|
ANAL FISTULA PLUG
|
Facility
|
IP
|
$2,209.00
|
|
| Hospital Charge Code |
270332624
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$331.35 |
| Max. Negotiated Rate |
$534.58 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$441.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$534.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$331.35
|
|
|
ANAL FISTULA PLUG
|
Facility
|
OP
|
$2,209.00
|
|
| Hospital Charge Code |
270332624
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$62.74 |
| Max. Negotiated Rate |
$1,104.50 |
| Rate for Payer: Aetna Commercial |
$839.42
|
| Rate for Payer: Aetna Medicare Advantage |
$662.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$563.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$563.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$441.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$563.29
|
| Rate for Payer: Cigna Commercial |
$1,104.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$534.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$331.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$69.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$62.74
|
|
|
ANALGESICS NON-OPIOID 1 OR 2
|
Facility
|
OP
|
$190.45
|
|
|
Service Code
|
HCPCS 80329
|
| Hospital Charge Code |
39990213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna Medicare Advantage |
$57.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.56
|
| Rate for Payer: Cigna Commercial |
$95.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.41
|
|
|
ANALGESICS NON-OPIOID 1 OR 2
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80329
|
| Hospital Charge Code |
39990213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
ANALGESICS NON-OPIOID 1 OR 2
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80329
|
| Hospital Charge Code |
38430013
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
ANALGESICS NON-OPIOID 1 OR 2
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80329
|
| Hospital Charge Code |
3039013
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
ANALGESICS NON-OPIOID 1 OR 2
|
Facility
|
OP
|
$190.45
|
|
|
Service Code
|
HCPCS 80329
|
| Hospital Charge Code |
38430013
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna Medicare Advantage |
$57.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.56
|
| Rate for Payer: Cigna Commercial |
$95.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.41
|
|
|
ANALGESICS NON-OPIOID 1 OR 2
|
Facility
|
OP
|
$190.45
|
|
|
Service Code
|
HCPCS 80329
|
| Hospital Charge Code |
3039013
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna Medicare Advantage |
$57.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.56
|
| Rate for Payer: Cigna Commercial |
$95.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.41
|
|
|
ANALGESICS NON-OPIOID 3-5
|
Facility
|
OP
|
$190.45
|
|
|
Service Code
|
HCPCS 80330
|
| Hospital Charge Code |
3039014
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna Medicare Advantage |
$57.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.56
|
| Rate for Payer: Cigna Commercial |
$95.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.41
|
|
|
ANALGESICS NON-OPIOID 3-5
|
Facility
|
OP
|
$190.45
|
|
|
Service Code
|
HCPCS 80330
|
| Hospital Charge Code |
39990214
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna Medicare Advantage |
$57.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.56
|
| Rate for Payer: Cigna Commercial |
$95.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.41
|
|
|
ANALGESICS NON-OPIOID 3-5
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80330
|
| Hospital Charge Code |
3039014
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
ANALGESICS NON-OPIOID 3-5
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80330
|
| Hospital Charge Code |
38430014
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
ANALGESICS NON-OPIOID 3-5
|
Facility
|
OP
|
$190.45
|
|
|
Service Code
|
HCPCS 80330
|
| Hospital Charge Code |
38430014
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna Medicare Advantage |
$57.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.56
|
| Rate for Payer: Cigna Commercial |
$95.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.41
|
|
|
ANALGESICS NON-OPIOID 3-5
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80330
|
| Hospital Charge Code |
39990214
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
ANALGESICS NON-OPIOID 6/MORE
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80331
|
| Hospital Charge Code |
3039015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
ANALGESICS NON-OPIOID 6/MORE
|
Facility
|
OP
|
$190.45
|
|
|
Service Code
|
HCPCS 80331
|
| Hospital Charge Code |
39990215
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna Medicare Advantage |
$57.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.56
|
| Rate for Payer: Cigna Commercial |
$95.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.41
|
|
|
ANALGESICS NON-OPIOID 6/MORE
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80331
|
| Hospital Charge Code |
38430015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
ANALGESICS NON-OPIOID 6/MORE
|
Facility
|
OP
|
$190.45
|
|
|
Service Code
|
HCPCS 80331
|
| Hospital Charge Code |
38430015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna Medicare Advantage |
$57.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.56
|
| Rate for Payer: Cigna Commercial |
$95.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.41
|
|
|
ANALGESICS NON-OPIOID 6/MORE
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80331
|
| Hospital Charge Code |
39990215
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
ANALGESICS NON-OPIOID 6/MORE
|
Facility
|
OP
|
$190.45
|
|
|
Service Code
|
HCPCS 80331
|
| Hospital Charge Code |
3039015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna Medicare Advantage |
$57.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.56
|
| Rate for Payer: Cigna Commercial |
$95.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.41
|
|
|
ANALYTE IMMUNOASSAY, EACH, #1
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
3032059B
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$31.36
|
| Rate for Payer: Aetna Medicare Advantage |
$37.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.83
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.53
|
| Rate for Payer: Clover Medicare Advantage |
$10.95
|
| Rate for Payer: EmblemHealth Commercial |
$34.59
|
| Rate for Payer: Humana Medicare Advantage |
$11.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.40
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
ANALYTE IMMUNOASSAY, EACH, #1
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
3032059B
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ANALYTE IMMUNOASSAY, EACH, #2
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
3032059C
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$31.36
|
| Rate for Payer: Aetna Medicare Advantage |
$37.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.83
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.53
|
| Rate for Payer: Clover Medicare Advantage |
$10.95
|
| Rate for Payer: EmblemHealth Commercial |
$34.59
|
| Rate for Payer: Humana Medicare Advantage |
$11.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.40
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
ANALYTE IMMUNOASSAY, EACH, #2
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
3032059C
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ANALYZE NEUROSTIM COMPLEX
|
Facility
|
IP
|
$460.72
|
|
|
Service Code
|
HCPCS 95972
|
| Hospital Charge Code |
1600000290
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$69.11 |
| Max. Negotiated Rate |
$69.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.11
|
|