|
INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES
|
Facility
|
IP
|
$40,391.39
|
|
|
Service Code
|
APR-DRG 2284
|
| Min. Negotiated Rate |
$39,599.40 |
| Max. Negotiated Rate |
$40,391.39 |
| Rate for Payer: UnitedHealthcare Community & State |
$39,599.40
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$40,391.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39,599.40
|
|
|
INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES
|
Facility
|
IP
|
$21,610.60
|
|
|
Service Code
|
APR-DRG 2283
|
| Min. Negotiated Rate |
$21,186.86 |
| Max. Negotiated Rate |
$21,610.60 |
| Rate for Payer: UnitedHealthcare Community & State |
$21,186.86
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$21,610.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21,186.86
|
|
|
INHALATION TREATMENT
|
Facility
|
OP
|
$1,122.00
|
|
|
Service Code
|
HCPCS 94640
|
| Hospital Charge Code |
412394640
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$31.86 |
| Max. Negotiated Rate |
$1,440.00 |
| Rate for Payer: Aetna Commercial |
$707.61
|
| Rate for Payer: Aetna Medicare Advantage |
$842.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$943.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$943.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$260.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$40.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$943.69
|
| Rate for Payer: Cigna Commercial |
$521.47
|
| Rate for Payer: Cigna Medicare Advantage |
$260.15
|
| Rate for Payer: Clover Medicare Advantage |
$247.14
|
| Rate for Payer: EmblemHealth Commercial |
$780.45
|
| Rate for Payer: Humana Medicare Advantage |
$267.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$260.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$291.72
|
| Rate for Payer: Oxford Commercial |
$1,367.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,440.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$260.15
|
| Rate for Payer: Wellcare Medicare Advantage |
$260.15
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.86
|
|
|
INHALATION TREATMENT
|
Facility
|
IP
|
$1,122.00
|
|
|
Service Code
|
HCPCS 94640
|
| Hospital Charge Code |
412394640
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$168.30 |
| Max. Negotiated Rate |
$168.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$168.30
|
|
|
INHIBIN A
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
HCPCS 86336
|
| Hospital Charge Code |
38477009
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare Advantage |
$50.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.55
|
| Rate for Payer: Cigna Commercial |
$55.00
|
| Rate for Payer: Cigna Medicare Advantage |
$15.59
|
| Rate for Payer: Clover Medicare Advantage |
$14.81
|
| Rate for Payer: EmblemHealth Commercial |
$46.77
|
| Rate for Payer: Humana Medicare Advantage |
$16.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15.59
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.60
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15.59
|
| Rate for Payer: Wellcare Medicare Advantage |
$15.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.12
|
|
|
INHIBIN A
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
HCPCS 86336
|
| Hospital Charge Code |
38479406
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.50
|
|
|
INHIBIN A
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
HCPCS 86336
|
| Hospital Charge Code |
38479406
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare Advantage |
$50.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.55
|
| Rate for Payer: Cigna Commercial |
$55.00
|
| Rate for Payer: Cigna Medicare Advantage |
$15.59
|
| Rate for Payer: Clover Medicare Advantage |
$14.81
|
| Rate for Payer: EmblemHealth Commercial |
$46.77
|
| Rate for Payer: Humana Medicare Advantage |
$16.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15.59
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.60
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15.59
|
| Rate for Payer: Wellcare Medicare Advantage |
$15.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.12
|
|
|
INHIBIN A
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
HCPCS 86336
|
| Hospital Charge Code |
38477009
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.50
|
|
|
INHIBIN A
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86336
|
| Hospital Charge Code |
39900216
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
INHIBIN A
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86336
|
| Hospital Charge Code |
39900216
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare Advantage |
$50.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$56.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$56.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$56.55
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$15.59
|
| Rate for Payer: Clover Medicare Advantage |
$14.81
|
| Rate for Payer: EmblemHealth Commercial |
$46.77
|
| Rate for Payer: Humana Medicare Advantage |
$16.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15.59
