|
POD DEB CALLUS I
|
Facility
|
IP
|
$592.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
84208020
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$88.80 |
| Max. Negotiated Rate |
$88.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$88.80
|
|
|
POD DEB ULCER SUBCUT
|
Facility
|
IP
|
$1,447.00
|
|
|
Service Code
|
HCPCS 11042
|
| Hospital Charge Code |
84208015
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$217.05 |
| Max. Negotiated Rate |
$217.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.05
|
|
|
POD DEB ULCER SUBCUT
|
Facility
|
OP
|
$1,447.00
|
|
|
Service Code
|
HCPCS 11042
|
| Hospital Charge Code |
84208015
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$45.73 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,313.62
|
| Rate for Payer: Aetna Medicare Advantage |
$1,564.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$482.95
|
| 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 |
$1,751.90
|
| Rate for Payer: Cigna Commercial |
$968.07
|
| Rate for Payer: Cigna Medicare Advantage |
$482.95
|
| Rate for Payer: Clover Medicare Advantage |
$458.80
|
| Rate for Payer: EmblemHealth Commercial |
$1,448.85
|
| Rate for Payer: Humana Medicare Advantage |
$497.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$482.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$376.22
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$217.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$45.73
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$1,058.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,037.98
|
|
|
POD DEB VERRUCA 1
|
Facility
|
IP
|
$372.00
|
|
|
Service Code
|
HCPCS 17000
|
| Hospital Charge Code |
84208100
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$55.80 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
|
|
POD DEB VERRUCA 1
|
Facility
|
OP
|
$372.00
|
|
|
Service Code
|
HCPCS 17000
|
| Hospital Charge Code |
84208100
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$864.65 |
| Rate for Payer: Aetna Commercial |
$648.34
|
| Rate for Payer: Aetna Medicare Advantage |
$772.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$864.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$864.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$238.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$50.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$864.65
|
| Rate for Payer: Cigna Commercial |
$477.79
|
| Rate for Payer: Cigna Medicare Advantage |
$238.36
|
| Rate for Payer: Clover Medicare Advantage |
$226.44
|
| Rate for Payer: EmblemHealth Commercial |
$715.08
|
| Rate for Payer: Humana Medicare Advantage |
$245.51
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$238.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$96.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.76
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.56
|
|
|
POD DEB VERRUCA 15+
|
Facility
|
IP
|
$1,117.00
|
|
|
Service Code
|
HCPCS 17004
|
| Hospital Charge Code |
84208110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$167.55 |
| Max. Negotiated Rate |
$167.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$167.55
|
|
|
POD DEB VERRUCA 15+
|
Facility
|
OP
|
$1,117.00
|
|
|
Service Code
|
HCPCS 17004
|
| Hospital Charge Code |
84208110
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$31.72 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$1,313.62
|
| Rate for Payer: Aetna Medicare Advantage |
$1,564.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,751.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$482.95
|
| 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 |
$1,751.90
|
| Rate for Payer: Cigna Commercial |
$968.07
|
| Rate for Payer: Cigna Medicare Advantage |
$482.95
|
| Rate for Payer: Clover Medicare Advantage |
$458.80
|
| Rate for Payer: EmblemHealth Commercial |
$1,448.85
|
| Rate for Payer: Humana Medicare Advantage |
$497.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$482.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$290.42
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$167.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.72
|
|
|
POD DEB VERRUCA 2-14
|
Facility
|
OP
|
$189.00
|
|
|
Service Code
|
HCPCS 17003
|
| Hospital Charge Code |
84208105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$71.82
|
| Rate for Payer: Aetna Medicare Advantage |
$56.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.20
|
| 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 |
$48.20
|
| Rate for Payer: Cigna Commercial |
$94.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$49.14
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.37
|
|
|
POD DEB VERRUCA 2-14
|
Facility
|
IP
|
$189.00
|
|
|
Service Code
|
HCPCS 17003
|
| Hospital Charge Code |
84208105
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$28.35 |
| Max. Negotiated Rate |
$28.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.35
|
|
|
POD DISLOCATE IPJ CR
|
Facility
|
IP
|
$645.00
|
|
|
Service Code
|
HCPCS 28660
|
| Hospital Charge Code |
84208165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$96.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.75
|
|
|
POD DISLOCATE IPJ CR
|
Facility
|
OP
|
$645.00
|
|
|
Service Code
|
HCPCS 28660
|
| Hospital Charge Code |
84208165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| 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 |
$1,063.04
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$167.70
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.38
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.32
|
|
|
POD DISLOCATE IPJ CR W/A
|
Facility
|
OP
|
$6,359.00
|
|
|
Service Code
|
HCPCS 28665
|
| Hospital Charge Code |
84208170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$180.60 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$903.80
|
| Rate for Payer: Aetna Medicare Advantage |
$1,076.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,205.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,205.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$332.28
|
| 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 |
$1,205.35
|
| Rate for Payer: Cigna Commercial |
$666.07
|
| Rate for Payer: Cigna Medicare Advantage |
$332.28
|
| Rate for Payer: Clover Medicare Advantage |
$315.67
|
| Rate for Payer: EmblemHealth Commercial |
$996.84
|
| Rate for Payer: Humana Medicare Advantage |
