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Service Code HCPCS 27438
Hospital Charge Code 1600000558
Hospital Revenue Code 360
Min. Negotiated Rate $8,384.35
Max. Negotiated Rate $8,384.35
Rate for Payer: Qualcare PPO/HMO/WC $8,384.35
Service Code HCPCS 27438
Hospital Charge Code 1600000558
Hospital Revenue Code 360
Min. Negotiated Rate $1,587.44
Max. Negotiated Rate $55,329.13
Rate for Payer: Aetna Commercial $41,487.32
Rate for Payer: Aetna Medicare Advantage $49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $15,252.69
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 $55,329.13
Rate for Payer: Cigna Commercial $30,573.98
Rate for Payer: Cigna Medicare Advantage $15,252.69
Rate for Payer: Clover Medicare Advantage $14,490.06
Rate for Payer: EmblemHealth Commercial $45,758.07
Rate for Payer: Humana Medicare Advantage $15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $14,532.88
Rate for Payer: Oxford Commercial $13,407.00
Rate for Payer: Qualcare PPO/HMO/WC $8,384.35
Rate for Payer: UnitedHealthcare Commercial $14,869.00
Rate for Payer: UnitedHealthcare Community & State $1,766.30
Rate for Payer: UnitedHealthcare Medicare Advantage $15,252.69
Rate for Payer: Wellcare Medicare Advantage $15,252.69
Rate for Payer: Wellpoint Medicaid Managed Care $1,587.44
Service Code HCPCS 25332
Hospital Charge Code 16000617
Hospital Revenue Code 360
Min. Negotiated Rate $1,275.61
Max. Negotiated Rate $14,100.89
Rate for Payer: Aetna Commercial $10,573.24
Rate for Payer: Aetna Medicare Advantage $12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $3,887.22
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 $14,100.89
Rate for Payer: Cigna Commercial $7,791.93
Rate for Payer: Cigna Medicare Advantage $3,887.22
Rate for Payer: Clover Medicare Advantage $3,692.86
Rate for Payer: EmblemHealth Commercial $11,661.66
Rate for Payer: Humana Medicare Advantage $4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $11,678.16
Rate for Payer: Oxford Commercial $11,677.00
Rate for Payer: Qualcare PPO/HMO/WC $6,737.40
Rate for Payer: UnitedHealthcare Commercial $12,906.00
Rate for Payer: UnitedHealthcare Community & State $1,419.35
Rate for Payer: UnitedHealthcare Medicare Advantage $3,887.22
Rate for Payer: Wellcare Medicare Advantage $3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care $1,275.61
Service Code HCPCS 25332
Hospital Charge Code 16000617
Hospital Revenue Code 360
Min. Negotiated Rate $6,737.40
Max. Negotiated Rate $6,737.40
Rate for Payer: Qualcare PPO/HMO/WC $6,737.40
Service Code HCPCS 27702
Hospital Charge Code 16000896
Hospital Revenue Code 360
Min. Negotiated Rate $326.06
Max. Negotiated Rate $116,935.87
Rate for Payer: Aetna Commercial $87,681.76
Rate for Payer: Aetna Medicare Advantage $104,444.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $116,935.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $116,935.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $32,235.94
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 $116,935.87
Rate for Payer: Cigna Commercial $64,616.81
Rate for Payer: Cigna Medicare Advantage $32,235.94
Rate for Payer: Clover Medicare Advantage $30,624.14
Rate for Payer: EmblemHealth Commercial $96,707.82
Rate for Payer: Humana Medicare Advantage $33,203.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $32,235.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $2,985.09
Rate for Payer: Oxford Commercial $13,407.00
Rate for Payer: Qualcare PPO/HMO/WC $1,722.16
Rate for Payer: UnitedHealthcare Commercial $14,869.00
Rate for Payer: UnitedHealthcare Community & State $362.80
Rate for Payer: UnitedHealthcare Medicare Advantage $32,235.94
Rate for Payer: Wellcare Medicare Advantage $32,235.94
Rate for Payer: Wellpoint Medicaid Managed Care $326.06
Service Code HCPCS 27702
Hospital Charge Code 16000896
