|
POD FX HALLUX
|
Facility
|
IP
|
$645.00
|
|
|
Service Code
|
HCPCS 28490
|
| Hospital Charge Code |
84208145
|
|
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 HALLUX
|
Facility
|
OP
|
$645.00
|
|
|
Service Code
|
HCPCS 28490
|
| Hospital Charge Code |
84208145
|
|
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 HALLUX CR
|
Facility
|
IP
|
$645.00
|
|
|
Service Code
|
HCPCS 28495
|
| Hospital Charge Code |
84208150
|
|
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 HALLUX CR
|
Facility
|
OP
|
$645.00
|
|
|
Service Code
|
HCPCS 28495
|
| Hospital Charge Code |
84208150
|
|
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 MET
|
Facility
|
IP
|
$715.00
|
|
|
Service Code
|
HCPCS 28470
|
| Hospital Charge Code |
84208135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$107.25 |
| Max. Negotiated Rate |
$107.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.25
|
|
|
POD FX MET
|
Facility
|
OP
|
$715.00
|
|
|
Service Code
|
HCPCS 28470
|
| Hospital Charge Code |
84208135
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$20.31 |
| 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 |
$185.90
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.31
|
|
|
POD FX MET CR
|
Facility
|
IP
|
$715.00
|
|
|
Service Code
|
HCPCS 28475
|
| Hospital Charge Code |
84208140
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$107.25 |
| Max. Negotiated Rate |
$107.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.25
|
|
|
POD FX MET CR
|
Facility
|
OP
|
$715.00
|
|
|
Service Code
|
HCPCS 28475
|
| Hospital Charge Code |
84208140
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$20.31 |
| 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 |
$185.90
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.31
|
|
|
PODIATRY KIT
|
Facility
|
IP
|
$161.00
|
|
| Hospital Charge Code |
270338753
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.15 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.15
|
|
|
PODIATRY KIT
|
Facility
|
OP
|
$161.00
|
|
| Hospital Charge Code |
270338753
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$80.50 |
| Rate for Payer: Aetna Commercial |
$61.18
|
| Rate for Payer: Aetna Medicare Advantage |
$48.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.05
|
| Rate for Payer: Cigna Commercial |
$80.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.86
|
| Rate for Payer: Oxford Commercial |
$32.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$32.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.57
|
|
|
PODIATRY PACK
|
Facility
|
IP
|
$702.00
|
|
| Hospital Charge Code |
270330816
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.30 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.30
|
|
|
PODIATRY PACK
|
Facility
|
OP
|
$702.00
|
|
| Hospital Charge Code |
270330816
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.94 |
| Max. Negotiated Rate |
$351.00 |
| Rate for Payer: Aetna Commercial |
$266.76
|
| Rate for Payer: Aetna Medicare Advantage |
$210.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$179.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$179.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$179.01
|
| Rate for Payer: Cigna Commercial |
$351.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$182.52
|
| Rate for Payer: Oxford Commercial |
$140.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$140.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.94
|
|
|
POD I&D NAIL
|
Facility
|
OP
|
$1,643.00
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
84208001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$51.92 |
| Max. Negotiated Rate |
$3,536.00 |
| 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 |
$3,536.00
|
| 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 |
$427.18
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$246.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$51.92
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$962.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$943.15
|
|
|
POD I&D NAIL
|
Facility
|
IP
|
$1,643.00
|
|
|
Service Code
|
HCPCS 10060
|
| Hospital Charge Code |
84208001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$246.45 |
| Max. Negotiated Rate |
$246.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$246.45
|
|
|
POD I&D NAIL MULTIPLE EACH
|
Facility
|
IP
|
$1,643.00
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
84208005
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$246.45 |
| Max. Negotiated Rate |
$246.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$246.45
|
|
|
POD I&D NAIL MULTIPLE EACH
|
Facility
|
OP
|
$1,643.00
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
84208005
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$46.66 |
| Max. Negotiated Rate |
$1,751.90 |
| 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 |
$121.69
|
| 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 |
$427.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$246.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$51.92
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$46.66
|
|
|
POD INJ/ASP F&A B/C/G
|
Facility
|
OP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20605
|
| Hospital Charge Code |
84208125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$30.98 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$991.90
|
| Rate for Payer: Aetna Medicare Advantage |
$1,181.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,322.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,322.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$364.67
