|
GROUP CHILD OP Medicaid
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4822616
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
GROUP CHILD OP Medicaid
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4824616
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
GROUP CHILD OP Medicaid
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4527616
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
GROUP CHILD OP Medicaid
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4824616
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
GROUP CHILD OP Medicaid
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4511616
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
GROUP CHILD OP Medicaid
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4511616
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
GROUP CHILD OP Medicaid
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4515616
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
GROUP CHILD OP Medicaid
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4546616
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
GROUP CHILD OP Medicaid
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4527616
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
GROUP CHILD OP Medicaid
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4504616
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
GROUP CHILD OP Medicaid
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4515616
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
GROUP CHILD OP MEDICAID
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4824625
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
GROUP CHILD OP MEDICAID
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4824625
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
GROUP CHILD PH MEDICAID
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS H0035
|
| Hospital Charge Code |
4510625
|
|
Hospital Revenue Code
|
913
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
GROUP CHILD PH MEDICAID
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS H0035
|
| Hospital Charge Code |
4510625
|
|
Hospital Revenue Code
|
913
|
| Min. Negotiated Rate |
$17.91 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$17.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
GROUP CHILD PH MEDICAID
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4822625
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
GROUP CHILD PH MEDICAID
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS 90853
|
| Hospital Charge Code |
4822625
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$21.30 |
| Max. Negotiated Rate |
$437.80 |
| Rate for Payer: Aetna Commercial |
$328.28
|
| Rate for Payer: Aetna Medicare Advantage |
$391.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$437.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$120.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$437.80
|
| Rate for Payer: Cigna Commercial |
$241.93
|
| Rate for Payer: Cigna Medicare Advantage |
$120.69
|
| Rate for Payer: Clover Medicare Advantage |
$114.66
|
| Rate for Payer: EmblemHealth Commercial |
$362.07
|
| Rate for Payer: Humana Medicare Advantage |
$124.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$120.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$120.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
GROUP CHILD PH MEDICAID
|
Facility
|
OP
|
$750.00
|
|
|
Service Code
|
HCPCS H0035
|
| Hospital Charge Code |
4509625
|
|
Hospital Revenue Code
|
913
|
| Min. Negotiated Rate |
$17.91 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$285.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.70
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$17.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.30
|
|
|
GROUP CHILD PH MEDICAID
|
Facility
|
IP
|
$750.00
|
|
|
Service Code
|
HCPCS H0035
|
| Hospital Charge Code |
4509625
|
|
Hospital Revenue Code
|
913
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
GROUP COUNSELING EDUC 2-4 PT
|
Facility
|
IP
|
$61.65
|
|
|
Service Code
|
HCPCS 98961
|
| Hospital Charge Code |
9300007
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$9.25 |
| Max. Negotiated Rate |
$9.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.25
|
|
|
GROUP COUNSELING EDUC 2-4 PT
|
Facility
|
OP
|
$61.65
|
|
|
Service Code
|
HCPCS 98961
|
| Hospital Charge Code |
9300007
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$1,203.00 |
| Rate for Payer: Aetna Commercial |
$23.43
|
| Rate for Payer: Aetna Medicare Advantage |
$18.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.72
|
| Rate for Payer: Cigna Commercial |
$30.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.03
|
| Rate for Payer: Oxford Commercial |
$1,060.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,203.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.75
|
|
|
GROUP COUNSELING EDUC 2-4 PT
|
Facility
|
IP
|
$164.00
|
|
|
Service Code
|
HCPCS 98961
|
| Hospital Charge Code |
9200085
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$24.60 |
| Max. Negotiated Rate |
$24.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.60
|
|
|
GROUP COUNSELING EDUC 2-4 PT
|
Facility
|
OP
|
$2,700.00
|
|
|
Service Code
|
HCPCS 98961
|
| Hospital Charge Code |
9200039
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$8.63 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna Commercial |
$1,026.00
|
| Rate for Payer: Aetna Medicare Advantage |
$810.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$688.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$688.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$688.50
|
| Rate for Payer: Cigna Commercial |
$1,350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$702.00
|
| Rate for Payer: Oxford Commercial |
$1,060.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$405.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,203.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$85.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$76.68
|
|
|
GROUP COUNSELING EDUC 2-4 PT
|
Facility
|
IP
|
$2,700.00
|
|
|
Service Code
|
HCPCS 98961
|
| Hospital Charge Code |
9200039
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$405.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$405.00
|
|
|
GROUP COUNSELING EDUC 2-4 PT
|
Facility
|
OP
|
$164.00
|
|
|
Service Code
|
HCPCS 98961
|
| Hospital Charge Code |
9200085
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$1,203.00 |
| Rate for Payer: Aetna Commercial |
$62.32
|
| Rate for Payer: Aetna Medicare Advantage |
$49.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.82
|
| Rate for Payer: Cigna Commercial |
$82.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.64
|
| Rate for Payer: Oxford Commercial |
$1,060.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,203.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.66
|
|
