|
INF THERAP DIFF DRUG 1ST HR
|
Facility
|
OP
|
$2,145.09
|
|
|
Service Code
|
HCPCS 96367
|
| Hospital Charge Code |
5700404
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$557.72 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$557.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$321.76
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60.92
|
|
|
INF THERAP DIFF DRUG 1ST HR
|
Facility
|
OP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96367
|
| Hospital Charge Code |
73050925
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$418.82
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.75
|
|
|
INF THERAP DIFF DRUG 1ST HR
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96367
|
| Hospital Charge Code |
100128
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$728.00
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$88.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$79.52
|
|
|
INF THERAP DIFF DRUG 1ST HR
|
Facility
|
IP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96367
|
| Hospital Charge Code |
8200517
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$241.63 |
| Max. Negotiated Rate |
$241.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
|
|
INF THERAP DIFF DRUG 1ST HR
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96367
|
| Hospital Charge Code |
83653140
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$728.00
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$88.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$79.52
|
|
|
INF THERAP DIFF DRUG 1ST HR
|
Facility
|
IP
|
$2,145.09
|
|
|
Service Code
|
HCPCS 96367
|
| Hospital Charge Code |
5700404
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$321.76 |
| Max. Negotiated Rate |
$321.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$321.76
|
|
|
INF THERAP DIFF DRUG 1ST HR
|
Facility
|
OP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96367
|
| Hospital Charge Code |
8200517
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$418.82
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.75
|
|
|
INF THERAP DIFF DRUG 1ST HR
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96367
|
| Hospital Charge Code |
83653140
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
411096365
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$40.99 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$916.67
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$728.00
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$88.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$79.52
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
IP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
2250414
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$241.63 |
| Max. Negotiated Rate |
$241.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
411096365
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
5700259
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
5700259
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$40.99 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$916.67
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$728.00
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$88.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$79.52
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
IP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
93500019
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$241.63 |
| Max. Negotiated Rate |
$241.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
OP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
74308235
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$40.99 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$916.67
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$418.82
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.75
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
93500029
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
5700375
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
IP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
5100782
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$241.63 |
| Max. Negotiated Rate |
$241.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
OP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
4501035
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$40.99 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$916.67
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$418.82
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.75
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
OP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
93500019
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$40.99 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$916.67
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$418.82
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.75
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
IP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
8200515
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$241.63 |
| Max. Negotiated Rate |
$241.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
OP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
5100782
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$40.99 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$916.67
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$418.82
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.75
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
OP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
2250414
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$40.99 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$916.67
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$418.82
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.75
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
IP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
73237021
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$241.63 |
| Max. Negotiated Rate |
$241.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
|
|
INF THERAPEUTIC 1ST HR
|
Facility
|
OP
|
$1,610.84
|
|
|
Service Code
|
HCPCS 96365
|
| Hospital Charge Code |
93082001
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$40.99 |
| Max. Negotiated Rate |
$1,235.00 |
| Rate for Payer: Aetna Commercial |
$687.34
|
| Rate for Payer: Aetna Medicare Advantage |
$818.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$916.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$252.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$916.67
|
| Rate for Payer: Cigna Commercial |
$506.53
|
| Rate for Payer: Cigna Medicare Advantage |
$252.70
|
| Rate for Payer: Clover Medicare Advantage |
$240.06
|
| Rate for Payer: EmblemHealth Commercial |
$758.10
|
| Rate for Payer: Humana Medicare Advantage |
$260.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$252.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$418.82
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$252.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.75
|
|
