|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$15,443.85
|
|
|
Service Code
|
HCPCS 22515
|
| Hospital Charge Code |
411022515
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$438.61 |
| Max. Negotiated Rate |
$7,721.93 |
| Rate for Payer: Aetna Commercial |
$5,868.66
|
| Rate for Payer: Aetna Medicare Advantage |
$4,633.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,938.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,938.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,913.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,938.18
|
| Rate for Payer: Cigna Commercial |
$7,721.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,015.40
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,316.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$488.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$438.61
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$15,443.85
|
|
|
Service Code
|
HCPCS 22515
|
| Hospital Charge Code |
5701108
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,316.58 |
| Max. Negotiated Rate |
$2,316.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,316.58
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$15,443.85
|
|
|
Service Code
|
HCPCS 22515
|
| Hospital Charge Code |
5701108
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$438.61 |
| Max. Negotiated Rate |
$7,721.93 |
| Rate for Payer: Aetna Commercial |
$5,868.66
|
| Rate for Payer: Aetna Medicare Advantage |
$4,633.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,938.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,938.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,913.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,938.18
|
| Rate for Payer: Cigna Commercial |
$7,721.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,015.40
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,316.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$488.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$438.61
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22513
|
| Hospital Charge Code |
366822513
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$5,630.17 |
| Max. Negotiated Rate |
$5,630.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22514
|
| Hospital Charge Code |
411022514
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,065.98 |
| 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 |
$4,797.40
|
| 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 |
$6,034.40
|
| 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 |
$9,758.96
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,186.09
|
| 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 |
$1,065.98
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22513
|
| Hospital Charge Code |
5701106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,065.98 |
| 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 |
$9,758.96
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,186.09
|
| 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 |
$1,065.98
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22514
|
| Hospital Charge Code |
321022514
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$5,630.17 |
| Max. Negotiated Rate |
$5,630.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$33,638.52
|
|
|
Service Code
|
HCPCS 22514
|
| Hospital Charge Code |
1600000450
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.33 |
| 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 |
$8,746.02
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,045.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,062.98
|
| 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 |
$955.33
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22513
|
| Hospital Charge Code |
5701106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,630.17 |
| Max. Negotiated Rate |
$5,630.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22513
|
| Hospital Charge Code |
7411355
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$5,630.17 |
| Max. Negotiated Rate |
$5,630.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22513
|
| Hospital Charge Code |
366822513
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,065.98 |
| 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 |
$4,820.87
|
| 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 |
$6,034.40
|
| 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 |
$9,758.96
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,186.09
|
| 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 |
$1,065.98
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$15,443.85
|
|
|
Service Code
|
HCPCS 22515
|
| Hospital Charge Code |
366822515
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$438.61 |
| Max. Negotiated Rate |
$7,721.93 |
| Rate for Payer: Aetna Commercial |
$5,868.66
|
| Rate for Payer: Aetna Medicare Advantage |
$4,633.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,938.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,938.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,913.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,938.18
|
| Rate for Payer: Cigna Commercial |
$7,721.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,015.40
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,316.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$488.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$438.61
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22514
|
| Hospital Charge Code |
366822514
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$5,630.17 |
| Max. Negotiated Rate |
$5,630.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$33,638.52
|
|
|
Service Code
|
HCPCS 22514
|
| Hospital Charge Code |
1600000450
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,045.78 |
| Max. Negotiated Rate |
$5,045.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,045.78
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22514
|
| Hospital Charge Code |
7411356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$5,630.17 |
| Max. Negotiated Rate |
$5,630.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$15,443.85
|
|
|
Service Code
|
HCPCS 22515
|
| Hospital Charge Code |
366822515
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,316.58 |
| Max. Negotiated Rate |
$2,316.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,316.58
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22514
|
| Hospital Charge Code |
366822514
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,065.98 |
| 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 |
$4,797.40
|
| 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 |
$6,034.40
|
| 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 |
$9,758.96
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,186.09
|
| 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 |
$1,065.98
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$15,443.85
|
|
|
Service Code
|
HCPCS 22515
|
| Hospital Charge Code |
411022515
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,316.58 |
| Max. Negotiated Rate |
$2,316.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,316.58
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22514
|
| Hospital Charge Code |
5701107
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,065.98 |
| 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 |
$4,797.40
|
| 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 |
$6,034.40
|
| 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 |
$9,758.96
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,186.09
|
| 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 |
$1,065.98
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22513
|
| Hospital Charge Code |
411022513
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$5,630.17 |
| Max. Negotiated Rate |
$5,630.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22513
|
| Hospital Charge Code |
411022513
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,065.98 |
| 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 |
$4,820.87
|
| 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 |
$6,034.40
|
| 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 |
$9,758.96
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,186.09
|
| 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 |
$1,065.98
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22514
|
| Hospital Charge Code |
5701107
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$5,630.17 |
| Max. Negotiated Rate |
$5,630.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22514
|
| Hospital Charge Code |
7411356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,065.98 |
| 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 |
$4,797.40
|
| 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 |
$6,034.40
|
| 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 |
$9,758.96
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,186.09
|
| 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 |
$1,065.98
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
IP
|
$15,443.85
|
|
|
Service Code
|
HCPCS 22515
|
| Hospital Charge Code |
7411357
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,316.58 |
| Max. Negotiated Rate |
$2,316.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,316.58
|
|
|
PERQ VERTEBRAL AUGMENTATION
|
Facility
|
OP
|
$37,534.48
|
|
|
Service Code
|
HCPCS 22513
|
| Hospital Charge Code |
321022513
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,065.98 |
| 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 |
$4,820.87
|
| 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 |
$6,034.40
|
| 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 |
$9,758.96
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,630.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,186.09
|
| 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 |
$1,065.98
|
|