|
IR AORTA CATHETER INTRO
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 36200
|
| Hospital Charge Code |
2004323
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
IR AORTOGRAPHY ABDOMEN
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75625
|
| Hospital Charge Code |
2001105
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
IR AORTOGRAPHY ABDOMEN
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75625
|
| Hospital Charge Code |
2001105
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$249.48 |
| 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 |
$249.48
|
| 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 |
$2,625.82
|
| 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 |
$4,021.81
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$488.80
|
| 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 |
$439.31
|
|
|
IR AORTOGRAPHY ABDOMEN
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75625
|
| Hospital Charge Code |
321075625
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
IR AORTOGRAPHY ABDOMEN
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75625
|
| Hospital Charge Code |
321075625
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$249.48 |
| 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 |
$249.48
|
| 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 |
$2,625.82
|
| 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 |
$4,021.81
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$488.80
|
| 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 |
$439.31
|
|
|
IR AORTO THORACIC W/SERALGRPHY
|
Facility
|
OP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 75605
|
| Hospital Charge Code |
321075605
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$236.49 |
| Max. Negotiated Rate |
$23,980.53 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$236.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,980.53
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$4,627.53
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,663.40
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$809.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$727.85
|
|
|
IR AORTO THORACIC W/SERALGRPHY
|
Facility
|
IP
|
$13,031.00
|
|
|
Service Code
|
HCPCS 75605
|
| Hospital Charge Code |
7411687
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,954.65 |
| Max. Negotiated Rate |
$1,954.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,954.65
|
|
|
IR AORTO THORACIC W/SERALGRPHY
|
Facility
|
IP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 75605
|
| Hospital Charge Code |
321075605
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$3,844.27 |
| Max. Negotiated Rate |
$3,844.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
|
|
IR AORTO THORACIC W/SERALGRPHY
|
Facility
|
OP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 75605
|
| Hospital Charge Code |
2600043
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$236.49 |
| Max. Negotiated Rate |
$23,980.53 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$236.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,980.53
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$4,627.53
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,663.40
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$809.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$727.85
|
|
|
IR AORTO THORACIC W/SERALGRPHY
|
Facility
|
IP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 75605
|
| Hospital Charge Code |
2600043
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$3,844.27 |
| Max. Negotiated Rate |
$3,844.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
|
|
IR AORTO THORACIC W/SERALGRPHY
|
Facility
|
OP
|
$13,031.00
|
|
|
Service Code
|
HCPCS 75605
|
| Hospital Charge Code |
7411687
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$236.49 |
| Max. Negotiated Rate |
$23,980.53 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$236.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,980.53
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$4,627.53
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,388.06
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,954.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$411.78
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$370.08
|
|
|
IR ARTERIAL MECH THROBECTOMY
|
Facility
|
IP
|
$12,129.00
|
|
|
Service Code
|
HCPCS 37184
|
| Hospital Charge Code |
2001361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,819.35 |
| Max. Negotiated Rate |
$1,819.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,819.35
|
|
|
IR ARTERIAL MECH THROBECTOMY
|
Facility
|
OP
|
$12,129.00
|
|
|
Service Code
|
HCPCS 37184
|
| Hospital Charge Code |
2001361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$344.46 |
| Max. Negotiated Rate |
$79,001.40 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| 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 |
$79,001.40
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,153.54
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,819.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$383.28
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$344.46
|
|
|
IR ARTHROCENTESIS,INTRM INJ AS
|
Facility
|
OP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20605
|
| Hospital Charge Code |
2680030
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$30.98 |
| Max. Negotiated Rate |
$3,536.00 |
| 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 |
$3,536.00
|
| 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 |
$283.66
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.98
|
|
|
IR ARTHROCENTESIS,INTRM INJ AS
|
Facility
|
OP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20605
|
| Hospital Charge Code |
7411345
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$30.98 |
| Max. Negotiated Rate |
$3,536.00 |
| 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 |
$3,536.00
|
| 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 |
$283.66
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.98
|
|
|
IR ARTHROCENTESIS,INTRM INJ AS
|
Facility
|
IP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20605
|
| Hospital Charge Code |
7411345
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.65 |
| Max. Negotiated Rate |
$163.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
|
|
IR ARTHROCENTESIS,INTRM INJ AS
|
Facility
|
IP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20605
|
| Hospital Charge Code |
2680030
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.65 |
| Max. Negotiated Rate |
$163.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
|
|
IR ARTHROCENTESIS MAJOR JOINT
|
Facility
|
OP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
2680035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$30.98 |
| Max. Negotiated Rate |
$3,536.00 |
| 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 |
$3,536.00
|
| 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 |
$283.66
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.98
|
|
|
IR ARTHROCENTESIS MAJOR JOINT
|
Facility
|
IP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
7411346
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.65 |
| Max. Negotiated Rate |
$163.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
|
|
IR ARTHROCENTESIS MAJOR JOINT
|
Facility
|
IP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
2680035
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.65 |
| Max. Negotiated Rate |
$163.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
|
|
IR ARTHROCENTESIS MAJOR JOINT
|
Facility
|
OP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20610
|
| Hospital Charge Code |
7411346
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$30.98 |
| Max. Negotiated Rate |
$3,536.00 |
| 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 |
$3,536.00
|
| 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 |
$283.66
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.98
|
|
|
IR ARTHROGRAM TRAY
|
Facility
|
IP
|
$360.00
|
|
| Hospital Charge Code |
4800975
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.00
|
|
|
IR ARTHROGRAM TRAY
|
Facility
|
OP
|
$360.00
|
|
| Hospital Charge Code |
4800975
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.22 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna Commercial |
$136.80
|
| Rate for Payer: Aetna Medicare Advantage |
$108.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.80
|
| Rate for Payer: Cigna Commercial |
$180.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$93.60
|
| Rate for Payer: Oxford Commercial |
$72.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$72.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.22
|
|
|
IR ARTHRO SHOULDER
|
Facility
|
IP
|
$1,633.00
|
|
|
Service Code
|
HCPCS 73040LT
|
| Hospital Charge Code |
2007050
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$244.95 |
| Max. Negotiated Rate |
$244.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$244.95
|
|
|
IR ARTHRO SHOULDER
|
Facility
|
OP
|
$1,633.00
|
|
|
Service Code
|
HCPCS 73040
|
| Hospital Charge Code |
7411664
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$34.65 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$1,127.36
|
| Rate for Payer: Aetna Medicare Advantage |
$1,342.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,503.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,503.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$414.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,503.49
|
| Rate for Payer: Cigna Commercial |
$830.80
|
| Rate for Payer: Cigna Medicare Advantage |
$290.13
|
| Rate for Payer: Clover Medicare Advantage |
$393.75
|
| Rate for Payer: EmblemHealth Commercial |
$1,243.41
|
| Rate for Payer: Humana Medicare Advantage |
$426.90
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$414.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$424.58
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$244.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$51.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$414.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$414.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$46.38
|
|