Hospital Revenue Code 360
Min. Negotiated Rate $1,722.16
Max. Negotiated Rate $1,722.16
Rate for Payer: Qualcare PPO/HMO/WC $1,722.16
Service Code HCPCS 29891
Hospital Charge Code 16000483
Hospital Revenue Code 360
Min. Negotiated Rate $7,587.90
Max. Negotiated Rate $7,587.90
Rate for Payer: Qualcare PPO/HMO/WC $7,587.90
Service Code HCPCS 29891
Hospital Charge Code 16000483
Hospital Revenue Code 360
Min. Negotiated Rate $1,436.64
Max. Negotiated Rate $14,869.00
Rate for Payer: Aetna Commercial $10,573.24
Rate for Payer: Aetna Medicare Advantage $12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $3,887.22
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 $14,100.89
Rate for Payer: Cigna Commercial $7,791.93
Rate for Payer: Cigna Medicare Advantage $3,887.22
Rate for Payer: Clover Medicare Advantage $3,692.86
Rate for Payer: EmblemHealth Commercial $11,661.66
Rate for Payer: Humana Medicare Advantage $4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $13,152.36
Rate for Payer: Oxford Commercial $13,407.00
Rate for Payer: Qualcare PPO/HMO/WC $7,587.90
Rate for Payer: UnitedHealthcare Commercial $14,869.00
Rate for Payer: UnitedHealthcare Community & State $1,598.52
Rate for Payer: UnitedHealthcare Medicare Advantage $3,887.22
Rate for Payer: Wellcare Medicare Advantage $3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care $1,436.64
Service Code HCPCS 29888
Hospital Charge Code 16000193
Hospital Revenue Code 360
Min. Negotiated Rate $2,356.06
Max. Negotiated Rate $31,271.12
Rate for Payer: Aetna Commercial $23,447.95
Rate for Payer: Aetna Medicare Advantage $27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $8,620.57
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 $31,271.12
Rate for Payer: Cigna Commercial $17,279.91
Rate for Payer: Cigna Medicare Advantage $8,620.57
Rate for Payer: Clover Medicare Advantage $8,189.54
Rate for Payer: EmblemHealth Commercial $25,861.71
Rate for Payer: Humana Medicare Advantage $8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $21,569.52
Rate for Payer: Oxford Commercial $13,407.00
Rate for Payer: Qualcare PPO/HMO/WC $12,443.95
Rate for Payer: UnitedHealthcare Commercial $14,869.00
Rate for Payer: UnitedHealthcare Community & State $2,621.53
Rate for Payer: UnitedHealthcare Medicare Advantage $8,620.57
Rate for Payer: Wellcare Medicare Advantage $8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care $2,356.06
Service Code HCPCS 29888
Hospital Charge Code 16000193
Hospital Revenue Code 360
Min. Negotiated Rate $12,443.95
Max. Negotiated Rate $12,443.95
Rate for Payer: Qualcare PPO/HMO/WC $12,443.95
Service Code HCPCS 29863
Hospital Charge Code 16000417
Hospital Revenue Code 360
Min. Negotiated Rate $7,587.90
Max. Negotiated Rate $7,587.90
Rate for Payer: Qualcare PPO/HMO/WC $7,587.90
Service Code HCPCS 29863
Hospital Charge Code 16000417
Hospital Revenue Code 360
Min. Negotiated Rate $1,436.64
Max. Negotiated Rate $14,869.00
Rate for Payer: Aetna Commercial $10,573.24
Rate for Payer: Aetna Medicare Advantage $12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $3,887.22
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 $14,100.89
Rate for Payer: Cigna Commercial $7,791.93
Rate for Payer: Cigna Medicare Advantage $3,887.22
Rate for Payer: Clover Medicare Advantage $3,692.86
Rate for Payer: EmblemHealth Commercial $11,661.66
Rate for Payer: Humana Medicare Advantage $4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $13,152.36
Rate for Payer: Oxford Commercial $13,407.00
Rate for Payer: Qualcare PPO/HMO/WC $7,587.90
Rate for Payer: UnitedHealthcare Commercial $14,869.00
Rate for Payer: UnitedHealthcare Community & State $1,598.52
Rate for Payer: UnitedHealthcare Medicare Advantage $3,887.22
Rate for Payer: Wellcare Medicare Advantage $3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care $1,436.64
