|
IR CATH IN ART INIT 3RD LEFT
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
HCPCS 36247LT
|
| Hospital Charge Code |
2101174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.60 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.60
|
|
|
IR CATH IN ART INIT 3RD LEFT
|
Facility
|
OP
|
$484.00
|
|
|
Service Code
|
HCPCS 36247LT
|
| Hospital Charge Code |
321036247L
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$183.92
|
| Rate for Payer: Aetna Medicare Advantage |
$145.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$123.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$123.42
|
| 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 |
$123.42
|
| Rate for Payer: Cigna Commercial |
$242.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.75
|
|
|
IR CATH IN ART INIT 3RD LEFT
|
Facility
|
OP
|
$484.00
|
|
|
Service Code
|
HCPCS 36247LT
|
| Hospital Charge Code |
2101174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$183.92
|
| Rate for Payer: Aetna Medicare Advantage |
$145.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$123.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$123.42
|
| 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 |
$123.42
|
| Rate for Payer: Cigna Commercial |
$242.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.75
|
|
|
IR CATH IN ART INIT 3RD LEFT
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
HCPCS 36247LT
|
| Hospital Charge Code |
321036247L
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.60 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.60
|
|
|
IR CATH IN ART INIT 3RD RIGHT
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
HCPCS 36247RT
|
| Hospital Charge Code |
321036247R
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.60 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.60
|
|
|
IR CATH IN ART INIT 3RD RIGHT
|
Facility
|
OP
|
$484.00
|
|
|
Service Code
|
HCPCS 36247RT
|
| Hospital Charge Code |
321036247R
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$183.92
|
| Rate for Payer: Aetna Medicare Advantage |
$145.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$123.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$123.42
|
| 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 |
$123.42
|
| Rate for Payer: Cigna Commercial |
$242.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.75
|
|
|
IR CATH IN ART INIT 3RD RIGHT
|
Facility
|
OP
|
$484.00
|
|
|
Service Code
|
HCPCS 36247RT
|
| Hospital Charge Code |
2101173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13.75 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$183.92
|
| Rate for Payer: Aetna Medicare Advantage |
$145.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$123.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$123.42
|
| 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 |
$123.42
|
| Rate for Payer: Cigna Commercial |
$242.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.75
|
|
|
IR CATH IN ART INIT 3RD RIGHT
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
HCPCS 36247RT
|
| Hospital Charge Code |
2101173
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.60 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.60
|
|
|
IR CATH PLCMNT RENAL ARTRY BIL
|
Facility
|
OP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 36254
|
| Hospital Charge Code |
411036254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$353.94 |
| 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 |
$3,240.34
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$393.83
|
| 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 |
$353.94
|
|
|
IR CATH PLCMNT RENAL ARTRY BIL
|
Facility
|
IP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 36254
|
| Hospital Charge Code |
366836254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,869.43 |
| Max. Negotiated Rate |
$1,869.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
|
|
IR CATH PLCMNT RENAL ARTRY BIL
|
Facility
|
OP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 36254
|
| Hospital Charge Code |
366836254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$353.94 |
| 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 |
$3,240.34
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$393.83
|
| 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 |
$353.94
|
|
|
IR CATH PLCMNT RENAL ARTRY BIL
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36254
|
| Hospital Charge Code |
321036254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
IR CATH PLCMNT RENAL ARTRY BIL
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36254
|
| Hospital Charge Code |
321036254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$439.31 |
| 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 |
$4,021.81
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| 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 CATH PLCMNT RENAL ARTRY BIL
|
Facility
|
IP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 36254
|
| Hospital Charge Code |
411036254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,869.43 |
| Max. Negotiated Rate |
$1,869.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
|
|
IR CATH PLCMNT RENAL ARTRY BIL
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36254
|
| Hospital Charge Code |
2670105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$439.31 |
| 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 |
$4,021.81
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| 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 CATH PLCMNT RENAL ARTRY BIL
|
Facility
|
IP
|
$10,405.00
|
|
|
Service Code
|
HCPCS 36254
|
| Hospital Charge Code |
7411435
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,560.75 |
| Max. Negotiated Rate |
$1,560.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,560.75
|
|
|
IR CATH PLCMNT RENAL ARTRY BIL
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36254
|
| Hospital Charge Code |
2670105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
IR CATH PLCMNT RENAL ARTRY BIL
|
Facility
|
OP
|
$10,405.00
|
|
|
Service Code
|
HCPCS 36254
|
| Hospital Charge Code |
7411435
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$295.50 |
| 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 |
$2,705.30
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,560.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$328.80
|
| 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 |
$295.50
|
|
|
IR-CECO/COLONIC TUBE
|
Facility
|
IP
|
$5,489.85
|
|
|
Service Code
|
HCPCS 49442
|
| Hospital Charge Code |
7411595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$823.48 |
| Max. Negotiated Rate |
$823.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$823.48
|
|
|
IR-CECO/COLONIC TUBE
|
Facility
|
IP
|
$5,489.85
|
|
|
Service Code
|
HCPCS 49442
|
| Hospital Charge Code |
366849442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$823.48 |
| Max. Negotiated Rate |
$823.48 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$823.48
|
|
|
IR-CECO/COLONIC TUBE
|
Facility
|
OP
|
$5,489.85
|
|
|
Service Code
|
HCPCS 49442
|
| Hospital Charge Code |
7411595
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.91 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| 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 |
$5,157.00
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,427.36
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$823.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$173.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$155.91
|
|
|
IR-CECO/COLONIC TUBE
|
Facility
|
OP
|
$5,489.85
|
|
|
Service Code
|
HCPCS 49442
|
| Hospital Charge Code |
366849442
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.91 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| 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 |
$5,157.00
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,427.36
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$823.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$173.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$155.91
|
|
|
IR-CERV PUNCT FOR MYELOGRAM
|
Facility
|
IP
|
$3,103.00
|
|
|
Service Code
|
HCPCS 61055
|
| Hospital Charge Code |
2680235
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.45 |
| Max. Negotiated Rate |
$465.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$465.45
|
|
|
IR-CERV PUNCT FOR MYELOGRAM
|
Facility
|
OP
|
$3,103.00
|
|
|
Service Code
|
HCPCS 61055
|
| Hospital Charge Code |
7411641
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$88.13 |
| 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 |
$806.78
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$465.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$98.05
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$88.13
|
|
|
IR-CERV PUNCT FOR MYELOGRAM
|
Facility
|
IP
|
$3,103.00
|
|
|
Service Code
|
HCPCS 61055
|
| Hospital Charge Code |
7411641
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$465.45 |
| Max. Negotiated Rate |
$465.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$465.45
|
|
