|
INSERT LOCKING
|
Facility
|
IP
|
$550.00
|
|
| Hospital Charge Code |
270640258
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$133.10 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$110.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$133.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
INSERT MESH/PELVIC FLR ADDON
|
Facility
|
IP
|
$7,795.00
|
|
|
Service Code
|
HCPCS 57267
|
| Hospital Charge Code |
1600000434
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,169.25 |
| Max. Negotiated Rate |
$1,169.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,169.25
|
|
|
INSERT MESH/PELVIC FLR ADDON
|
Facility
|
OP
|
$7,795.00
|
|
|
Service Code
|
HCPCS 57267
|
| Hospital Charge Code |
1600000434
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$221.38 |
| Max. Negotiated Rate |
$3,897.50 |
| Rate for Payer: Aetna Commercial |
$2,962.10
|
| Rate for Payer: Aetna Medicare Advantage |
$2,338.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,987.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,987.72
|
| 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 |
$1,987.72
|
| Rate for Payer: Cigna Commercial |
$3,897.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,026.70
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,169.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$246.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$221.38
|
|
|
INSERT MULTI-COMP PENIS PROS
|
Facility
|
IP
|
$94,816.00
|
|
|
Service Code
|
HCPCS 54405
|
| Hospital Charge Code |
16000168
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$14,222.40 |
| Max. Negotiated Rate |
$14,222.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14,222.40
|
|
|
INSERT MULTI-COMP PENIS PROS
|
Facility
|
OP
|
$94,816.00
|
|
|
Service Code
|
HCPCS 54405
|
| Hospital Charge Code |
16000168
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,692.77 |
| Max. Negotiated Rate |
$89,320.59 |
| Rate for Payer: Aetna Commercial |
$66,975.05
|
| Rate for Payer: Aetna Medicare Advantage |
$79,779.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89,320.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89,320.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24,623.18
|
| 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 |
$89,320.59
|
| Rate for Payer: Cigna Commercial |
$49,357.08
|
| Rate for Payer: Cigna Medicare Advantage |
$24,623.18
|
| Rate for Payer: Clover Medicare Advantage |
$23,392.02
|
| Rate for Payer: EmblemHealth Commercial |
$73,869.54
|
| Rate for Payer: Humana Medicare Advantage |
$25,361.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24,623.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24,652.16
|
| Rate for Payer: Oxford Commercial |
$15,591.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14,222.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$17,348.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,996.19
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24,623.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$24,623.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,692.77
|
|
|
INSERT NG TUBE
|
Facility
|
OP
|
$889.60
|
|
|
Service Code
|
HCPCS 43752
|
| Hospital Charge Code |
2500262
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$25.26 |
| Max. Negotiated Rate |
$2,297.00 |
| Rate for Payer: Aetna Commercial |
$1,443.56
|
| Rate for Payer: Aetna Medicare Advantage |
$1,719.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,925.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,925.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$530.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,925.19
|
| Rate for Payer: Cigna Commercial |
$1,063.82
|
| Rate for Payer: Cigna Medicare Advantage |
$530.72
|
| Rate for Payer: Clover Medicare Advantage |
$504.18
|
| Rate for Payer: EmblemHealth Commercial |
$1,592.16
|
| Rate for Payer: Humana Medicare Advantage |
$546.64
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$530.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$231.30
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.11
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$530.72
|
| Rate for Payer: Wellcare Medicare Advantage |
$530.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.26
|
|
|
INSERT NG TUBE
|
Facility
|
IP
|
$889.60
|
|
|
Service Code
|
HCPCS 43752
|
| Hospital Charge Code |
2500262
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$133.44 |
| Max. Negotiated Rate |
$133.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.44
|
|
|
INSERT NON TUNNEL CV CATH
|
Facility
|
IP
|
$18,533.40
|
|
|
Service Code
|
HCPCS 36556
|
| Hospital Charge Code |
1600000414
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,780.01 |
| Max. Negotiated Rate |
$2,780.01 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,780.01
|
|
|
INSERT NON TUNNEL CV CATH
|
Facility
|
OP
|
$18,533.40
|
|
|
Service Code
|
HCPCS 36556
|
| Hospital Charge Code |
1600000414
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$526.35 |
| Max. Negotiated Rate |
$13,607.37 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| 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 |
$13,607.37
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,818.68
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,780.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$585.66
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$526.35
|
|
|
INSERT PELV FIXATION DEVICE
|
Facility
|
IP
|
$1,610.24
|
|
|
Service Code
|
HCPCS 22848
|
| Hospital Charge Code |
16000809
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$241.54 |
| Max. Negotiated Rate |
$241.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.54
|
|
|
INSERT PELV FIXATION DEVICE
|
Facility
|
OP
|
$1,610.24
|
|
|
Service Code
|
HCPCS 22848
|
| Hospital Charge Code |
16000809
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$45.73 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$611.89
|
| Rate for Payer: Aetna Medicare Advantage |
$483.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$410.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$410.61
|
| 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 |
$410.61
|
| Rate for Payer: Cigna Commercial |
$805.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$418.66
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$241.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.73
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
OP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
404236573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$182.09 |
| Max. Negotiated Rate |
$6,783.93 |
| Rate for Payer: Aetna Commercial |
$5,086.78
|
| Rate for Payer: Aetna Medicare Advantage |
$6,059.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,870.14
|
| 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 |
$6,783.93
|
| Rate for Payer: Cigna Commercial |
$3,748.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,870.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,776.63
|
| Rate for Payer: EmblemHealth Commercial |
$5,610.42
|
| Rate for Payer: Humana Medicare Advantage |
$1,926.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,870.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,667.05
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$202.61
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$182.09
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
