|
NM TUMOR LOCALIZATION LIMITED
|
Facility
|
OP
|
$12,000.00
|
|
|
Service Code
|
HCPCS 78800
|
| Hospital Charge Code |
4500690
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$226.05 |
| Max. Negotiated Rate |
$4,820.00 |
| Rate for Payer: Aetna Commercial |
$1,291.84
|
| Rate for Payer: Aetna Medicare Advantage |
$1,538.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,722.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,722.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$474.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$226.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,722.84
|
| Rate for Payer: Cigna Commercial |
$952.02
|
| Rate for Payer: Cigna Medicare Advantage |
$332.46
|
| Rate for Payer: Clover Medicare Advantage |
$451.19
|
| Rate for Payer: EmblemHealth Commercial |
$1,424.82
|
| Rate for Payer: Humana Medicare Advantage |
$489.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$474.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,120.00
|
| Rate for Payer: Oxford Commercial |
$4,820.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,800.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,748.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$379.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$340.80
|
|
|
NM TUMOR LOCALIZATION MULTIPLE
|
Facility
|
IP
|
$2,820.00
|
|
|
Service Code
|
HCPCS 78801
|
| Hospital Charge Code |
4500682
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$423.00 |
| Max. Negotiated Rate |
$423.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$423.00
|
|
|
NM TUMOR LOCALIZATION MULTIPLE
|
Facility
|
OP
|
$2,820.00
|
|
|
Service Code
|
HCPCS 78801
|
| Hospital Charge Code |
4500682
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$80.09 |
| Max. Negotiated Rate |
$4,820.00 |
| Rate for Payer: Aetna Commercial |
$1,291.84
|
| Rate for Payer: Aetna Medicare Advantage |
$1,538.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,722.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,722.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$474.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$248.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,722.84
|
| Rate for Payer: Cigna Commercial |
$952.02
|
| Rate for Payer: Cigna Medicare Advantage |
$332.46
|
| Rate for Payer: Clover Medicare Advantage |
$451.19
|
| Rate for Payer: EmblemHealth Commercial |
$1,424.82
|
| Rate for Payer: Humana Medicare Advantage |
$489.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$474.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$733.20
|
| Rate for Payer: Oxford Commercial |
$4,820.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$423.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,748.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$89.11
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$80.09
|
|
|
NM TUMOR LOCALIZATION (SPECT)
|
Facility
|
OP
|
$12,000.00
|
|
|
Service Code
|
HCPCS 78803
|
| Hospital Charge Code |
4500708
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$157.08 |
| Max. Negotiated Rate |
$4,820.00 |
| Rate for Payer: Aetna Commercial |
$1,754.56
|
| Rate for Payer: Aetna Medicare Advantage |
$2,089.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,339.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,339.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$645.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$157.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,339.96
|
| Rate for Payer: Cigna Commercial |
$1,293.03
|
| Rate for Payer: Cigna Medicare Advantage |
$451.54
|
| Rate for Payer: Clover Medicare Advantage |
$612.81
|
| Rate for Payer: EmblemHealth Commercial |
$1,935.18
|
| Rate for Payer: Humana Medicare Advantage |
$664.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$645.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,120.00
|
| Rate for Payer: Oxford Commercial |
$4,820.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,800.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,748.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$379.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$340.80
|
|
|
NM TUMOR LOCALIZATION (SPECT)
|
Facility
|
IP
|
$12,000.00
|
|
|
Service Code
|
HCPCS 78803
|
| Hospital Charge Code |
4500708
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,800.00
|
|
|
NM TUMOR LOCALIZ - WHOLE BODY
|
Facility
|
OP
|
$12,000.00
|
|
|
Service Code
|
HCPCS 78802
|
| Hospital Charge Code |
4500674
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$4,820.00 |
| Rate for Payer: Aetna Commercial |
$1,754.56
|
| Rate for Payer: Aetna Medicare Advantage |
