|
IR ABSC DRNGE PERC LIVER
|
Facility
|
IP
|
$6,769.70
|
|
|
Service Code
|
HCPCS 49405
|
| Hospital Charge Code |
411049405
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,015.46 |
| Max. Negotiated Rate |
$1,015.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,015.46
|
|
|
IR ABSC DRNGE PERC LIVER
|
Facility
|
IP
|
$8,054.80
|
|
|
Service Code
|
HCPCS 49405
|
| Hospital Charge Code |
321049405
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,208.22 |
| Max. Negotiated Rate |
$1,208.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,208.22
|
|
|
IR ABSC DRNGE PERC LIVER
|
Facility
|
OP
|
$8,054.80
|
|
|
Service Code
|
HCPCS 49405
|
| Hospital Charge Code |
321049405
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$228.76 |
| Max. Negotiated Rate |
$7,117.66 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| 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 |
$7,117.66
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,094.25
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,208.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$254.53
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$228.76
|
|
|
IR ABSC DRNGE PERC LIVER
|
Facility
|
IP
|
$6,420.00
|
|
|
Service Code
|
HCPCS 49405
|
| Hospital Charge Code |
7411580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$963.00 |
| Max. Negotiated Rate |
$963.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$963.00
|
|
|
IR ABSC DRNGE PERC LIVER
|
Facility
|
OP
|
$6,420.00
|
|
|
Service Code
|
HCPCS 49405
|
| Hospital Charge Code |
7411580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$182.33 |
| Max. Negotiated Rate |
$7,117.66 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| 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 |
$7,117.66
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,669.20
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$963.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$202.87
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$182.33
|
|
|
IR ABSCESS DRAINAGE
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 75989
|
| Hospital Charge Code |
2002327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
IR ABSCESS DRAINAGE
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 75989
|
| Hospital Charge Code |
321075989
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
IR ABSCESS DRAINAGE
|
Facility
|
OP
|
$3,408.00
|
|
|
Service Code
|
HCPCS 75989
|
| Hospital Charge Code |
7411748
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$96.79 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$1,295.04
|
| Rate for Payer: Aetna Medicare Advantage |
$1,022.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$869.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$869.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$216.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$869.04
|
| Rate for Payer: Cigna Commercial |
$1,704.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$886.08
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$511.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$107.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.79
|
|
|
IR ABSCESS DRAINAGE
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 75989
|
| Hospital Charge Code |
2002327
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$144.84 |
| Max. Negotiated Rate |
$2,550.00 |
| Rate for Payer: Aetna Commercial |
$1,938.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$216.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,300.50
|
| Rate for Payer: Cigna Commercial |
$2,550.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
IR ABSCESS DRAINAGE
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 75989
|
| Hospital Charge Code |
411075989
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$144.84 |
| Max. Negotiated Rate |
$2,550.00 |
| Rate for Payer: Aetna Commercial |
$1,938.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$216.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,300.50
|
| Rate for Payer: Cigna Commercial |
$2,550.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
IR ABSCESS DRAINAGE
|
Facility
|
IP
|
$3,408.00
|
|
|
Service Code
|
HCPCS 75989
|
| Hospital Charge Code |
7411748
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$511.20 |
| Max. Negotiated Rate |
$511.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$511.20
|
|
|
IR ABSCESS DRAINAGE
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 75989
|
| Hospital Charge Code |
411075989
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
IR ABSCESS DRAINAGE
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 75989
|
| Hospital Charge Code |
366875989
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$144.84 |
| Max. Negotiated Rate |
$2,550.00 |
| Rate for Payer: Aetna Commercial |
$1,938.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$216.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,300.50
|
| Rate for Payer: Cigna Commercial |
$2,550.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
IR ABSCESS DRAINAGE
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 75989
|
| Hospital Charge Code |
366875989
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
IR ABSCESS DRAINAGE
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 75989
|
| Hospital Charge Code |
321075989
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$144.84 |
| Max. Negotiated Rate |
$2,550.00 |
| Rate for Payer: Aetna Commercial |
$1,938.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$216.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,300.50
|
| Rate for Payer: Cigna Commercial |
$2,550.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
IR ABSCESS DRAINAGE EMPYEM HEM
|
Facility
|
IP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
366832551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$737.17 |
| Max. Negotiated Rate |
$737.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$737.17
|
|
|
IR ABSCESS DRAINAGE EMPYEM HEM
|
Facility
|
OP
|
$6,404.20
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
2003085
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$202.37 |
| 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 |
$1,665.09
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$960.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$202.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,475.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,426.75
|
|
|
IR ABSCESS DRAINAGE EMPYEM HEM
|
Facility
|
IP
|
$6,404.20
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
2003085
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$960.63 |
| Max. Negotiated Rate |
$960.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$960.63
|
|
|
IR ABSCESS DRAINAGE EMPYEM HEM
|
Facility
|
OP
|
$6,404.20
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
321032551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$202.37 |
| 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 |
$1,665.09
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$960.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$202.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,475.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,426.75
|
|
|
IR ABSCESS DRAINAGE EMPYEM HEM
|
Facility
|
IP
|
$6,404.20
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
321032551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$960.63 |
| Max. Negotiated Rate |
$960.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$960.63
|
|
|
IR ABSCESS DRAINAGE EMPYEM HEM
|
Facility
|
OP
|
$2,275.00
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
7411379
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$71.89 |
| 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 |
$591.50
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$341.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$71.89
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,475.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,426.75
|
|
|
IR ABSCESS DRAINAGE EMPYEM HEM
|
Facility
|
IP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
411032511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$737.17 |
| Max. Negotiated Rate |
$737.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$737.17
|
|
|
IR ABSCESS DRAINAGE EMPYEM HEM
|
Facility
|
IP
|
$2,275.00
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
7411379
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$341.25 |
| Max. Negotiated Rate |
$341.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$341.25
|
|
|
IR ABSCESS DRAINAGE EMPYEM HEM
|
Facility
|
OP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
366832551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.30 |
| 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 |
$1,277.77
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$737.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$155.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,475.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,426.75
|
|
|
IR ABSCESS DRAINAGE EMPYEM HEM
|
Facility
|
OP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 32551
|
| Hospital Charge Code |
411032511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.30 |
| 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 |
$1,277.77
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$737.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$155.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,475.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,426.75
|
|