OP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
366836573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$182.09 |
| Max. Negotiated Rate |
$6,783.93 |
| Rate for Payer: Aetna Commercial |
$5,086.78
|
| Rate for Payer: Aetna Medicare Advantage |
$6,059.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,870.14
|
| 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 |
$6,783.93
|
| Rate for Payer: Cigna Commercial |
$3,748.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,870.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,776.63
|
| Rate for Payer: EmblemHealth Commercial |
$5,610.42
|
| Rate for Payer: Humana Medicare Advantage |
$1,926.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,870.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,667.05
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$202.61
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$182.09
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
IP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
321036573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$961.76 |
| Max. Negotiated Rate |
$961.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
OP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
366236573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$182.09 |
| Max. Negotiated Rate |
$6,783.93 |
| Rate for Payer: Aetna Commercial |
$5,086.78
|
| Rate for Payer: Aetna Medicare Advantage |
$6,059.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,870.14
|
| 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 |
$6,783.93
|
| Rate for Payer: Cigna Commercial |
$3,748.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,870.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,776.63
|
| Rate for Payer: EmblemHealth Commercial |
$5,610.42
|
| Rate for Payer: Humana Medicare Advantage |
$1,926.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,870.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,667.05
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$202.61
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$182.09
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
OP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
321036573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$182.09 |
| Max. Negotiated Rate |
$6,783.93 |
| Rate for Payer: Aetna Commercial |
$5,086.78
|
| Rate for Payer: Aetna Medicare Advantage |
$6,059.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,870.14
|
| 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 |
$6,783.93
|
| Rate for Payer: Cigna Commercial |
$3,748.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,870.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,776.63
|
| Rate for Payer: EmblemHealth Commercial |
$5,610.42
|
| Rate for Payer: Humana Medicare Advantage |
$1,926.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,870.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,667.05
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$202.61
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$182.09
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
IP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
404636573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$961.76 |
| Max. Negotiated Rate |
$961.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
IP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
404236573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$961.76 |
| Max. Negotiated Rate |
$961.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
IP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
366236573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$961.76 |
| Max. Negotiated Rate |
$961.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
OP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
404636573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$182.09 |
| Max. Negotiated Rate |
$6,783.93 |
| Rate for Payer: Aetna Commercial |
$5,086.78
|
| Rate for Payer: Aetna Medicare Advantage |
$6,059.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,870.14
|
| 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 |
$6,783.93
|
| Rate for Payer: Cigna Commercial |
$3,748.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,870.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,776.63
|
| Rate for Payer: EmblemHealth Commercial |
$5,610.42
|
| Rate for Payer: Humana Medicare Advantage |
$1,926.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,870.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,667.05
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$202.61
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$182.09
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
OP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
411036573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$182.09 |
| Max. Negotiated Rate |
$6,783.93 |
| Rate for Payer: Aetna Commercial |
$5,086.78
|
| Rate for Payer: Aetna Medicare Advantage |
$6,059.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,870.14
|
| 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 |
$6,783.93
|
| Rate for Payer: Cigna Commercial |
$3,748.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,870.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,776.63
|
| Rate for Payer: EmblemHealth Commercial |
$5,610.42
|
| Rate for Payer: Humana Medicare Advantage |
$1,926.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,870.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,667.05
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$202.61
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$182.09
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
IP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
366836573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$961.76 |
| Max. Negotiated Rate |
$961.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
|
|
INSERT PICC >5YRS W IMAGING
|
Facility
|
IP
|
$6,411.73
|
|
|
Service Code
|
HCPCS 36573
|
| Hospital Charge Code |
411036573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$961.76 |
| Max. Negotiated Rate |
$961.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$961.76
|
|
|
INSERT PICC W/O IMAGING > 5YRS
|
Facility
|
OP
|
$7,852.40
|
|
|
Service Code
|
HCPCS 36569
|
| Hospital Charge Code |
5790100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$6,783.93 |
| Rate for Payer: Aetna Commercial |
$5,086.78
|
| Rate for Payer: Aetna Medicare Advantage |
$6,059.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,870.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$166.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,783.93
|
| Rate for Payer: Cigna Commercial |
$3,748.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,870.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,776.63
|
| Rate for Payer: EmblemHealth Commercial |
$5,610.42
|
| Rate for Payer: Humana Medicare Advantage |
$1,926.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,870.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,041.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,177.86
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$223.01
|
|
|
INSERT PICC W/O IMAGING > 5YRS
|
Facility
|
IP
|
$7,852.40
|
|
|
Service Code
|
HCPCS 36569
|
| Hospital Charge Code |
5790100
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,177.86 |
| Max. Negotiated Rate |
$1,177.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,177.86
|
|