$2,089.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,339.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,339.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$645.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$99.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,339.96
|
| Rate for Payer: Cigna Commercial |
$1,293.03
|
| Rate for Payer: Cigna Medicare Advantage |
$451.54
|
| Rate for Payer: Clover Medicare Advantage |
$612.81
|
| Rate for Payer: EmblemHealth Commercial |
$1,935.18
|
| Rate for Payer: Humana Medicare Advantage |
$664.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$645.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,120.00
|
| Rate for Payer: Oxford Commercial |
$4,820.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,800.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,748.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$379.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$340.80
|
|
|
NM TUMOR LOCALIZ - WHOLE BODY
|
Facility
|
IP
|
$12,000.00
|
|
|
Service Code
|
HCPCS 78802
|
| Hospital Charge Code |
4500674
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,800.00
|
|
|
NM TUMOR WHOLE BODY 2+DAYS IMG
|
Facility
|
IP
|
$12,000.00
|
|
|
Service Code
|
HCPCS 78804
|
| Hospital Charge Code |
406078804
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,800.00
|
|
|
NM TUMOR WHOLE BODY 2+DAYS IMG
|
Facility
|
OP
|
$12,000.00
|
|
|
Service Code
|
HCPCS 78804
|
| Hospital Charge Code |
406078804
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$324.56 |
| Max. Negotiated Rate |
$4,820.00 |
| Rate for Payer: Aetna Commercial |
$1,754.56
|
| Rate for Payer: Aetna Medicare Advantage |
$2,089.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,339.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,339.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$645.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$324.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,339.96
|
| Rate for Payer: Cigna Commercial |
$1,293.03
|
| Rate for Payer: Cigna Medicare Advantage |
$451.54
|
| Rate for Payer: Clover Medicare Advantage |
$612.81
|
| Rate for Payer: EmblemHealth Commercial |
$1,935.18
|
| Rate for Payer: Humana Medicare Advantage |
$664.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$645.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,120.00
|
| Rate for Payer: Oxford Commercial |
$4,820.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,800.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,748.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$379.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$340.80
|
|
|
NM URETERAL REFLUX STUDY
|
Facility
|
OP
|
$1,908.00
|
|
|
Service Code
|
HCPCS 78740
|
| Hospital Charge Code |
4500609
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$54.19 |
| Max. Negotiated Rate |
$4,820.00 |
| Rate for Payer: Aetna Commercial |
$1,291.84
|
| Rate for Payer: Aetna Medicare Advantage |
$1,538.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,722.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,722.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$474.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$82.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,722.84
|
| Rate for Payer: Cigna Commercial |
$952.02
|
| Rate for Payer: Cigna Medicare Advantage |
$332.46
|
| Rate for Payer: Clover Medicare Advantage |
$451.19
|
| Rate for Payer: EmblemHealth Commercial |
$1,424.82
|
| Rate for Payer: Humana Medicare Advantage |
$489.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$474.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$496.08
|
| Rate for Payer: Oxford Commercial |
$4,820.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$286.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,748.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$60.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$54.19
|
|
|
NM URETERAL REFLUX STUDY
|
Facility
|
IP
|
$1,908.00
|
|
|
Service Code
|
HCPCS 78740
|
| Hospital Charge Code |
4500609
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$286.20 |
| Max. Negotiated Rate |
$286.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$286.20
|
|
|
NM VENA CAVA
|
Facility
|
OP
|
$12,000.00
|
|
|
Service Code
|
HCPCS 78445
|
| Hospital Charge Code |
4500369
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$99.00 |
| Max. Negotiated Rate |
$4,820.00 |
| Rate for Payer: Aetna Commercial |
$1,291.84
|
| Rate for Payer: Aetna Medicare Advantage |
$1,538.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,722.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,722.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$474.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$99.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,722.84
