commercial |
$37.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$37.01
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.85
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.26
|
|
|
FP INJ;SNGL TENDON,LGMT;APONE
|
Facility
|
OP
|
$317.00
|
|
|
Service Code
|
HCPCS 20550
|
| Hospital Charge Code |
83652089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$1,322.84 |
| Rate for Payer: Aetna Commercial |
$991.90
|
| Rate for Payer: Aetna Medicare Advantage |
$1,181.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,322.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,322.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$364.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,322.84
|
| Rate for Payer: Cigna Commercial |
$730.97
|
| Rate for Payer: Cigna Medicare Advantage |
$364.67
|
| Rate for Payer: Clover Medicare Advantage |
$346.44
|
| Rate for Payer: EmblemHealth Commercial |
$1,094.01
|
| Rate for Payer: Humana Medicare Advantage |
$375.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$364.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.42
|
| Rate for Payer: Oxford Commercial |
$63.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.02
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.00
|
|
|
FP INJ;SNGL TENDON,LGMT;APONE
|
Facility
|
IP
|
$317.00
|
|
|
Service Code
|
HCPCS 20550
|
| Hospital Charge Code |
83652089
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$47.55 |
| Max. Negotiated Rate |
$47.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.55
|
|
|
FP I&REMOVAL FB SUB C COMPLIC
|
Facility
|
IP
|
$8,995.35
|
|
|
Service Code
|
HCPCS 10121
|
| Hospital Charge Code |
87502430
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,349.30 |
| Max. Negotiated Rate |
$1,349.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,349.30
|
|
|
FP I&REMOVAL FB SUB C COMPLIC
|
Facility
|
OP
|
$8,995.35
|
|
|
Service Code
|
HCPCS 10121
|
| Hospital Charge Code |
87502430
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.15 |
| Max. Negotiated Rate |
$7,117.66 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$168.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,117.66
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,338.79
|
| Rate for Payer: Oxford Commercial |
$1,799.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,349.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,799.07
|
| Rate for Payer: UnitedHealthcare Community & State |
$284.25
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$4,474.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$255.47
|
|
|
FP I&REMOVAL FB.SUBC COMPLICAT
|
Facility
|
OP
|
$1,490.00
|
|
|
Service Code
|
HCPCS 10121
|
| Hospital Charge Code |
83652007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$42.32 |
| Max. Negotiated Rate |
$7,117.66 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$168.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,117.66
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$387.40
|
| Rate for Payer: Oxford Commercial |
$298.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$223.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$298.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$47.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$4,474.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.32
|
|
|
FP I&REMOVAL FB.SUBC COMPLICAT
|
Facility
|
IP
|
$1,490.00
|
|
|
Service Code
|
HCPCS 10121
|
| Hospital Charge Code |
83652007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$223.50 |
| Max. Negotiated Rate |
$223.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$223.50
|
|
|
FP I& REMOVAL FB SUB CUT SIMPL
|
Facility
|
IP
|
$1,822.15
|
|
|
Service Code
|
HCPCS 10120
|
| Hospital Charge Code |
87502425
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.32 |
| Max. Negotiated Rate |
$273.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$273.32
|
|
|
FP I& REMOVAL FB SUB CUT SIMPL
|
Facility
|
OP
|
$1,822.15
|
|
|
Service Code
|
HCPCS 10120
|
| Hospital Charge Code |
87502425
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$51.75 |
| Max. Negotiated Rate |
$1,751.90 |
| Rate for Payer: Aetna Commercial |
$1,313.62
|
| Rate for Payer: Aetna Medicare Advantage |
$1,564.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$482.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$87.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,751.90
|
| Rate for Payer: Cigna Commercial |
$968.07
|
| Rate for Payer: Cigna Medicare Advantage |
$482.95
|
| Rate for Payer: Clover Medicare Advantage |
$458.80
|
| Rate for Payer: EmblemHealth Commercial |
$1,448.85
|
| Rate for Payer: Humana Medicare Advantage |
$497.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$482.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$473.76
|
| Rate for Payer: Oxford Commercial |
$364.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$273.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$364.43
|
| Rate for Payer: UnitedHealthcare Community & State |
$57.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$1,058.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$51.75
|
|
|
FP NAIL EXCISION/PARTIAL/COMP
|
Facility
|
OP
|
$2,081.00
|
|
|
Service Code
|
HCPCS 11750
|
| Hospital Charge Code |
83652057
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.10 |
| Max. Negotiated Rate |
$1,751.90 |
| Rate for Payer: Aetna Commercial |
$1,313.62
|
| Rate for Payer: Aetna Medicare Advantage |
$1,564.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$482.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$134.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,751.90
|
| Rate for Payer: Cigna Commercial |
$968.07
|
| Rate for Payer: Cigna Medicare Advantage |
$482.95
|
| Rate for Payer: Clover Medicare Advantage |
$458.80
|
| Rate for Payer: EmblemHealth Commercial |
$1,448.85
|
| Rate for Payer: Humana Medicare Advantage |
$497.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$482.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$541.06
|
| Rate for Payer: Oxford Commercial |
$416.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$312.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$416.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$65.76
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$59.10
|
|
|
FP NAIL EXCISION/PARTIAL/COMP
|
Facility
|
OP
|
$2,081.00
|
|
|
Service Code
|
HCPCS 11750
|
| Hospital Charge Code |
87502495
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.10 |
| Max. Negotiated Rate |
$1,751.90 |
| Rate for Payer: Aetna Commercial |
$1,313.62
|
| Rate for Payer: Aetna Medicare Advantage |
$1,564.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$482.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$134.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,751.90
|
| Rate for Payer: Cigna Commercial |
$968.07
|
| Rate for Payer: Cigna Medicare Advantage |
$482.95
|
| Rate for Payer: Clover Medicare Advantage |
$458.80
|
| Rate for Payer: EmblemHealth Commercial |
$1,448.85
|
| Rate for Payer: Humana Medicare Advantage |
$497.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$482.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$541.06
|
| Rate for Payer: Oxford Commercial |
$416.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$312.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$416.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$65.76
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$59.10
|
|
|
FP NAIL EXCISION/PARTIAL/COMP
|
Facility
|
IP
|
$2,081.00
|
|
|
Service Code
|
HCPCS 11750
|
| Hospital Charge Code |
87502495
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$312.15 |
| Max. Negotiated Rate |
$312.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$312.15
|
|
|
FP NAIL EXCISION/PARTIAL/COMP
|
Facility
|
IP
|
$2,081.00
|
|
|
Service Code
|
HCPCS 11750
|
| Hospital Charge Code |
83652057
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$312.15 |
| Max. Negotiated Rate |
$312.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$312.15
|
|
|
FP PARING BENIGN 2-4 LESIONS
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
HCPCS 11056
|
| Hospital Charge Code |
87502560
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.50
|
|