|
IR INS CATH REN ART 2ND UNILAT
|
Facility
|
IP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 36253
|
| Hospital Charge Code |
5700211
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,844.27 |
| Max. Negotiated Rate |
$3,844.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
|
|
IR INS ENDOVAS VENA CAVA FILTR
|
Facility
|
IP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 37191
|
| Hospital Charge Code |
321037191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,844.27 |
| Max. Negotiated Rate |
$3,844.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
|
|
IR INS ENDOVAS VENA CAVA FILTR
|
Facility
|
OP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 37191
|
| Hospital Charge Code |
5700251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$727.85 |
| 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 |
$3,536.00
|
| 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 |
$6,610.76
|
| 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 |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| 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 INS ENDOVAS VENA CAVA FILTR
|
Facility
|
IP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 37191
|
| Hospital Charge Code |
5700251
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,844.27 |
| Max. Negotiated Rate |
$3,844.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
|
|
IR INS ENDOVAS VENA CAVA FILTR
|
Facility
|
OP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 37191
|
| Hospital Charge Code |
321037191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$727.85 |
| 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 |
$3,536.00
|
| 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 |
$6,610.76
|
| 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 |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| 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 INSERT CV CATHPIC WPORT>5YR
|
Facility
|
OP
|
$10,497.00
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
7411461
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$298.11 |
| 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 |
$2,729.22
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,574.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$331.71
|
| 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 |
$298.11
|
|
|
IR INSERT CV CATHPIC WPORT>5YR
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
321036571
|
|
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 INSERT CV CATHPIC WPORT>5YR
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
321036571
|
|
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 INSERT CV CATHPIC WPORT>5YR
|
Facility
|
IP
|
$10,497.00
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
7411461
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,574.55 |
| Max. Negotiated Rate |
$1,574.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,574.55
|
|
|
IR INSERT CV CATHPIC WPORT>5YR
|
Facility
|
IP
|
$3,317.65
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
366836571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$497.65 |
| Max. Negotiated Rate |
$497.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$497.65
|
|
|
IR INSERT CV CATHPIC WPORT>5YR
|
Facility
|
OP
|
$3,317.65
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
366836571
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$94.22 |
| 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 |
$862.59
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$497.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$104.84
|
| 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 |
$94.22
|
|
|
IR INSERT CV CATHPIC WPORT>5YR
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
2011096
|
|
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 INSERT CV CATHPIC WPORT>5YR
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36571
|
| Hospital Charge Code |
2011096
|
|
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 INSERT CV CATH W/O PORT>5YR
|
Facility
|
IP
|
$7,852.40
|
|
|
Service Code
|
HCPCS 36569
|
| Hospital Charge Code |
2011091
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,177.86 |
| Max. Negotiated Rate |
$1,177.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,177.86
|
|
|
IR INSERT CV CATH W/O PORT>5YR
|
Facility
|
OP
|
$7,852.40
|
|
|
Service Code
|
HCPCS 36569
|
| Hospital Charge Code |
2011091
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$223.01 |
| 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 |
$2,041.62
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,177.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$248.14
|
| 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
|
|
|
IR INSERT CV CATH W/O PORT>5YR
|
Facility
|
IP
|
$7,852.40
|
|
|
Service Code
|
HCPCS 36569
|
| Hospital Charge Code |
7411459
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,177.86 |
| Max. Negotiated Rate |
$1,177.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,177.86
|
|
|
IR INSERT CV CATH W/O PORT>5YR
|
Facility
|
OP
|
$7,852.40
|
|
|
Service Code
|
HCPCS 36569
|
| Hospital Charge Code |
7411459
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$223.01 |
| 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 |
$2,041.62
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,177.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$248.14
|
| 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
|
|
|
IR INSERT HEPATIC SHUNT (TIPS)
|
Facility
|
IP
|
$18,561.00
|
|
|
Service Code
|
HCPCS 37182
|
| Hospital Charge Code |
411037182H
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,784.15 |
| Max. Negotiated Rate |
$2,784.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,784.15
|
|
|
IR INSERT HEPATIC SHUNT (TIPS)
|
Facility
|
OP
|
$18,561.00
|
|
|
Service Code
|
HCPCS 37182
|
| Hospital Charge Code |
411037182H
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$527.13 |
| 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 |
$4,825.86
|
| Rate for Payer: Oxford Commercial |
$14,968.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,784.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,639.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$586.53
|
| 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 |
$527.13
|
|
|
IR INSERT HEPATIC SHUNT (TIPS)
|
Facility
|
IP
|
$1,600.00
|
|
|
Service Code
|
HCPCS 37182
|
| Hospital Charge Code |
321037182
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$240.00 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.00
|
|
|
IR INSERT HEPATIC SHUNT (TIPS)
|
Facility
|
OP
|
$1,600.00
|
|
|
Service Code
|
HCPCS 37182
|
| Hospital Charge Code |
321037182
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$45.44 |
| 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 |
$416.00
|
| Rate for Payer: Oxford Commercial |
$14,968.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,639.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.56
|
| 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 |
$45.44
|
|
|
IR INSERT HEPATIC SHUNT (TIPS)
|
Facility
|
OP
|
$1,600.00
|
|
|
Service Code
|
HCPCS 37182
|
| Hospital Charge Code |
2011292
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$45.44 |
| 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 |
$416.00
|
| Rate for Payer: Oxford Commercial |
$14,968.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,639.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.56
|
| 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 |
$45.44
|
|
|
IR INSERT HEPATIC SHUNT (TIPS)
|
Facility
|
IP
|
$1,600.00
|
|
|
Service Code
|
HCPCS 37182
|
| Hospital Charge Code |
2011292
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$240.00 |
| Max. Negotiated Rate |
$240.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.00
|
|
|
IR INSERT TIPS W/ IMAGE GUIDE
|
Facility
|
OP
|
$18,561.00
|
|
|
Service Code
|
HCPCS 37182
|
| Hospital Charge Code |
411037182
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$527.13 |
| 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 |
$4,825.86
|
| Rate for Payer: Oxford Commercial |
$14,968.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,784.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,639.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$586.53
|
| 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 |
$527.13
|
|
|
IR INSERT TIPS W/ IMAGE GUIDE
|
Facility
|
OP
|
$1,600.00
|
|
|
Service Code
|
HCPCS 37182
|
| Hospital Charge Code |
2011099
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$45.44 |
| 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 |
$416.00
|
| Rate for Payer: Oxford Commercial |
$14,968.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,639.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.56
|
| 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 |
$45.44
|
|