|
| 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 |
$12.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15.59
|
| Rate for Payer: Wellcare Medicare Advantage |
$15.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
INHIBIN B
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82397
|
| Hospital Charge Code |
39900439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
INHIBIN B
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82397
|
| Hospital Charge Code |
39900439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$38.41
|
| Rate for Payer: Aetna Medicare Advantage |
$45.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.22
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.12
|
| Rate for Payer: Clover Medicare Advantage |
$13.41
|
| Rate for Payer: EmblemHealth Commercial |
$42.36
|
| Rate for Payer: Humana Medicare Advantage |
$14.54
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.12
|
| 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 |
$11.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.12
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.12
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
INITIAL PREVENTIVE PHY EXAM GE
|
Facility
|
IP
|
$500.45
|
|
|
Service Code
|
HCPCS G0402
|
| Hospital Charge Code |
87502820
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$75.07 |
| Max. Negotiated Rate |
$75.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.07
|
|
|
INITIAL PREVENTIVE PHY EXAM GE
|
Facility
|
OP
|
$500.45
|
|
|
Service Code
|
HCPCS G0402
|
| Hospital Charge Code |
87502820
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$14.21 |
| Max. Negotiated Rate |
$573.76 |
| Rate for Payer: Aetna Commercial |
$430.22
|
| Rate for Payer: Aetna Medicare Advantage |
$512.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$158.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.76
|
| Rate for Payer: Cigna Commercial |
$317.04
|
| Rate for Payer: Cigna Medicare Advantage |
$158.17
|
| Rate for Payer: Clover Medicare Advantage |
$150.26
|
| Rate for Payer: EmblemHealth Commercial |
$474.51
|
| Rate for Payer: Humana Medicare Advantage |
$162.92
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$158.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.12
|
| Rate for Payer: Oxford Commercial |
$100.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$100.09
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.81
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.21
|
|
|
INJ/AIR/CONT INTO PERITONEAL
|
Facility
|
OP
|
$509.70
|
|
|
Service Code
|
HCPCS 49400
|
| Hospital Charge Code |
1600000353
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$193.69
|
| Rate for Payer: Aetna Medicare Advantage |
$152.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$129.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$129.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$129.97
|
| Rate for Payer: Cigna Commercial |
$254.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$132.52
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$76.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.48
|
|
|
INJ/AIR/CONT INTO PERITONEAL
|
Facility
|
IP
|
$509.70
|
|
|
Service Code
|
HCPCS 49400
|
| Hospital Charge Code |
1600000353
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$76.45 |
| Max. Negotiated Rate |
$76.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$76.45
|
|
|
INJ ANESTH,PUDENDAL NERVE
|
Facility
|
OP
|
$7,956.80
|
|
|
Service Code
|
HCPCS 64430
|
| Hospital Charge Code |
16001032
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$225.97 |
| Max. Negotiated Rate |
$3,811.70 |
| Rate for Payer: Aetna Commercial |
$2,858.12
|
| Rate for Payer: Aetna Medicare Advantage |
$3,404.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,811.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,811.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,050.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,811.70
|
| Rate for Payer: Cigna Commercial |
$2,106.27
|
| Rate for Payer: Cigna Medicare Advantage |
$1,050.78
|
| Rate for Payer: Clover Medicare Advantage |
$998.24
|
| Rate for Payer: EmblemHealth Commercial |
$3,152.34
|
| Rate for Payer: Humana Medicare Advantage |
$1,082.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,050.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,068.77
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,193.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$251.43
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$225.97
|
|
|
INJ ANESTH,PUDENDAL NERVE
|
Facility
|
IP
|
$7,956.80
|
|
|
Service Code
|
HCPCS 64430
|
| Hospital Charge Code |
16001032
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,193.52 |
| Max. Negotiated Rate |
$1,193.52 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,193.52
|
|
|
INJ ANESTH,STELLATE GANGLION
|
Facility
|
IP
|
$3,152.73
|
|
|
Service Code
|
HCPCS 64510
|
| Hospital Charge Code |
16001039
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$472.91 |
| Max. Negotiated Rate |
