|
IR UNLISTED PROCEDURE - LIVER
|
Facility
|
IP
|
$2,392.95
|
|
|
Service Code
|
HCPCS 47399
|
| Hospital Charge Code |
7411556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$358.94 |
| Max. Negotiated Rate |
$358.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$358.94
|
|
|
IR UNLISTED PROCEDURE - LIVER
|
Facility
|
IP
|
$3,392.55
|
|
|
Service Code
|
HCPCS 47399
|
| Hospital Charge Code |
321047399
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$508.88 |
| Max. Negotiated Rate |
$508.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$508.88
|
|
|
IR UNLISTED PROCEDURE - LIVER
|
Facility
|
OP
|
$3,392.55
|
|
|
Service Code
|
HCPCS 47399
|
| Hospital Charge Code |
5600188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.35 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,288.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,725.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$841.28
|
| 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 |
$3,051.74
|
| Rate for Payer: Cigna Commercial |
$1,686.34
|
| Rate for Payer: Cigna Medicare Advantage |
$841.28
|
| Rate for Payer: Clover Medicare Advantage |
$799.22
|
| Rate for Payer: EmblemHealth Commercial |
$2,523.84
|
| Rate for Payer: Humana Medicare Advantage |
$866.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$841.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$882.06
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$508.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$107.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.35
|
|
|
IR UNLISTED PROCEDURE - LIVER
|
Facility
|
OP
|
$2,864.05
|
|
|
Service Code
|
HCPCS 47399
|
| Hospital Charge Code |
366847399
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$81.34 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,288.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,725.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$841.28
|
| 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 |
$3,051.74
|
| Rate for Payer: Cigna Commercial |
$1,686.34
|
| Rate for Payer: Cigna Medicare Advantage |
$841.28
|
| Rate for Payer: Clover Medicare Advantage |
$799.22
|
| Rate for Payer: EmblemHealth Commercial |
$2,523.84
|
| Rate for Payer: Humana Medicare Advantage |
$866.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$841.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$744.65
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$429.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$90.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$81.34
|
|
|
IR UNLISTED PROCEDURE - LIVER
|
Facility
|
OP
|
$3,392.55
|
|
|
Service Code
|
HCPCS 47399
|
| Hospital Charge Code |
321047399
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.35 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,288.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,725.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$841.28
|
| 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 |
$3,051.74
|
| Rate for Payer: Cigna Commercial |
$1,686.34
|
| Rate for Payer: Cigna Medicare Advantage |
$841.28
|
| Rate for Payer: Clover Medicare Advantage |
$799.22
|
| Rate for Payer: EmblemHealth Commercial |
$2,523.84
|
| Rate for Payer: Humana Medicare Advantage |
$866.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$841.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$882.06
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$508.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$107.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.35
|
|
|
IR UNLISTED PROCEDURE - LIVER
|
Facility
|
OP
|
$2,864.05
|
|
|
Service Code
|
HCPCS 47399
|
| Hospital Charge Code |
411047399
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$81.34 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,288.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,725.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$841.28
|
| 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 |
$3,051.74
|
| Rate for Payer: Cigna Commercial |
$1,686.34
|
| Rate for Payer: Cigna Medicare Advantage |
$841.28
|
| Rate for Payer: Clover Medicare Advantage |
$799.22
|
| Rate for Payer: EmblemHealth Commercial |
$2,523.84
|
| Rate for Payer: Humana Medicare Advantage |
$866.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$841.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$744.65
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$429.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$90.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$81.34
|
|
|
IR UNLISTED PROCEDURE - LIVER
|
Facility
|
IP
|
$3,392.55
|
|
|
Service Code
|
HCPCS 47399
|
| Hospital Charge Code |
5600188
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$508.88 |
| Max. Negotiated Rate |
$508.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$508.88
|
|
|
IR UNLISTED PROCEDURE - LIVER
|
Facility
|
OP
|
$2,392.95
|
|
|
Service Code
|
HCPCS 47399
|
| Hospital Charge Code |
7411556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$67.96 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,288.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,725.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$841.28
|
| 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 |
$3,051.74
|
| Rate for Payer: Cigna Commercial |
$1,686.34
|
| Rate for Payer: Cigna Medicare Advantage |
$841.28
|
| Rate for Payer: Clover Medicare Advantage |
$799.22
|
| Rate for Payer: EmblemHealth Commercial |
$2,523.84
|
| Rate for Payer: Humana Medicare Advantage |
$866.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$841.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$622.17
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$358.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$75.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$67.96
|
|
|
IR UNLISTED PROCEDURE - LIVER
|
Facility
|
IP
|
$2,864.05
|
|
|
Service Code
|
HCPCS 47399
|
| Hospital Charge Code |
411047399
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$429.61 |
| Max. Negotiated Rate |
$429.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$429.61
|
|
|
IR UNLISTED VASCULAR PROCEDUR
|
Facility
|
IP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 37799
|
| Hospital Charge Code |
321037799
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$544.61 |
| Max. Negotiated Rate |
$544.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
|
|
IR UNLISTED VASCULAR PROCEDUR
|
Facility
|
IP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 37799
|
| Hospital Charge Code |
2600185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$544.61 |
| Max. Negotiated Rate |
$544.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
|
|
IR UNLISTED VASCULAR PROCEDUR
|
Facility
|
OP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 37799
|
| Hospital Charge Code |
321037799
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.11 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,703.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,703.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,703.39