$342.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$332.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,653.34
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$953.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$200.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$332.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$332.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$180.60
|
|
|
POD DISLOCATE IPJ CR W/A
|
Facility
|
IP
|
$6,359.00
|
|
|
Service Code
|
HCPCS 28665
|
| Hospital Charge Code |
84208170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$953.85 |
| Max. Negotiated Rate |
$953.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$953.85
|
|
|
POD EVAC NAIL HEMATOMA
|
Facility
|
OP
|
$216.00
|
|
|
Service Code
|
HCPCS 11740
|
| Hospital Charge Code |
84208075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6.83 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: Aetna Medicare Advantage |
$512.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$158.06
|
| 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 |
$573.36
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$158.06
|
| Rate for Payer: Clover Medicare Advantage |
$150.16
|
| Rate for Payer: EmblemHealth Commercial |
$474.18
|
| Rate for Payer: Humana Medicare Advantage |
$162.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$158.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.16
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$197.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$193.50
|
|
|
POD EVAC NAIL HEMATOMA
|
Facility
|
IP
|
$216.00
|
|
|
Service Code
|
HCPCS 11740
|
| Hospital Charge Code |
84208075
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$32.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.40
|
|
|
POD EXC F BODY
|
Facility
|
IP
|
$3,473.00
|
|
|
Service Code
|
HCPCS 28190
|
| Hospital Charge Code |
84208130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$520.95 |
| Max. Negotiated Rate |
$520.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$520.95
|
|
|
POD EXC F BODY
|
Facility
|
OP
|
$3,473.00
|
|
|
Service Code
|
HCPCS 28190
|
| Hospital Charge Code |
84208130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.63 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,288.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,725.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$841.28
|
| 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 |
$3,051.74
|
| Rate for Payer: Cigna Commercial |
$1,686.34
|
| Rate for Payer: Cigna Medicare Advantage |
$841.28
|
| Rate for Payer: Clover Medicare Advantage |
$799.22
|
| Rate for Payer: EmblemHealth Commercial |
$2,523.84
|
| Rate for Payer: Humana Medicare Advantage |
$866.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$841.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$902.98
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$520.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$109.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$98.63
|
|
|
POD EXCISION LESION 1.1-2
|
Facility
|
OP
|
$3,473.00
|
|
|
Service Code
|
HCPCS 11422
|
| Hospital Charge Code |
84208045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.63 |
| Max. Negotiated Rate |
$7,117.66 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| 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 |
$7,117.66
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$902.98
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$520.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$109.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$98.63
|
|
|
POD EXCISION LESION 1.1-2
|
Facility
|
IP
|
$3,473.00
|
|
|
Service Code
|
HCPCS 11422
|
| Hospital Charge Code |
84208045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$520.95 |
| Max. Negotiated Rate |
$520.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$520.95
|
|
|
POD EXCISION LESION.6-1
|
Facility
|
OP
|
$3,473.00
|
|
|
Service Code
|
HCPCS 11421
|
| Hospital Charge Code |
84208040
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$98.63 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,288.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,725.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$841.28
|
| 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 |
$3,051.74
|
| Rate for Payer: Cigna Commercial |
$1,686.34
|
| Rate for Payer: Cigna Medicare Advantage |
$841.28
|
| Rate for Payer: Clover Medicare Advantage |
$799.22
|
| Rate for Payer: EmblemHealth Commercial |
$2,523.84
|
| Rate for Payer: Humana Medicare Advantage |
$866.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$841.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$902.98
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$520.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$109.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$98.63
|
|
|
POD EXCISION LESION.6-1
|
Facility
|
IP
|
$3,473.00
|
|
|
Service Code
|
HCPCS 11421
|
| Hospital Charge Code |
84208040
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$520.95 |
| Max. Negotiated Rate |
$520.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$520.95
|
|
|
POD FX DIGIT
|
Facility
|
IP
|
$645.00
|
|
|
Service Code
|
HCPCS 28510
|
| Hospital Charge Code |
84208155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$96.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.75
|
|
|
POD FX DIGIT
|
Facility
|
OP
|
$645.00
|
|
|
Service Code
|
HCPCS 28510
|
| Hospital Charge Code |
84208155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| 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 |
$1,063.04
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$167.70
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.38
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.32
|
|
|
POD FX DIGIT CR
|
Facility
|
IP
|
$645.00
|
|
|
Service Code
|
HCPCS 28515
|
| Hospital Charge Code |
84208160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$96.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.75
|
|
|
POD FX DIGIT CR
|
Facility
|
OP
|
$645.00
|
|
|
Service Code
|
HCPCS 28515
|
| Hospital Charge Code |
84208160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| 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 |
$1,063.04
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$167.70
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.38
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.32
|
|