Service Code HCPCS 29871
Hospital Charge Code 16000730
Hospital Revenue Code 360
Min. Negotiated Rate $3,840.57
Max. Negotiated Rate $3,840.57
Rate for Payer: Qualcare PPO/HMO/WC $3,840.57
Service Code HCPCS 29871
Hospital Charge Code 16000730
Hospital Revenue Code 360
Min. Negotiated Rate $727.15
Max. Negotiated Rate $14,100.89
Rate for Payer: Aetna Commercial $10,573.24
Rate for Payer: Aetna Medicare Advantage $12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $3,887.22
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 $14,100.89
Rate for Payer: Cigna Commercial $7,791.93
Rate for Payer: Cigna Medicare Advantage $3,887.22
Rate for Payer: Clover Medicare Advantage $3,692.86
Rate for Payer: EmblemHealth Commercial $11,661.66
Rate for Payer: Humana Medicare Advantage $4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $6,656.99
Rate for Payer: Oxford Commercial $9,354.00
Rate for Payer: Qualcare PPO/HMO/WC $3,840.57
Rate for Payer: UnitedHealthcare Commercial $10,269.00
Rate for Payer: UnitedHealthcare Community & State $809.08
Rate for Payer: UnitedHealthcare Medicare Advantage $3,887.22
Rate for Payer: Wellcare Medicare Advantage $3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care $727.15
Service Code HCPCS 29875
Hospital Charge Code 16000312
Hospital Revenue Code 360
Min. Negotiated Rate $4,916.25
Max. Negotiated Rate $4,916.25
Rate for Payer: Qualcare PPO/HMO/WC $4,916.25
Service Code HCPCS 29875
Hospital Charge Code 16000312
Hospital Revenue Code 360
Min. Negotiated Rate $930.81
Max. Negotiated Rate $14,100.89
Rate for Payer: Aetna Commercial $10,573.24
Rate for Payer: Aetna Medicare Advantage $12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $3,887.22
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 $14,100.89
Rate for Payer: Cigna Commercial $7,791.93
Rate for Payer: Cigna Medicare Advantage $3,887.22
Rate for Payer: Clover Medicare Advantage $3,692.86
Rate for Payer: EmblemHealth Commercial $11,661.66
Rate for Payer: Humana Medicare Advantage $4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $8,521.50
Rate for Payer: Oxford Commercial $9,354.00
Rate for Payer: Qualcare PPO/HMO/WC $4,916.25
Rate for Payer: UnitedHealthcare Commercial $10,269.00
Rate for Payer: UnitedHealthcare Community & State $1,035.69
Rate for Payer: UnitedHealthcare Medicare Advantage $3,887.22
Rate for Payer: Wellcare Medicare Advantage $3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care $930.81
Service Code HCPCS 29874
Hospital Charge Code 16000731
Hospital Revenue Code 360
Min. Negotiated Rate $727.15
Max. Negotiated Rate $14,100.89
Rate for Payer: Aetna Commercial $10,573.24
Rate for Payer: Aetna Medicare Advantage $12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $3,887.22
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 $14,100.89
Rate for Payer: Cigna Commercial $7,791.93
Rate for Payer: Cigna Medicare Advantage $3,887.22
Rate for Payer: Clover Medicare Advantage $3,692.86
Rate for Payer: EmblemHealth Commercial $11,661.66
Rate for Payer: Humana Medicare Advantage $4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $6,656.99
Rate for Payer: Oxford Commercial $9,354.00
Rate for Payer: Qualcare PPO/HMO/WC $3,840.57
Rate for Payer: UnitedHealthcare Commercial $10,269.00
Rate for Payer: UnitedHealthcare Community & State $809.08
Rate for Payer: UnitedHealthcare Medicare Advantage $3,887.22
Rate for Payer: Wellcare Medicare Advantage $3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care $727.15
Service Code HCPCS 29874
Hospital Charge Code 16000731
Hospital Revenue Code 360
Min. Negotiated Rate $3,840.57
Max. Negotiated Rate $3,840.57
Rate for Payer: Qualcare PPO/HMO/WC $3,840.57
Service Code HCPCS 29884
Hospital Charge Code 16000232
Hospital Revenue Code 360
Min. Negotiated Rate $727.15
Max. Negotiated Rate $14,100.89
Rate for Payer: Aetna Commercial $10,573.24
