|
IR FINE NEEDLE W/O IMAGNG GUID
|
Facility
|
OP
|
$642.00
|
|
|
Service Code
|
HCPCS 10021
|
| Hospital Charge Code |
2670235
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18.23 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,313.62
|
| Rate for Payer: Aetna Medicare Advantage |
$1,564.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$482.95
|
| 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 |
$1,751.90
|
| Rate for Payer: Cigna Commercial |
$968.07
|
| Rate for Payer: Cigna Medicare Advantage |
$482.95
|
| Rate for Payer: Clover Medicare Advantage |
$458.80
|
| Rate for Payer: EmblemHealth Commercial |
$1,448.85
|
| Rate for Payer: Humana Medicare Advantage |
$497.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$482.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$166.92
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.23
|
|
|
IR FISTLA/SINUS TRCT ABSC STDY
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 76080
|
| Hospital Charge Code |
411076080
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$34.65 |
| Max. Negotiated Rate |
$2,354.83 |
| Rate for Payer: Aetna Commercial |
$1,765.72
|
| Rate for Payer: Aetna Medicare Advantage |
$2,103.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,354.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,354.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$649.16
|
| 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 |
$2,354.83
|
| Rate for Payer: Cigna Commercial |
$1,301.24
|
| Rate for Payer: Cigna Medicare Advantage |
$454.41
|
| Rate for Payer: Clover Medicare Advantage |
$616.70
|
| Rate for Payer: EmblemHealth Commercial |
$1,947.48
|
| Rate for Payer: Humana Medicare Advantage |
$668.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$649.16
|
| 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: UnitedHealthcare Medicare Advantage |
$649.16
|
| Rate for Payer: Wellcare Medicare Advantage |
$649.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
IR FISTLA/SINUS TRCT ABSC STDY
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 76080
|
| Hospital Charge Code |
411076080
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
IR FISTLA/SINUS TRCT ABSC STDY
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 76080
|
| Hospital Charge Code |
2600086
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
IR FISTLA/SINUS TRCT ABSC STDY
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 76080
|
| Hospital Charge Code |
366876080
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$34.65 |
| Max. Negotiated Rate |
$2,354.83 |
| Rate for Payer: Aetna Commercial |
$1,765.72
|
| Rate for Payer: Aetna Medicare Advantage |
$2,103.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,354.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,354.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$649.16
|
| 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 |
$2,354.83
|
| Rate for Payer: Cigna Commercial |
$1,301.24
|
| Rate for Payer: Cigna Medicare Advantage |
$454.41
|
| Rate for Payer: Clover Medicare Advantage |
$616.70
|
| Rate for Payer: EmblemHealth Commercial |
$1,947.48
|
| Rate for Payer: Humana Medicare Advantage |
$668.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$649.16
|
| 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: UnitedHealthcare Medicare Advantage |
$649.16
|
| Rate for Payer: Wellcare Medicare Advantage |
$649.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
IR FISTLA/SINUS TRCT ABSC STDY
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 76080
|
| Hospital Charge Code |
366876080
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
IR FISTLA/SINUS TRCT ABSC STDY
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 76080
|
| Hospital Charge Code |
321076080
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
IR FISTLA/SINUS TRCT ABSC STDY
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 76080
|
| Hospital Charge Code |
321076080
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$34.65 |
| Max. Negotiated Rate |
$2,354.83 |
| Rate for Payer: Aetna Commercial |
$1,765.72
|
| Rate for Payer: Aetna Medicare Advantage |
$2,103.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,354.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,354.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$649.16
|
| 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 |
$2,354.83
|
| Rate for Payer: Cigna Commercial |
$1,301.24
|
| Rate for Payer: Cigna Medicare Advantage |
$454.41
|
| Rate for Payer: Clover Medicare Advantage |
$616.70
|
| Rate for Payer: EmblemHealth Commercial |
$1,947.48
|
| Rate for Payer: Humana Medicare Advantage |
$668.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$649.16
|
| 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: UnitedHealthcare Medicare Advantage |
$649.16
|
| Rate for Payer: Wellcare Medicare Advantage |
$649.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
IR FISTLA/SINUS TRCT ABSC STDY
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 76080
|
| Hospital Charge Code |
2600086
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$34.65 |
| Max. Negotiated Rate |
$2,354.83 |
| Rate for Payer: Aetna Commercial |
$1,765.72
|
| Rate for Payer: Aetna Medicare Advantage |
$2,103.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,354.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,354.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$649.16
|
| 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 |
$2,354.83
|
| Rate for Payer: Cigna Commercial |
$1,301.24
|
| Rate for Payer: Cigna Medicare Advantage |
$454.41
|
| Rate for Payer: Clover Medicare Advantage |
$616.70
|
| Rate for Payer: EmblemHealth Commercial |
$1,947.48
|
| Rate for Payer: Humana Medicare Advantage |
$668.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$649.16
|
| 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: UnitedHealthcare Medicare Advantage |
$649.16
|
| Rate for Payer: Wellcare Medicare Advantage |
$649.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
IR FLUOR GUID CV ACCESS DEVICE
|
Facility
|
IP
|
$8,692.60
|
|
|
Service Code
|
HCPCS 77001
|
| Hospital Charge Code |
2004892
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,303.89 |
| Max. Negotiated Rate |
$1,303.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,303.89
|
|
|
IR FLUOR GUID CV ACCESS DEVICE
|
Facility
|
OP
|
$8,692.60
|
|
|
Service Code
|
HCPCS 77001
|
| Hospital Charge Code |
321077001
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.26 |
| Max. Negotiated Rate |
$4,346.30 |
| Rate for Payer: Aetna Commercial |
$3,303.19
|
| Rate for Payer: Aetna Medicare Advantage |