|
| 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 |
$1,322.84
|
| Rate for Payer: Cigna Commercial |
$730.97
|
| Rate for Payer: Cigna Medicare Advantage |
$364.67
|
| Rate for Payer: Clover Medicare Advantage |
$346.44
|
| Rate for Payer: EmblemHealth Commercial |
$1,094.01
|
| Rate for Payer: Humana Medicare Advantage |
$375.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$364.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$283.66
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.98
|
|
|
POD INJ/ASP F&A B/C/G
|
Facility
|
IP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20605
|
| Hospital Charge Code |
84208125
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.65 |
| Max. Negotiated Rate |
$163.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
|
|
POD INJ/ASP TOE B/C/G/
|
Facility
|
OP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20600
|
| Hospital Charge Code |
84208120
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$30.98 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$991.90
|
| Rate for Payer: Aetna Medicare Advantage |
$1,181.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,322.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,322.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$364.67
|
| 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 |
$1,322.84
|
| Rate for Payer: Cigna Commercial |
$730.97
|
| Rate for Payer: Cigna Medicare Advantage |
$364.67
|
| Rate for Payer: Clover Medicare Advantage |
$346.44
|
| Rate for Payer: EmblemHealth Commercial |
$1,094.01
|
| Rate for Payer: Humana Medicare Advantage |
$375.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$364.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$283.66
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.98
|
|
|
POD INJ/ASP TOE B/C/G/
|
Facility
|
IP
|
$1,091.00
|
|
|
Service Code
|
HCPCS 20600
|
| Hospital Charge Code |
84208120
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.65 |
| Max. Negotiated Rate |
$163.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.65
|
|
|
POD INJ DIAG THER NERVE BLOCK
|
Facility
|
OP
|
$1,587.00
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
84208215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$45.07 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,281.02
|
| Rate for Payer: Aetna Medicare Advantage |
$2,717.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,042.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,042.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$838.61
|
| 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 |
$3,042.06
|
| Rate for Payer: Cigna Commercial |
$1,680.99
|
| Rate for Payer: Cigna Medicare Advantage |
$838.61
|
| Rate for Payer: Clover Medicare Advantage |
$796.68
|
| Rate for Payer: EmblemHealth Commercial |
$2,515.83
|
| Rate for Payer: Humana Medicare Advantage |
$863.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$838.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$412.62
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$238.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.15
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$838.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$838.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.07
|
|
|
POD INJ DIAG THER NERVE BLOCK
|
Facility
|
IP
|
$1,587.00
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
84208215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$238.05 |
| Max. Negotiated Rate |
$238.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$238.05
|
|
|
POD INJECTION INTRALESION
|
Facility
|
OP
|
$1,033.25
|
|
|
Service Code
|
HCPCS 11900
|
| Hospital Charge Code |
84208095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$29.34 |
| Max. Negotiated Rate |
$3,536.00 |
| 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 |
$3,536.00
|
| 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 |
$268.64
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$154.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.34
|
|
|
POD INJECTION INTRALESION
|
Facility
|
IP
|
$1,033.25
|
|
|
Service Code
|
HCPCS 11900
|
| Hospital Charge Code |
84208095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.99 |
| Max. Negotiated Rate |
$154.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$154.99
|
|
|
POD INJECTION NEUROLYSIS
|
Facility
|
OP
|
$3,103.00
|
|
|
Service Code
|
HCPCS 64640
|
| Hospital Charge Code |
84208220
|
|
Hospital Revenue Code
|
519
|
| Min. Negotiated Rate |
$87.12 |
| Max. Negotiated Rate |
$3,811.70 |
| Rate for Payer: Aetna Commercial |
$2,858.12
|
| Rate for Payer: Aetna Medicare Advantage |
$3,404.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,811.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,811.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,050.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$87.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,811.70
|
| Rate for Payer: Cigna Commercial |
$2,106.27
|
| Rate for Payer: Cigna Medicare Advantage |
$1,050.78
|
| Rate for Payer: Clover Medicare Advantage |
$998.24
|
| Rate for Payer: EmblemHealth Commercial |
$3,152.34
|
| Rate for Payer: Humana Medicare Advantage |
$1,082.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,050.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$806.78
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$465.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$98.05
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$2,311.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$88.13
|
|