|
| Rate for Payer: Cigna Commercial |
$952.02
|
| Rate for Payer: Cigna Medicare Advantage |
$332.46
|
| Rate for Payer: Clover Medicare Advantage |
$451.19
|
| Rate for Payer: EmblemHealth Commercial |
$1,424.82
|
| Rate for Payer: Humana Medicare Advantage |
$489.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$474.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,120.00
|
| Rate for Payer: Oxford Commercial |
$4,820.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,800.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,748.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$379.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$340.80
|
|
|
NM VENA CAVA
|
Facility
|
IP
|
$12,000.00
|
|
|
Service Code
|
HCPCS 78445
|
| Hospital Charge Code |
4500369
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,800.00 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,800.00
|
|
|
NM VENOUS THROMBO VENOGRAM BI
|
Facility
|
OP
|
$1,189.00
|
|
|
Service Code
|
HCPCS 78458
|
| Hospital Charge Code |
4500916
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$33.77 |
| Max. Negotiated Rate |
$4,820.00 |
| Rate for Payer: Aetna Commercial |
$1,291.84
|
| Rate for Payer: Aetna Medicare Advantage |
$1,538.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,722.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,722.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$474.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$272.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,722.84
|
| Rate for Payer: Cigna Commercial |
$952.02
|
| Rate for Payer: Cigna Medicare Advantage |
$332.46
|
| Rate for Payer: Clover Medicare Advantage |
$451.19
|
| Rate for Payer: EmblemHealth Commercial |
$1,424.82
|
| Rate for Payer: Humana Medicare Advantage |
$489.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$474.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$309.14
|
| Rate for Payer: Oxford Commercial |
$4,820.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$178.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,748.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$37.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$474.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.77
|
|
|
NM VENOUS THROMBO VENOGRAM BI
|
Facility
|
IP
|
$1,189.00
|
|
|
Service Code
|
HCPCS 78458
|
| Hospital Charge Code |
4500916
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$178.35 |
| Max. Negotiated Rate |
$178.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$178.35
|
|
|
NM VENOUS THROMBO VENOGRAM UNI
|
Facility
|
OP
|
$1,189.00
|
|
|
Service Code
|
HCPCS 78457
|
| Hospital Charge Code |
4500914
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$33.77 |
| Max. Negotiated Rate |
$4,820.00 |
| Rate for Payer: Aetna Commercial |
$1,754.56
|
| Rate for Payer: Aetna Medicare Advantage |
$2,089.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,339.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,339.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$645.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$181.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,339.96
|
| Rate for Payer: Cigna Commercial |
$1,293.03
|
| Rate for Payer: Cigna Medicare Advantage |
$451.54
|
| Rate for Payer: Clover Medicare Advantage |
$612.81
|
| Rate for Payer: EmblemHealth Commercial |
$1,935.18
|
| Rate for Payer: Humana Medicare Advantage |
$664.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$645.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$309.14
|
| Rate for Payer: Oxford Commercial |
$4,820.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$178.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,748.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$37.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$645.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.77
|
|
|
NM VENOUS THROMBO VENOGRAM UNI
|
Facility
|
IP
|
$1,189.00
|
|
|
Service Code
|
HCPCS 78457
|
| Hospital Charge Code |
4500914
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$178.35 |
| Max. Negotiated Rate |
$178.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$178.35
|
|
|
No.3 Knife Handle
|
Facility
|
IP
|
$19.20
|
|
| Hospital Charge Code |
270607725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.88 |
| Max. Negotiated Rate |
$2.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.88
|
|
|
No.3 Knife Handle
|
Facility
|
OP
|
$19.20
|
|
| Hospital Charge Code |
270607725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$9.60 |
| Rate for Payer: Aetna Commercial |
$7.30
|
| Rate for Payer: Aetna Medicare Advantage |
