|
INJECTION IM/SUBQ
|
Facility
|
OP
|
$345.05
|
|
|
Service Code
|
HCPCS 96372
|
| Hospital Charge Code |
93950121
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$9.80 |
| 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 |
$12.90
|
| 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 |
$89.71
|
| Rate for Payer: Oxford Commercial |
$1,092.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.80
|
|
|
INJECTION IM/SUBQ
|
Facility
|
IP
|
$345.05
|
|
|
Service Code
|
HCPCS 96372
|
| Hospital Charge Code |
93950121
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$51.76 |
| Max. Negotiated Rate |
$51.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.76
|
|
|
INJECTION IM/SUBQ
|
Facility
|
OP
|
$554.81
|
|
|
Service Code
|
HCPCS 96372
|
| Hospital Charge Code |
5700247
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$12.90 |
| Max. Negotiated Rate |
$310.30 |
| 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 |
$12.90
|
| 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 |
$144.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.22
|
| 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 |
$15.76
|
|
|
INJECTION IM/SUBQ
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
HCPCS 96372
|
| Hospital Charge Code |
83653145
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
|
|
INJECTION IM/SUBQ
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96372
|
| Hospital Charge Code |
3400256
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
INJECTION IM/SUBQ
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96372
|
| Hospital Charge Code |
4832524
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$12.90 |
| 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 |
$12.90
|
| 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
|
|
|
INJECTION IM/SUBQ
|
Facility
|
IP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96372
|
| Hospital Charge Code |
1600505
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$420.00 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$420.00
|
|
|
INJECTION IM/SUBQ
|
Facility
|
OP
|
$2,800.00
|
|
|
Service Code
|
HCPCS 96372
|
| Hospital Charge Code |
2301091
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$12.90 |
| 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 |
$12.90
|
| 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
|
|
|
INJECTION TENDON ORIGIN
|
Facility
|
OP
|
$1,449.20
|
|
|
Service Code
|
HCPCS 20551
|
| Hospital Charge Code |
412320551
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$27.70 |
| 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 |
$27.70
|
| 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 |
$376.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.38
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.79
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$41.16
|
|
|
INJECTION TENDON ORIGIN
|
Facility
|
IP
|
$1,449.20
|
|
|
Service Code
|
HCPCS 20551
|
| Hospital Charge Code |
412320551
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$217.38 |
| Max. Negotiated Rate |
$217.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.38
|
|
|
INJECTION THERAPY OF VEIN
|
Facility
|
IP
|
$2,127.90
|
|
|
Service Code
|
HCPCS 36470
|
| Hospital Charge Code |
421036470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$319.19 |
| Max. Negotiated Rate |
$319.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$319.19
|
|
|
INJECTION THERAPY OF VEIN
|
Facility
|
OP
|
$2,127.90
|
|
|
Service Code
|
HCPCS 36470
|
| Hospital Charge Code |
421036470
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$15.40 |
| 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 |
$15.40
|
| 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 |
$553.25
|
| Rate for Payer: Oxford Commercial |
$425.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$319.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$425.58
|
| Rate for Payer: UnitedHealthcare Community & State |
$67.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60.43
|
|
|
INJECTION THERAPY OF VEINS
|
Facility
|
IP
|
$2,127.90
|
|
|
Service Code
|
HCPCS 36471
|
| Hospital Charge Code |
421036471
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$319.19 |
| Max. Negotiated Rate |
$319.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$319.19
|
|
|
INJECTION THERAPY OF VEINS
|
Facility
|
IP
|
$1,243.20
|
|
|
Service Code
|
HCPCS 36471
|
| Hospital Charge Code |
1600000779
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$186.48 |
| Max. Negotiated Rate |
$186.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$186.48
|
|
|
INJECTION THERAPY OF VEINS
|
Facility
|
OP
|
$1,243.20
|
|
|
Service Code
|
HCPCS 36471
|
| Hospital Charge Code |
1600000779
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$35.31 |
| Max. Negotiated Rate |
$3,536.00 |
| 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 |
$3,536.00
|
| 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 |
$323.23
