|
INJ PARAVERT F JNT L/S 2 LEV
|
Facility
|
IP
|
$5,111.97
|
|
|
Service Code
|
HCPCS 64494
|
| Hospital Charge Code |
321564494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$766.80 |
| Max. Negotiated Rate |
$766.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$766.80
|
|
|
INJ PARAVERT F JNT L/S 2 LEV
|
Facility
|
OP
|
$5,111.97
|
|
|
Service Code
|
HCPCS 64494
|
| Hospital Charge Code |
321564494
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$161.54 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,942.55
|
| Rate for Payer: Aetna Medicare Advantage |
$1,533.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,303.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,303.55
|
| 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 |
$1,303.55
|
| Rate for Payer: Cigna Commercial |
$2,555.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,329.11
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$766.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.54
|
|
|
INJ PARAVERT F JNT L/S 2 LEV
|
Facility
|
OP
|
$5,111.97
|
|
|
Service Code
|
HCPCS 64494
|
| Hospital Charge Code |
1600000737
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$161.54 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,942.55
|
| Rate for Payer: Aetna Medicare Advantage |
$1,533.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,303.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,303.55
|
| 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 |
$1,303.55
|
| Rate for Payer: Cigna Commercial |
$2,555.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,329.11
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$766.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.54
|
|
|
INJ PARAVERT F JNT L/S 2 LEV
|
Facility
|
IP
|
$5,111.97
|
|
|
Service Code
|
HCPCS 64494
|
| Hospital Charge Code |
1600000737
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$766.80 |
| Max. Negotiated Rate |
$766.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$766.80
|
|
|
INJ PARAVERT F JNT L/S 2-LEV
|
Facility
|
OP
|
$6,666.60
|
|
|
Service Code
|
HCPCS 64494
|
| Hospital Charge Code |
1600000430
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$210.66 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$2,533.31
|
| Rate for Payer: Aetna Medicare Advantage |
$1,999.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,699.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,699.98
|
| 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 |
$1,699.98
|
| Rate for Payer: Cigna Commercial |
$3,333.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,733.32
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$999.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.66
|
|
|
INJ PARAVERT F JNT L/S 2-LEV
|
Facility
|
IP
|
$6,666.60
|
|
|
Service Code
|
HCPCS 64494
|
| Hospital Charge Code |
1600000430
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$999.99 |
| Max. Negotiated Rate |
$999.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$999.99
|
|
|
INJ PARAVERT F JNT L/S 3 LEV
|
Facility
|
IP
|
$5,111.97
|
|
|
Service Code
|
HCPCS 64495
|
| Hospital Charge Code |
321564495
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$766.80 |
| Max. Negotiated Rate |
$766.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$766.80
|
|
|
INJ PARAVERT F JNT L/S 3 LEV
|
Facility
|
OP
|
$5,111.97
|
|
|
Service Code
|
HCPCS 64495
|
| Hospital Charge Code |
321564495
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$161.54 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,942.55
|
| Rate for Payer: Aetna Medicare Advantage |
$1,533.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,303.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,303.55
|
| 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 |
$1,303.55
|
| Rate for Payer: Cigna Commercial |
$2,555.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,329.11
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$766.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.54
|
|
|
INJ PARAVERT F JNT L/S 3-LEV
|
Facility
|
OP
|
$6,666.60
|
|
|
Service Code
|
HCPCS 64495
|
| Hospital Charge Code |
1600000431
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$210.66 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$2,533.31
|
| Rate for Payer: Aetna Medicare Advantage |
$1,999.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,699.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,699.98
|
| 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 |
$1,699.98
|
| Rate for Payer: Cigna Commercial |
$3,333.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,733.32
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$999.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.66
|
|
|
INJ PARAVERT F JNT L/S 3-LEV
|
Facility
|
IP
|
$6,666.60
|
|
|
Service Code
|
HCPCS 64495
|
| Hospital Charge Code |
1600000431
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$999.99 |
| Max. Negotiated Rate |
$999.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$999.99
|
|
|
INJ PROC AORTOGRAPHY
|
Facility
|
IP
|
$408.00
|
|
|
Service Code
|
HCPCS 93567
|
| Hospital Charge Code |
7411247
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.20
|
|
|
INJ PROC AORTOGRAPHY
|
Facility
|
OP
|
$408.00
|
|
|
Service Code
|
HCPCS 93567
|
| Hospital Charge Code |
366893567
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$4,213.00 |