Rate for Payer: Aetna Medicare Advantage $12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $3,887.22
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 $14,100.89
Rate for Payer: Cigna Commercial $7,791.93
Rate for Payer: Cigna Medicare Advantage $3,887.22
Rate for Payer: Clover Medicare Advantage $3,692.86
Rate for Payer: EmblemHealth Commercial $11,661.66
Rate for Payer: Humana Medicare Advantage $4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $6,656.99
Rate for Payer: Oxford Commercial $9,354.00
Rate for Payer: Qualcare PPO/HMO/WC $3,840.57
Rate for Payer: UnitedHealthcare Commercial $10,269.00
Rate for Payer: UnitedHealthcare Community & State $809.08
Rate for Payer: UnitedHealthcare Medicare Advantage $3,887.22
Rate for Payer: Wellcare Medicare Advantage $3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care $727.15
Service Code HCPCS 29884
Hospital Charge Code 16000232
Hospital Revenue Code 360
Min. Negotiated Rate $3,840.57
Max. Negotiated Rate $3,840.57
Rate for Payer: Qualcare PPO/HMO/WC $3,840.57
Service Code HCPCS 29881
Hospital Charge Code 16000186
Hospital Revenue Code 360
Min. Negotiated Rate $5,318.19
Max. Negotiated Rate $5,318.19
Rate for Payer: Qualcare PPO/HMO/WC $5,318.19
Service Code HCPCS 29881
Hospital Charge Code 16000186
Hospital Revenue Code 360
Min. Negotiated Rate $1,006.91
Max. Negotiated Rate $14,100.89
Rate for Payer: Aetna Commercial $10,573.24
Rate for Payer: Aetna Medicare Advantage $12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $3,887.22
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 $14,100.89
Rate for Payer: Cigna Commercial $7,791.93
Rate for Payer: Cigna Medicare Advantage $3,887.22
Rate for Payer: Clover Medicare Advantage $3,692.86
Rate for Payer: EmblemHealth Commercial $11,661.66
Rate for Payer: Humana Medicare Advantage $4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $9,218.19
Rate for Payer: Oxford Commercial $9,354.00
Rate for Payer: Qualcare PPO/HMO/WC $5,318.19
Rate for Payer: UnitedHealthcare Commercial $10,269.00
Rate for Payer: UnitedHealthcare Community & State $1,120.36
Rate for Payer: UnitedHealthcare Medicare Advantage $3,887.22
Rate for Payer: Wellcare Medicare Advantage $3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care $1,006.91
Service Code HCPCS 29880
Hospital Charge Code 16000178
Hospital Revenue Code 360
Min. Negotiated Rate $1,006.91
Max. Negotiated Rate $14,100.89
Rate for Payer: Aetna Commercial $10,573.24
Rate for Payer: Aetna Medicare Advantage $12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care $14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage $3,887.22
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 $14,100.89
Rate for Payer: Cigna Commercial $7,791.93
Rate for Payer: Cigna Medicare Advantage $3,887.22
Rate for Payer: Clover Medicare Advantage $3,692.86
Rate for Payer: EmblemHealth Commercial $11,661.66
Rate for Payer: Humana Medicare Advantage $4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage $3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC $9,218.19
Rate for Payer: Oxford Commercial $9,354.00
Rate for Payer: Qualcare PPO/HMO/WC $5,318.19
Rate for Payer: UnitedHealthcare Commercial $10,269.00
Rate for Payer: UnitedHealthcare Community & State $1,120.36
Rate for Payer: UnitedHealthcare Medicare Advantage $3,887.22
Rate for Payer: Wellcare Medicare Advantage $3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care $1,006.91
Service Code HCPCS 29880
Hospital Charge Code 16000178
Hospital Revenue Code 360
Min. Negotiated Rate $5,318.19
Max. Negotiated Rate $5,318.19
Rate for Payer: Qualcare PPO/HMO/WC $5,318.19
Service Code HCPCS 29882
Hospital Charge Code 16000307
Hospital Revenue Code 360
Min. Negotiated Rate $4,916.25
Max. Negotiated Rate $4,916.25
Rate for Payer: Qualcare PPO/HMO/WC $4,916.25