|
IR VENA RENAL UNILAT SELECTIVE
|
Facility
|
IP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75831
|
| Hospital Charge Code |
411075831
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,015.46 |
| Max. Negotiated Rate |
$2,015.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
|
|
IR VENA RENAL UNILAT SELECTIVE
|
Facility
|
OP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75831
|
| Hospital Charge Code |
411075831
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$269.53 |
| 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 |
$269.53
|
| 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 |
$2,625.82
|
| 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 |
$3,493.46
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$424.59
|
| 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 |
$381.59
|
|
|
IR VENA RENAL UNILAT SELECTIVE
|
Facility
|
IP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75831
|
| Hospital Charge Code |
366875831
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,015.46 |
| Max. Negotiated Rate |
$2,015.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
|
|
IR VENA RENAL UNILAT SELECTIVE
|
Facility
|
OP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75831
|
| Hospital Charge Code |
366875831
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$269.53 |
| 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 |
$269.53
|
| 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 |
$2,625.82
|
| 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 |
$3,493.46
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$424.59
|
| 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 |
$381.59
|
|
|
IR VENGRM HPTC W/HEMDYNMC EVAL
|
Facility
|
OP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75889
|
| Hospital Charge Code |
2600130
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$311.85 |
| 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 |
$311.85
|
| 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 |
$2,625.82
|
| 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 |
$3,493.46
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$424.59
|
| 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 |
$381.59
|
|
|
IR VENGRM HPTC W/HEMDYNMC EVAL
|
Facility
|
IP
|
$13,436.40
|
|
|
Service Code
|
HCPCS 75889
|
| Hospital Charge Code |
2600130
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,015.46 |
| Max. Negotiated Rate |
$2,015.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,015.46
|
|
|
IR VENGRM HPTC W/O HMDYNMC EVL
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75891
|
| Hospital Charge Code |
2600131
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
IR VENGRM HPTC W/O HMDYNMC EVL
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75891
|
| Hospital Charge Code |
2600131
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$269.53 |
| 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 |
$269.53
|
| 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 |
$2,625.82
|
| 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 |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| 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 VENGRM HPTC W/O HMDYNMC EVL
|
Facility
|
IP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 75891
|
| Hospital Charge Code |
366875891
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,869.43 |
| Max. Negotiated Rate |
$1,869.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
|
|
IR VENGRM HPTC W/O HMDYNMC EVL
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75891
|
| Hospital Charge Code |
321075891
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
IR VENGRM HPTC W/O HMDYNMC EVL
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 75891
|
| Hospital Charge Code |
321075891
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$269.53 |
| 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 |
$269.53
|
| 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 |
$2,625.82
|
| 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 |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| 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 VENGRM HPTC W/O HMDYNMC EVL
|
Facility
|
OP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 75891
|
| Hospital Charge Code |
411075891
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$269.53 |
| 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 |
$269.53
|
| 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 |
$2,625.82
|
| 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 |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| 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 VENGRM HPTC W/O HMDYNMC EVL
|
Facility
|
IP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 75891
|
| Hospital Charge Code |
411075891
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,869.43 |
| Max. Negotiated Rate |
$1,869.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
|
|
IR VENGRM HPTC W/O HMDYNMC EVL
|
Facility
|
OP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 75891
|
| Hospital Charge Code |
366875891
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$269.53 |
| 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 |
$269.53
|
| 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 |
$2,625.82
|
| 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 |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| 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 VENIPUNCTURE
