|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47533
|
| Hospital Charge Code |
7411562
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.30 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,335.10
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$405.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$364.30
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
7411563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.30 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,335.10
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$405.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$364.30
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
IP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
7411563
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,924.10 |
| Max. Negotiated Rate |
$1,924.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$17,259.20
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
321047534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.16 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,487.39
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,588.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$545.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$490.16
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
2250438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.30 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,335.10
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$405.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$364.30
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
IP
|
$17,259.20
|
|
|
Service Code
|
HCPCS 47533
|
| Hospital Charge Code |
321047533
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,588.88 |
| Max. Negotiated Rate |
$2,588.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,588.88
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$17,259.20
|
|
|
Service Code
|
HCPCS 47533
|
| Hospital Charge Code |
2600220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.16 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,487.39
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,588.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$545.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$490.16
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
IP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47533
|
| Hospital Charge Code |
2011564
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,924.10 |
| Max. Negotiated Rate |
$1,924.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
IP
|
$17,259.20
|
|
|
Service Code
|
HCPCS 47533
|
| Hospital Charge Code |
2600220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,588.88 |
| Max. Negotiated Rate |
$2,588.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,588.88
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
IP
|
$11,644.64
|
|
|
Service Code
|
HCPCS 47533
|
| Hospital Charge Code |
1600000299
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,746.70 |
| Max. Negotiated Rate |
$1,746.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,746.70
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
IP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
2011565
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,924.10 |
| Max. Negotiated Rate |
$1,924.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
IP
|
$14,554.80
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
411047534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,183.22 |
| Max. Negotiated Rate |
$2,183.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,183.22
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$14,554.80
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
411047534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$413.36 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,784.25
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,183.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$459.93
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$413.36
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$17,259.20
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
2600221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.16 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,487.39
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,588.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$545.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$490.16
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47533
|
| Hospital Charge Code |
2011564
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.30 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,335.10
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$405.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$364.30
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
IP
|
$17,259.20
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
2600221
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,588.88 |
| Max. Negotiated Rate |
$2,588.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,588.88
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
IP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
2250438
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,924.10 |
| Max. Negotiated Rate |
$1,924.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$17,259.20
|
|
|
Service Code
|
HCPCS 47533
|
| Hospital Charge Code |
321047533
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.16 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,487.39
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,588.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$545.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$490.16
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
IP
|
$17,259.20
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
321047534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,588.88 |
| Max. Negotiated Rate |
$2,588.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,588.88
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$12,827.31
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
2011565
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$364.30 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,335.10
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$405.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$364.30
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$14,554.80
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
366847534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$413.36 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,784.25
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,183.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$459.93
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$413.36
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
IP
|
$14,554.80
|
|
|
Service Code
|
HCPCS 47534
|
| Hospital Charge Code |
366847534
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,183.22 |
| Max. Negotiated Rate |
$2,183.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,183.22
|
|
|
PLMT BILIARY DRAINAGE CATH
|
Facility
|
OP
|
$11,644.64
|
|
|
Service Code
|
HCPCS 47533
|
| Hospital Charge Code |
1600000299
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$330.71 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,027.61
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,746.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$367.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$330.71
|
|
|
PLMT NEPHROSTOMY CATH
|
Facility
|
IP
|
$11,298.15
|
|
|
Service Code
|
HCPCS 50432
|
| Hospital Charge Code |
7411608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,694.72 |
| Max. Negotiated Rate |
$1,694.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,694.72
|
|
|
PLMT NEPHROSTOMY CATH
|
Facility
|
OP
|
$11,298.15
|
|
|
Service Code
|
HCPCS 50432
|
| Hospital Charge Code |
7411608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$320.87 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| 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 |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,937.52
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,694.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$357.02
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$320.87
|
|