$2,607.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,216.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,216.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,216.61
|
| Rate for Payer: Cigna Commercial |
$4,346.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,260.08
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,303.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$274.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$246.87
|
|
|
IR FLUOR GUID CV ACCESS DEVICE
|
Facility
|
IP
|
$8,692.60
|
|
|
Service Code
|
HCPCS 77001
|
| Hospital Charge Code |
321077001
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,303.89 |
| Max. Negotiated Rate |
$1,303.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,303.89
|
|
|
IR FLUOR GUID CV ACCESS DEVICE
|
Facility
|
OP
|
$8,692.60
|
|
|
Service Code
|
HCPCS 77001
|
| Hospital Charge Code |
7411754
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.26 |
| Max. Negotiated Rate |
$4,346.30 |
| Rate for Payer: Aetna Commercial |
$3,303.19
|
| Rate for Payer: Aetna Medicare Advantage |
$2,607.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,216.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,216.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,216.61
|
| Rate for Payer: Cigna Commercial |
$4,346.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,260.08
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,303.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$274.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$246.87
|
|
|
IR FLUOR GUID CV ACCESS DEVICE
|
Facility
|
OP
|
$8,692.60
|
|
|
Service Code
|
HCPCS 77001
|
| Hospital Charge Code |
2004892
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.26 |
| Max. Negotiated Rate |
$4,346.30 |
| Rate for Payer: Aetna Commercial |
$3,303.19
|
| Rate for Payer: Aetna Medicare Advantage |
$2,607.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,216.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,216.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,216.61
|
| Rate for Payer: Cigna Commercial |
$4,346.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,260.08
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,303.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$274.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$246.87
|
|
|
IR FLUOR GUID CV ACCESS DEVICE
|
Facility
|
IP
|
$8,692.60
|
|
|
Service Code
|
HCPCS 77001
|
| Hospital Charge Code |
7411754
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,303.89 |
| Max. Negotiated Rate |
$1,303.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,303.89
|
|
|
IR FLUOR GUID CV ACCESS DEVICE
|
Facility
|
IP
|
$8,692.60
|
|
|
Service Code
|
HCPCS 77001
|
| Hospital Charge Code |
366877001
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,303.89 |
| Max. Negotiated Rate |
$1,303.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,303.89
|
|
|
IR FLUOR GUID CV ACCESS DEVICE
|
Facility
|
OP
|
$8,692.60
|
|
|
Service Code
|
HCPCS 77001
|
| Hospital Charge Code |
366877001
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.26 |
| Max. Negotiated Rate |
$4,346.30 |
| Rate for Payer: Aetna Commercial |
$3,303.19
|
| Rate for Payer: Aetna Medicare Advantage |
$2,607.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,216.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,216.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,216.61
|
| Rate for Payer: Cigna Commercial |
$4,346.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,260.08
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,303.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$274.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$246.87
|
|
|
IR FLUORO GUID NEEDLE PLCMENT
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 77002
|
| Hospital Charge Code |
2004890
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
IR FLUORO GUID NEEDLE PLCMENT
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 77002
|
| Hospital Charge Code |
2004890
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.26 |
| 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 |
$47.26
|
| 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/GASTRO/CECO/COLON TUBE
|
Facility
|
IP
|
$4,459.55
|
|
|
Service Code
|
HCPCS 49450
|
| Hospital Charge Code |
2690165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$668.93 |
| Max. Negotiated Rate |
$668.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$668.93
|
|
|
IR/GASTRO/CECO/COLON TUBE
|
Facility
|
OP
|
$3,717.20
|
|
|
Service Code
|
HCPCS 49450
|
| Hospital Charge Code |
366849450
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$105.57 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,908.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,908.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| 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 |
$3,908.70
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$966.47
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$557.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$117.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$105.57
|
|
|
IR/GASTRO/CECO/COLON TUBE
|
Facility
|
IP
|
$3,717.20
|
|
|
Service Code
|
HCPCS 49450
|
| Hospital Charge Code |
411049450
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$557.58 |
| Max. Negotiated Rate |
$557.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$557.58
|
|
|
IR/GASTRO/CECO/COLON TUBE
|
Facility
|
IP
|
$3,717.20
|
|
|
Service Code
|
HCPCS 49450
|
| Hospital Charge Code |
366849450
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$557.58 |
| Max. Negotiated Rate |
$557.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$557.58
|
|
|
IR/GASTRO/CECO/COLON TUBE
|
Facility
|
IP
|
$4,459.55
|
|
|
Service Code
|
HCPCS 49450
|
| Hospital Charge Code |
321049450
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$668.93 |
| Max. Negotiated Rate |
$668.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$668.93
|
|
|
IR/GASTRO/CECO/COLON TUBE
|
Facility
|
OP
|
$3,717.20
|
|
|
Service Code
|
HCPCS 49450
|
| Hospital Charge Code |
411049450
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$105.57 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,908.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,908.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| 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 |
$3,908.70
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$966.47
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$557.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$117.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$105.57
|
|