$5.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.90
|
| Rate for Payer: Cigna Commercial |
$9.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.99
|
| Rate for Payer: Oxford Commercial |
$3.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.84
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.55
|
|
|
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC
|
Facility
|
IP
|
$91,968.77
|
|
|
Service Code
|
MSDRG 098
|
| Min. Negotiated Rate |
$28,003.31 |
| Max. Negotiated Rate |
$91,968.77 |
| Rate for Payer: Aetna Medicare Advantage |
$91,968.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59,565.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59,565.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$29,477.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59,565.75
|
| Rate for Payer: Cigna Commercial |
$51,160.21
|
| Rate for Payer: Cigna Medicare Advantage |
$29,477.17
|
| Rate for Payer: Clover Medicare Advantage |
$28,003.31
|
| Rate for Payer: EmblemHealth Commercial |
$88,431.51
|
| Rate for Payer: Humana Medicare Advantage |
$30,361.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$29,477.17
|
| Rate for Payer: Oxford Commercial |
$40,436.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$54,125.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$29,477.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$29,477.17
|
|
|
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC
|
Facility
|
IP
|
$133,574.28
|
|
|
Service Code
|
MSDRG 097
|
| Min. Negotiated Rate |
$40,671.66 |
| Max. Negotiated Rate |
$133,574.28 |
| Rate for Payer: Aetna Medicare Advantage |
$133,574.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100,846.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100,846.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$42,812.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100,846.20
|
| Rate for Payer: Cigna Commercial |
$80,517.86
|
| Rate for Payer: Cigna Medicare Advantage |
$42,812.27
|
| Rate for Payer: Clover Medicare Advantage |
$40,671.66
|
| Rate for Payer: EmblemHealth Commercial |
$128,436.81
|
| Rate for Payer: Humana Medicare Advantage |
$44,096.64
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$42,812.27
|
| Rate for Payer: Oxford Commercial |
$63,639.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$85,184.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$42,812.27
|
| Rate for Payer: Wellcare Medicare Advantage |
$42,812.27
|
|
|
NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$62,507.70
|
|
|
Service Code
|
MSDRG 099
|
| Min. Negotiated Rate |
$19,032.79 |
| Max. Negotiated Rate |
$62,507.70 |
| Rate for Payer: Aetna Medicare Advantage |
$62,507.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36,570.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36,570.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20,034.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36,570.60
|
| Rate for Payer: Cigna Commercial |
$30,371.98
|
| Rate for Payer: Cigna Medicare Advantage |
$20,034.52
|
| Rate for Payer: Clover Medicare Advantage |
$19,032.79
|
| Rate for Payer: EmblemHealth Commercial |
$60,103.56
|
| Rate for Payer: Humana Medicare Advantage |
$20,635.56
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20,034.52
|
| Rate for Payer: Oxford Commercial |
$24,005.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$32,132.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20,034.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$20,034.52
|
|
|
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS
|
Facility
|
IP
|
$15,633.61
|
|
|
Service Code
|
APR-DRG 0502
|
| Min. Negotiated Rate |
$15,327.07 |
| Max. Negotiated Rate |
$15,633.61 |
| Rate for Payer: UnitedHealthcare Community & State |
$15,327.07
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$15,633.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15,327.07
|
|
|
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS
|
Facility
|
IP
|
$48,762.94
|
|
|
Service Code
|
APR-DRG 0504
|
| Min. Negotiated Rate |
$47,806.80 |
| Max. Negotiated Rate |
$48,762.94 |
| Rate for Payer: UnitedHealthcare Community & State |
$47,806.80
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$48,762.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$47,806.80
|
|
|
NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS
|
Facility
|
IP
|
$9,250.62
|
|
|
Service Code
|
APR-DRG 0501
|
| Min. Negotiated Rate |
$9,069.24 |
| Max. Negotiated Rate |
$9,250.62 |
| Rate for Payer: UnitedHealthcare Community & State |
$9,069.24
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$9,250.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9,069.24
|
|