| Rate for Payer: Aetna Commercial |
$155.04
|
| Rate for Payer: Aetna Medicare Advantage |
$122.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$104.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$104.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,213.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$104.04
|
| Rate for Payer: Cigna Commercial |
$204.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.08
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.59
|
|
|
INJ PROC AORTOGRAPHY
|
Facility
|
IP
|
$408.00
|
|
|
Service Code
|
HCPCS 93567
|
| Hospital Charge Code |
366893567
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$61.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.20
|
|
|
INJ PROC AORTOGRAPHY
|
Facility
|
OP
|
$408.00
|
|
|
Service Code
|
HCPCS 93567
|
| Hospital Charge Code |
7411247
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$4,213.00 |
| Rate for Payer: Aetna Commercial |
$155.04
|
| Rate for Payer: Aetna Medicare Advantage |
$122.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$104.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$104.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,213.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$104.04
|
| Rate for Payer: Cigna Commercial |
$204.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.08
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.59
|
|
|
INJ PSEUDOANEURYSM
|
Facility
|
OP
|
$1,133.35
|
|
|
Service Code
|
HCPCS 36002
|
| Hospital Charge Code |
5100826
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$32.19 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,703.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,703.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,703.39
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$294.67
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.81
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.19
|
|
|
INJ PSEUDOANEURYSM
|
Facility
|
IP
|
$1,133.35
|
|
|
Service Code
|
HCPCS 36002
|
| Hospital Charge Code |
5100826
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$170.00 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$170.00
|
|
|
INJ PX CHOLANG EXISTING ACCESS
|
Facility
|
OP
|
$14,313.70
|
|
|
Service Code
|
HCPCS 47531
|
| Hospital Charge Code |
2600222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$406.51 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,721.56
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,147.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$452.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$406.51
|
|
|
INJ PX CHOLANG EXISTING ACCESS
|
Facility
|
IP
|
$14,313.70
|
|
|
Service Code
|
HCPCS 47531
|
| Hospital Charge Code |
2600222
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,147.05 |
| Max. Negotiated Rate |
$2,147.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,147.05
|
|
|
INJ PX CHOLANG EXISTING ACCESS
|
Facility
|
IP
|
$2,072.24
|
|
|
Service Code
|
HCPCS 47531
|
| Hospital Charge Code |
7411560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$310.84 |
| Max. Negotiated Rate |
$310.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$310.84
|
|
|
INJ PX CHOLANG EXISTING ACCESS
|
Facility
|
OP
|
$2,072.24
|
|
|
Service Code
|
HCPCS 47531
|
| Hospital Charge Code |
2011599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$58.85 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$538.78
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$310.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$65.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$58.85
|
|
|
INJ PX CHOLANG EXISTING ACCESS
|
Facility
|
IP
|
$2,072.24
|
|
|
Service Code
|
HCPCS 47531
|
| Hospital Charge Code |
2011599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$310.84 |
| Max. Negotiated Rate |
$310.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$310.84
|
|
|
INJ PX CHOLANG EXISTING ACCESS
|
Facility
|
OP
|
$2,072.24
|
|
|
Service Code
|
HCPCS 47531
|
| Hospital Charge Code |
7411560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$58.85 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$538.78
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$310.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$65.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$58.85
|
|
|
INJ PX CHOLANG NEW ACCESS
|
Facility
|
OP
|
$18,206.00
|
|
|
Service Code
|
HCPCS 47532
|
| Hospital Charge Code |
2600223
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$517.05 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,733.56
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,730.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$575.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$517.05
|
|
|
INJ PX CHOLANG NEW ACCESS
|
Facility
|
OP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47532
|
| Hospital Charge Code |
2011563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.30 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,335.10
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$405.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$364.30
|
|
|
INJ PX CHOLANG NEW ACCESS
|
Facility
|
IP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47532
|
| Hospital Charge Code |
2011563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,924.10 |
| Max. Negotiated Rate |
$1,924.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
|