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$186.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$39.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.31
|
|
|
INJECTION THERAPY OF VEINS
|
Facility
|
OP
|
$2,127.90
|
|
|
Service Code
|
HCPCS 36471
|
| Hospital Charge Code |
421036471
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.80 |
| 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 |
$19.80
|
| 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 |
$553.25
|
| Rate for Payer: Oxford Commercial |
$425.58
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$319.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$425.58
|
| Rate for Payer: UnitedHealthcare Community & State |
$67.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60.43
|
|
|
INJECTION TREATMENT OF NERVE
|
Facility
|
IP
|
$11,498.50
|
|
|
Service Code
|
HCPCS 64605
|
| Hospital Charge Code |
1600000527
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,724.78 |
| Max. Negotiated Rate |
$1,724.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,724.78
|
|
|
INJECTION TREATMENT OF NERVE
|
Facility
|
OP
|
$4,216.24
|
|
|
Service Code
|
HCPCS 64620
|
| Hospital Charge Code |
1600000781
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$133.23 |
| 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 |
$1,096.22
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$632.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$133.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,311.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,266.41
|
|
|
INJECTION TREATMENT OF NERVE
|
Facility
|
IP
|
$4,216.24
|
|
|
Service Code
|
HCPCS 64620
|
| Hospital Charge Code |
1600000781
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$632.44 |
| Max. Negotiated Rate |
$632.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$632.44
|
|
|
INJECTION TREATMENT OF NERVE
|
Facility
|
OP
|
$5,111.97
|
|
|
Service Code
|
HCPCS 64640
|
| Hospital Charge Code |
321564640
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$161.54 |
| 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 |
$1,329.11
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$766.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.54
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,311.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,266.41
|
|
|
INJECTION TREATMENT OF NERVE
|
Facility
|
IP
|
$5,111.97
|
|
|
Service Code
|
HCPCS 64640
|
| Hospital Charge Code |
321564640
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$766.80 |
| Max. Negotiated Rate |
$766.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$766.80
|
|
|
INJECTION TREATMENT OF NERVE
|
Facility
|
OP
|
$11,498.50
|
|
|
Service Code
|
HCPCS 64605
|
| Hospital Charge Code |
1600000527
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$363.35 |
| Max. Negotiated Rate |
$8,415.40 |
| Rate for Payer: Aetna Commercial |
$6,310.10
|
| Rate for Payer: Aetna Medicare Advantage |
$7,516.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,415.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,415.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,319.89
|
| 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 |
$8,415.40
|
| Rate for Payer: Cigna Commercial |
$4,650.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2,319.89
|
| Rate for Payer: Clover Medicare Advantage |
$2,203.90
|
| Rate for Payer: EmblemHealth Commercial |
$6,959.67
|
| Rate for Payer: Humana Medicare Advantage |
$2,389.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,319.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,989.61
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,724.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$363.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,319.89
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,319.89
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$5,656.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5,545.76
|
|
|
INJECTOR CT SYRINGE FL DUAL
|
Facility
|
OP
|
$71.94
|
|
| Hospital Charge Code |
270690349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.04 |
| Max. Negotiated Rate |
$35.97 |
| Rate for Payer: Aetna Commercial |
$27.34
|
| Rate for Payer: Aetna Medicare Advantage |
$21.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.34
|
| Rate for Payer: Cigna Commercial |
$35.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.70
|
| Rate for Payer: Oxford Commercial |
$14.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.39
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.04
|
|
|
INJECTOR CT SYRINGE FL DUAL
|
Facility
|
IP
|
$71.94
|
|
| Hospital Charge Code |
270690349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.79 |
| Max. Negotiated Rate |
$10.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.79
|
|
|
INJECTOR CT SYRINGE FL SINGLE
|
Facility
|
IP
|
$35.80
|
|
| Hospital Charge Code |
270690350
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$5.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.37
|
|