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$943.98
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$114.73
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$103.11
|
|
|
IR UNLISTED VASCULAR PROCEDUR
|
Facility
|
OP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 37799
|
| Hospital Charge Code |
2600185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.11 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,703.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,703.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,703.39
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$943.98
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$114.73
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$103.11
|
|
|
IR UNLISTE PROCEDURE URINARY
|
Facility
|
IP
|
$454.00
|
|
|
Service Code
|
HCPCS 53899
|
| Hospital Charge Code |
7411632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.10 |
| Max. Negotiated Rate |
$68.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.10
|
|
|
IR UNLISTE PROCEDURE URINARY
|
Facility
|
IP
|
$454.00
|
|
|
Service Code
|
HCPCS 53899
|
| Hospital Charge Code |
2680220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.10 |
| Max. Negotiated Rate |
$68.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.10
|
|
|
IR UNLISTE PROCEDURE URINARY
|
Facility
|
OP
|
$454.00
|
|
|
Service Code
|
HCPCS 53899
|
| Hospital Charge Code |
2680220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12.89 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$807.38
|
| Rate for Payer: Aetna Medicare Advantage |
$961.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,076.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,076.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$296.83
|
| 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 |
$1,076.75
|
| Rate for Payer: Cigna Commercial |
$594.98
|
| Rate for Payer: Cigna Medicare Advantage |
$296.83
|
| Rate for Payer: Clover Medicare Advantage |
$281.99
|
| Rate for Payer: EmblemHealth Commercial |
$890.49
|
| Rate for Payer: Humana Medicare Advantage |
$305.73
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$296.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$118.04
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.89
|
|
|
IR UNLISTE PROCEDURE URINARY
|
Facility
|
OP
|
$454.00
|
|
|
Service Code
|
HCPCS 53899
|
| Hospital Charge Code |
7411632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12.89 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$807.38
|
| Rate for Payer: Aetna Medicare Advantage |
$961.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,076.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,076.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$296.83
|
| 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 |
$1,076.75
|
| Rate for Payer: Cigna Commercial |
$594.98
|
| Rate for Payer: Cigna Medicare Advantage |
$296.83
|
| Rate for Payer: Clover Medicare Advantage |
$281.99
|
| Rate for Payer: EmblemHealth Commercial |
$890.49
|
| Rate for Payer: Humana Medicare Advantage |
$305.73
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$296.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$118.04
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.89
|
|
|
IR-URETHROGRAM VOIDING
|
Facility
|
IP
|
$769.00
|
|
|
Service Code
|
HCPCS 51600
|
| Hospital Charge Code |
2670225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$115.35 |
| Max. Negotiated Rate |
$115.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.35
|
|
|
IR-URETHROGRAM VOIDING
|
Facility
|
OP
|
$769.00
|
|
|
Service Code
|
HCPCS 51600
|
| Hospital Charge Code |
2670225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$21.84 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$292.22
|
| Rate for Payer: Aetna Medicare Advantage |
$230.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$196.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$196.09
|
| 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 |
$196.09
|
| Rate for Payer: Cigna Commercial |
$384.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$199.94
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.84
|
|
|
IR-URETHROGRAM VOIDING
|
Facility
|
IP
|
$769.00
|
|
|
Service Code
|
HCPCS 51600
|
| Hospital Charge Code |
321051600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$115.35 |
| Max. Negotiated Rate |
$115.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.35
|
|
|
IR-URETHROGRAM VOIDING
|
Facility
|
OP
|
$769.00
|
|
|
Service Code
|
HCPCS 51600
|
| Hospital Charge Code |
321051600
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$21.84 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$292.22
|
| Rate for Payer: Aetna Medicare Advantage |
$230.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$196.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$196.09
|
| 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 |
$196.09
|
| Rate for Payer: Cigna Commercial |
$384.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$199.94
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.84
|
|
|
IR-URETHROGRAM VOIDING
|
Facility
|
IP
|
$769.00
|
|
|
Service Code
|
HCPCS 51600
|
| Hospital Charge Code |
7411623
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$115.35 |
| Max. Negotiated Rate |
$115.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.35
|
|
|
IR-URETHROGRAM VOIDING
|
Facility
|
OP
|
$769.00
|
|
|
Service Code
|
HCPCS 51600
|
| Hospital Charge Code |
7411623
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$21.84 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$292.22
|
| Rate for Payer: Aetna Medicare Advantage |
$230.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$196.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$196.09
|
| 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 |
$196.09
|
| Rate for Payer: Cigna Commercial |
$384.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$199.94
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$24.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.84
|
|
|
IR VASC SEL CATH 1ST A/P/LE
|
Facility
|
IP
|
$364.00
|
|
|
Service Code
|
HCPCS 36245
|
| Hospital Charge Code |
2004273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$54.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.60
|
|
|
IR VASC SEL CATH 1ST A/P/LE
|
Facility
|
OP
|
$364.00
|
|
|
Service Code
|
HCPCS 36245
|
| Hospital Charge Code |
2004273
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$138.32
|
| Rate for Payer: Aetna Medicare Advantage |
$109.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$92.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$92.82
|
| 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 |
$92.82
|
| Rate for Payer: Cigna Commercial |
$182.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$94.64
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