|
Facility
|
OP
|
$135.80
|
|
|
Service Code
|
HCPCS 36415
|
| Hospital Charge Code |
2670195
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$25.40
|
| Rate for Payer: Aetna Medicare Advantage |
$30.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.88
|
| Rate for Payer: Cigna Commercial |
$67.90
|
| Rate for Payer: Cigna Medicare Advantage |
$9.34
|
| Rate for Payer: Clover Medicare Advantage |
$8.87
|
| Rate for Payer: EmblemHealth Commercial |
$28.02
|
| Rate for Payer: Humana Medicare Advantage |
$9.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.31
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.86
|
|
|
IR VENIPUNCTURE
|
Facility
|
IP
|
$135.80
|
|
|
Service Code
|
HCPCS 36415
|
| Hospital Charge Code |
2670195
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.37 |
| Max. Negotiated Rate |
$20.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.37
|
|
|
IR VENOGRAM ADRENAL BILATERAL
|
Facility
|
OP
|
$12,031.00
|
|
|
Service Code
|
HCPCS 75842
|
| Hospital Charge Code |
2600124
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$341.68 |
| Max. Negotiated Rate |
$6,015.50 |
| Rate for Payer: Aetna Commercial |
$4,571.78
|
| Rate for Payer: Aetna Medicare Advantage |
$3,609.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,067.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,067.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,067.91
|
| Rate for Payer: Cigna Commercial |
$6,015.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,128.06
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,804.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$380.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$341.68
|
|
|
IR VENOGRAM ADRENAL BILATERAL
|
Facility
|
IP
|
$12,031.00
|
|
|
Service Code
|
HCPCS 75842
|
| Hospital Charge Code |
2600124
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,804.65 |
| Max. Negotiated Rate |
$1,804.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,804.65
|
|
|
IR VENOGRAM ADRENAL BILATERAL
|
Facility
|
IP
|
$12,031.00
|
|
|
Service Code
|
HCPCS 75842
|
| Hospital Charge Code |
7411717
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,804.65 |
| Max. Negotiated Rate |
$1,804.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,804.65
|
|
|
IR VENOGRAM ADRENAL BILATERAL
|
Facility
|
OP
|
$12,031.00
|
|
|
Service Code
|
HCPCS 75842
|
| Hospital Charge Code |
7411717
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$341.68 |
| Max. Negotiated Rate |
$6,015.50 |
| Rate for Payer: Aetna Commercial |
$4,571.78
|
| Rate for Payer: Aetna Medicare Advantage |
$3,609.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,067.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,067.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,067.91
|
| Rate for Payer: Cigna Commercial |
$6,015.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,128.06
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,804.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$380.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$341.68
|
|
|
IR VENOGRAM ADRENAL UNILAT
|
Facility
|
OP
|
$12,031.00
|
|
|
Service Code
|
HCPCS 75840
|
| Hospital Charge Code |
7411716
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$269.53 |
| 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 |
$269.53
|
| 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 |
$2,625.82
|
| 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 |
$3,128.06
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,804.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$380.18
|
| 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 |
$341.68
|
|
|
IR VENOGRAM ADRENAL UNILAT
|
Facility
|
IP
|
$12,031.00
|
|
|
Service Code
|
HCPCS 75840
|
| Hospital Charge Code |
7411716
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,804.65 |
| Max. Negotiated Rate |
$1,804.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,804.65
|
|
|
IR VENOGRAM ADRENAL UNILAT
|
Facility
|
IP
|
$12,031.00
|
|
|
Service Code
|
HCPCS 75840
|
| Hospital Charge Code |
2600125
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,804.65 |
| Max. Negotiated Rate |
$1,804.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,804.65
|
|
|
IR VENOGRAM ADRENAL UNILAT
|
Facility
|
OP
|
$12,031.00
|
|
|
Service Code
|
HCPCS 75840
|
| Hospital Charge Code |
2600125
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$269.53 |
| 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 |
$269.53
|
| 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 |
$2,625.82
|
| 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 |
$3,128.06
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,804.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$380.18
|
| 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 |
$341.68
|
|
|
IR VENOGRAM CAVA SUPERIOR
|
Facility
|
OP
|
$4,267.00
|
|
|
Service Code
|
HCPCS 75827
|
| Hospital Charge Code |
7411713
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$121.18 |
| 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 |
$343.20
|
| 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 |
$1,309.10
|
| 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 |
$1,109.42
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$640.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$134.84
|
| 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 |
$121.18
|
|
