|
PLACE CATH THORACIC AORTA
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36221
|
| Hospital Charge Code |
5600221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$439.31 |
| 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 |
$3,536.00
|
| 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 |
$3,751.17
|
| 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 |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| 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
|
|
|
PLACE CATH THORACIC AORTA
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36221
|
| Hospital Charge Code |
5600221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
PLACE CATH THORACIC AORTA
|
Facility
|
IP
|
$11,691.56
|
|
|
Service Code
|
HCPCS 36221
|
| Hospital Charge Code |
1600000736
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,753.73 |
| Max. Negotiated Rate |
$1,753.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,753.73
|
|
|
PLACE CATH THORACIC AORTA
|
Facility
|
OP
|
$13,077.63
|
|
|
Service Code
|
HCPCS 36221
|
| Hospital Charge Code |
411036221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$371.40 |
| 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 |
$3,536.00
|
| 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 |
$3,751.17
|
| 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 |
$3,400.18
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,961.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$413.25
|
| 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 |
$371.40
|
|
|
PLACE CATH THORACIC AORTA
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36221
|
| Hospital Charge Code |
321036221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
PLACE CATH THORACIC AORTA
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 36221
|
| Hospital Charge Code |
321036221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$439.31 |
| 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 |
$3,536.00
|
| 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 |
$3,751.17
|
| 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 |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| 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
|
|
|
PLACE CATH THORACIC AORTA
|
Facility
|
OP
|
$11,691.56
|
|
|
Service Code
|
HCPCS 36221
|
| Hospital Charge Code |
1600000736
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$332.04 |
| 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 |
$3,536.00
|
| 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 |
$3,751.17
|
| 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 |
$3,039.81
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,753.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$369.45
|
| 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 |
$332.04
|
|
|
PLACE CATH THORACIC AORTA
|
Facility
|
OP
|
$13,077.63
|
|
|
Service Code
|
HCPCS 36221
|
| Hospital Charge Code |
366836221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$371.40 |
| 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 |
$3,536.00
|
| 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 |
$3,751.17
|
| 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 |
$3,400.18
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,961.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$413.25
|
| 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 |
$371.40
|
|
|
PLACE CATH THORACIC AORTA
|
Facility
|
IP
|
$13,077.63
|
|
|
Service Code
|
HCPCS 36221
|
| Hospital Charge Code |
411036221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,961.64 |
| Max. Negotiated Rate |
$1,961.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,961.64
|
|
|
PLACE CATH THORACIC AORTA
|
Facility
|
IP
|
$13,077.63
|
|
|
Service Code
|
HCPCS 36221
|
| Hospital Charge Code |
366836221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,961.64 |
| Max. Negotiated Rate |
$1,961.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,961.64
|
|
|
PLACE CATH VERTEBRAL ART
|
Facility
|
IP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 36226
|
| Hospital Charge Code |
5600226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,844.27 |
| Max. Negotiated Rate |
$3,844.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
|
|
PLACE CATH VERTEBRAL ART
|
Facility
|
OP
|
$21,387.78
|
|
|
Service Code
|
HCPCS 36226
|
| Hospital Charge Code |
411036226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$607.41 |
| Max. Negotiated Rate |
$23,980.53 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| 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 |
$23,980.53
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$6,610.76
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,560.82
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,208.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$675.85
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$607.41
|
|
|
PLACE CATH VERTEBRAL ART
|
Facility
|
OP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 36226
|
| Hospital Charge Code |
5600226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$727.85 |
| Max. Negotiated Rate |
$23,980.53 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| 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 |
$23,980.53
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$6,610.76
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,663.40
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$809.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$727.85
|
|
|
PLACE CATH VERTEBRAL ART
|
Facility
|
IP
|
$21,387.78
|
|
|
Service Code
|
HCPCS 36226
|
| Hospital Charge Code |
366836226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,208.17 |
| Max. Negotiated Rate |
$3,208.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,208.17
|
|
|
PLACE CATH VERTEBRAL ART
|
Facility
|
IP
|
$21,387.78
|
|
|
Service Code
|
HCPCS 36226
|
| Hospital Charge Code |
411036226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,208.17 |
| Max. Negotiated Rate |
$3,208.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,208.17
|
|
|
PLACE CATH VERTEBRAL ART
|
Facility
|
OP
|
$21,387.78
|
|
|
Service Code
|
HCPCS 36226
|
| Hospital Charge Code |
366836226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$607.41 |
| Max. Negotiated Rate |
$23,980.53 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| 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 |
$23,980.53
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$6,610.76
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,560.82
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,208.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$675.85
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$607.41
|
|
|
PLACE CATH VERTEBRAL ART
|
Facility
|
IP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 36226
|
| Hospital Charge Code |
321036226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,844.27 |
| Max. Negotiated Rate |
$3,844.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
|
|
PLACE CATH VERTEBRAL ART
|
Facility
|
OP
|
$25,628.45
|
|
|
Service Code
|
HCPCS 36226
|
| Hospital Charge Code |
321036226
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$727.85 |
| Max. Negotiated Rate |
$23,980.53 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| 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 |
$23,980.53
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$6,610.76
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,663.40
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,844.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$809.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$727.85
|
|
|
PLACE CATH VERTEBRAL ART BI
|
Facility
|
IP
|
$38,442.70
|
|
|
Service Code
|
HCPCS 36226
|
| Hospital Charge Code |
366836226B
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,766.40 |
| Max. Negotiated Rate |
$5,766.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,766.40
|
|
|
PLACE CATH VERTEBRAL ART BI
|
Facility
|
OP
|
$38,442.70
|
|
|
Service Code
|
HCPCS 36226
|
| Hospital Charge Code |
366836226B
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,091.77 |
| Max. Negotiated Rate |
$23,980.53 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,980.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| 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 |
$23,980.53
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$6,610.76
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,995.10
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,766.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,214.79
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,091.77
|
|
|
PLACE CATH VERTEBRAL ART BI
|
Facility
|
IP
|
$38,442.70
|
|
|
Service Code
|
HCPCS 3622650
|
| Hospital Charge Code |
411036226B
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,766.40 |
| Max. Negotiated Rate |
$5,766.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,766.40
|
|
|
PLACE CATH VERTEBRAL ART BI
|
Facility
|
OP
|
$38,442.70
|
|
|
Service Code
|
HCPCS 3622650
|
| Hospital Charge Code |
411036226B
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,091.77 |
| Max. Negotiated Rate |
$19,221.35 |
| Rate for Payer: Aetna Commercial |
$14,608.23
|
| Rate for Payer: Aetna Medicare Advantage |
$11,532.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,802.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,802.89
|
| 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 |
$9,802.89
|
| Rate for Payer: Cigna Commercial |
$19,221.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,995.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,766.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,214.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,091.77
|
|
|
PLACE CATH XTRNL CAROTID
|
Facility
|
IP
|
$2,919.00
|
|
|
Service Code
|
HCPCS 36227
|
| Hospital Charge Code |
7411429A
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$437.85 |
| Max. Negotiated Rate |
$437.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$437.85
|
|
|
PLACE CATH XTRNL CAROTID
|
Facility
|
IP
|
$18,125.00
|
|
|
Service Code
|
HCPCS 36227
|
| Hospital Charge Code |
5600227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,718.75 |
| Max. Negotiated Rate |
$2,718.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,718.75
|
|
|
PLACE CATH XTRNL CAROTID
|
Facility
|
IP
|
$2,919.00
|
|
|
Service Code
|
HCPCS 36227
|
| Hospital Charge Code |
366836227
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$437.85 |
| Max. Negotiated Rate |
$437.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$437.85
|
|