|
IR REP NTUND CV CATH W/O PORT
|
Facility
|
OP
|
$4,649.00
|
|
|
Service Code
|
HCPCS 36580
|
| Hospital Charge Code |
7411465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$132.03 |
| 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 |
$1,208.74
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$697.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$146.91
|
| 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 |
$132.03
|
|
|
IR REP NTUND CV CATH W/O PORT
|
Facility
|
IP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 36580
|
| Hospital Charge Code |
366836580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$737.17 |
| Max. Negotiated Rate |
$737.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$737.17
|
|
|
IR REP NTUND CV CATH W/O PORT
|
Facility
|
OP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 36580
|
| Hospital Charge Code |
366836580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$139.57 |
| 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: Wellpoint Medicaid Managed Care |
$139.57
|
|
|
IR REP NTUND CV CATH W/O PORT
|
Facility
|
IP
|
$6,404.20
|
|
|
Service Code
|
HCPCS 36580
|
| Hospital Charge Code |
2011093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$960.63 |
| Max. Negotiated Rate |
$960.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$960.63
|
|
|
IR REP NTUND CV CATH W/O PORT
|
Facility
|
IP
|
$4,649.00
|
|
|
Service Code
|
HCPCS 36580
|
| Hospital Charge Code |
7411465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$697.35 |
| Max. Negotiated Rate |
$697.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$697.35
|
|
|
IR REP NTUND CV CATH W/O PORT
|
Facility
|
OP
|
$6,404.20
|
|
|
Service Code
|
HCPCS 36580
|
| Hospital Charge Code |
2011093
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$181.88 |
| 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: Wellpoint Medicaid Managed Care |
$181.88
|
|
|
IR REP NTUND CV CATH W/O PORT
|
Facility
|
OP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 36580
|
| Hospital Charge Code |
411036580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$139.57 |
| 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: Wellpoint Medicaid Managed Care |
$139.57
|
|
|
IR REP NTUND CV CATH W/O PORT
|
Facility
|
IP
|
$4,914.50
|
|
|
Service Code
|
HCPCS 36580
|
| Hospital Charge Code |
411036580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$737.17 |
| Max. Negotiated Rate |
$737.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$737.17
|
|
|
IR REPOS INTRAVASC VENA CAVA F
|
Facility
|
IP
|
$10,625.00
|
|
|
Service Code
|
HCPCS 37192
|
| Hospital Charge Code |
2680185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,593.75 |
| Max. Negotiated Rate |
$1,593.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,593.75
|
|
|
IR REPOS INTRAVASC VENA CAVA F
|
Facility
|
IP
|
$12,618.93
|
|
|
Service Code
|
HCPCS 37192
|
| Hospital Charge Code |
7411498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,892.84 |
| Max. Negotiated Rate |
$1,892.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,892.84
|
|
|
IR REPOS INTRAVASC VENA CAVA F
|
Facility
|
OP
|
$10,625.00
|
|
|
Service Code
|
HCPCS 37192
|
| Hospital Charge Code |
2680185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$301.75 |
| 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 |
$2,762.50
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,593.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$335.75
|
| 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 |
$301.75
|
|
|
IR REPOS INTRAVASC VENA CAVA F
|
Facility
|
IP
|
$10,625.00
|
|
|
Service Code
|
HCPCS 37192
|
| Hospital Charge Code |
7411498A
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,593.75 |
| Max. Negotiated Rate |
$1,593.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,593.75
|
|
|
IR REPOS INTRAVASC VENA CAVA F
|
Facility
|
OP
|
$12,618.93
|
|
|
Service Code
|
HCPCS 37192
|
| Hospital Charge Code |
7411498
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$358.38 |
| 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 |
$3,280.92
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,892.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$398.76
|
| 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 |
$358.38
|
|
|
IR REPOS INTRAVASC VENA CAVA F
|
Facility
|
OP
|
$10,625.00
|
|
|
Service Code
|
HCPCS 37192
|
| Hospital Charge Code |
7411498A
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$301.75 |
| 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 |
$2,762.50
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,593.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$335.75
|
| 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 |
$301.75
|
|
|
IR REP TUND CV CATH W/O PORT
|
Facility
|
IP
|
$10,497.00
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
7411466
|
|
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 REP TUND CV CATH W/O PORT
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
321036581
|
|
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 REP TUND CV CATH W/O PORT
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
2011276
|
|
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 REP TUND CV CATH W/O PORT
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
2011276
|
|
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 REP TUND CV CATH W/O PORT
|
Facility
|
OP
|
$5,224.75
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
366836581
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$148.38 |
| 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 |
$1,358.43
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$783.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$165.10
|
| 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 |
$148.38
|
|
|
IR REP TUND CV CATH W/O PORT
|
Facility
|
IP
|
$5,224.75
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
366836581
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$783.71 |
| Max. Negotiated Rate |
$783.71 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$783.71
|
|
|
IR REP TUND CV CATH W/O PORT
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
321036581
|
|
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 REP TUND CV CATH W/O PORT
|
Facility
|
OP
|
$10,497.00
|
|
|
Service Code
|
HCPCS 36581
|
| Hospital Charge Code |
7411466
|
|
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 RETRIV INTRAVASC VENA CAVA
|
Facility
|
IP
|
$12,618.93
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
411037193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,892.84 |
| Max. Negotiated Rate |
$1,892.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,892.84
|
|
|
IR RETRIV INTRAVASC VENA CAVA
|
Facility
|
IP
|
$12,618.93
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
366837193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,892.84 |
| Max. Negotiated Rate |
$1,892.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,892.84
|
|
|
IR RETRIV INTRAVASC VENA CAVA
|
Facility
|
OP
|
$12,618.93
|
|
|
Service Code
|
HCPCS 37193
|
| Hospital Charge Code |
366837193
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$358.38 |
| 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 |
$3,280.92
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,892.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$398.76
|
| 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 |
$358.38
|
|