$472.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$472.91
|
|
|
INJ ANESTH,STELLATE GANGLION
|
Facility
|
OP
|
$3,152.73
|
|
|
Service Code
|
HCPCS 64510
|
| Hospital Charge Code |
16001039
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$89.54 |
| Max. Negotiated Rate |
$3,811.70 |
| Rate for Payer: Aetna Commercial |
$2,858.12
|
| Rate for Payer: Aetna Medicare Advantage |
$3,404.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,811.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,811.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,050.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,811.70
|
| Rate for Payer: Cigna Commercial |
$2,106.27
|
| Rate for Payer: Cigna Medicare Advantage |
$1,050.78
|
| Rate for Payer: Clover Medicare Advantage |
$998.24
|
| Rate for Payer: EmblemHealth Commercial |
$3,152.34
|
| Rate for Payer: Humana Medicare Advantage |
$1,082.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,050.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$819.71
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$472.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$99.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$89.54
|
|
|
INJ ANSTH,LUMB/THORSYMPATHETIC
|
Facility
|
OP
|
$3,152.73
|
|
|
Service Code
|
HCPCS 64520
|
| Hospital Charge Code |
16000434
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$89.54 |
| Max. Negotiated Rate |
$3,811.70 |
| Rate for Payer: Aetna Commercial |
$2,858.12
|
| Rate for Payer: Aetna Medicare Advantage |
$3,404.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,811.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,811.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,050.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,811.70
|
| Rate for Payer: Cigna Commercial |
$2,106.27
|
| Rate for Payer: Cigna Medicare Advantage |
$1,050.78
|
| Rate for Payer: Clover Medicare Advantage |
$998.24
|
| Rate for Payer: EmblemHealth Commercial |
$3,152.34
|
| Rate for Payer: Humana Medicare Advantage |
$1,082.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,050.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$819.71
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$472.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$99.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$89.54
|
|
|
INJ ANSTH,LUMB/THORSYMPATHETIC
|
Facility
|
IP
|
$3,152.73
|
|
|
Service Code
|
HCPCS 64520
|
| Hospital Charge Code |
16000434
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$472.91 |
| Max. Negotiated Rate |
$472.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$472.91
|
|
|
INJ ANSTH-PERIPHERL NRV/BRANCH
|
Facility
|
OP
|
$4,414.73
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
1600000416
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$125.38 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,281.02
|
| Rate for Payer: Aetna Medicare Advantage |
$2,717.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,042.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,042.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$838.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,042.06
|
| Rate for Payer: Cigna Commercial |
$1,680.99
|
| Rate for Payer: Cigna Medicare Advantage |
$838.61
|
| Rate for Payer: Clover Medicare Advantage |
$796.68
|
| Rate for Payer: EmblemHealth Commercial |
$2,515.83
|
| Rate for Payer: Humana Medicare Advantage |
$863.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$838.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,147.83
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$662.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$139.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$838.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$838.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$125.38
|
|
|
INJ ANSTH-PERIPHERL NRV/BRANCH
|
Facility
|
IP
|
$4,414.73
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
1600000416
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$662.21 |
| Max. Negotiated Rate |
$662.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$662.21
|
|
|
INJ ARIPIPRAZOLE ER 300 MG
|
Facility
|
OP
|
$9,554.27
|
|
|
Service Code
|
HCPCS J0401
|
| Hospital Charge Code |
6063943338
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.91 |
| Max. Negotiated Rate |
$2,312.13 |
| Rate for Payer: Aetna Commercial |
$19.77
|
| Rate for Payer: Aetna Medicare Advantage |
$23.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.37
|
| Rate for Payer: Cigna Medicare Advantage |
$7.27
|
| Rate for Payer: Clover Medicare Advantage |
$6.91
|
| Rate for Payer: EmblemHealth Commercial |
$21.81
|
| Rate for Payer: Humana Medicare Advantage |
$7.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,312.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,433.14
|
| Rate for Payer: UnitedHealthcare Community & State |
$301.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7.27
|
| Rate for Payer: Wellcare Medicare Advantage |
$7.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$271.34
|
|
