|
RW CRYO PREML 2ND - 14 LES
|
Facility
|
OP
|
$290.00
|
|
|
Service Code
|
HCPCS 17003
|
| Hospital Charge Code |
87502080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$145.00 |
| Rate for Payer: Aetna Commercial |
$110.20
|
| Rate for Payer: Aetna Medicare Advantage |
$87.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$73.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$73.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$73.95
|
| Rate for Payer: Cigna Commercial |
$145.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.40
|
| Rate for Payer: Oxford Commercial |
$58.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$58.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.24
|
|
|
RW CRYO PREML 2ND - 14 LES
|
Facility
|
IP
|
$290.00
|
|
|
Service Code
|
HCPCS 17003
|
| Hospital Charge Code |
87502080
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.50
|
|
|
RW CRYO PREML 2ND-14 LESIONS
|
Facility
|
OP
|
$372.00
|
|
|
Service Code
|
HCPCS 17110
|
| Hospital Charge Code |
87502865
|
|
Hospital Revenue Code
|
761
|
| 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 |
$39.60
|
| 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: Oxford Commercial |
$74.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$74.40
|
| 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
|
|
|
RW CRYO PREML 2ND-14 LESIONS
|
Facility
|
IP
|
$372.00
|
|
|
Service Code
|
HCPCS 17110
|
| Hospital Charge Code |
87502865
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.80 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
|
|
RW CRYO PREML 2ND-14 LESIONS
|
Facility
|
OP
|
$290.00
|
|
|
Service Code
|
HCPCS 17003
|
| Hospital Charge Code |
84206070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$145.00 |
| Rate for Payer: Aetna Commercial |
$110.20
|
| Rate for Payer: Aetna Medicare Advantage |
$87.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$73.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$73.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$73.95
|
| Rate for Payer: Cigna Commercial |
$145.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.40
|
| Rate for Payer: Oxford Commercial |
$58.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$58.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.24
|
|
|
RW CRYO PREML 2ND-14 LESIONS
|
Facility
|
IP
|
$290.00
|
|
|
Service Code
|
HCPCS 17003
|
| Hospital Charge Code |
84206070
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.50
|
|
|
RW CRYO PREML LESION -1ST
|
Facility
|
IP
|
$372.00
|
|
|
Service Code
|
HCPCS 17000
|
| Hospital Charge Code |
8750275
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.80 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
|
|
RW CRYO PREML LESION -1ST
|
Facility
|
OP
|
$372.00
|
|
|
Service Code
|
HCPCS 17000
|
| Hospital Charge Code |
8750275
|
|
Hospital Revenue Code
|
761
|
| 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: Oxford Commercial |
$74.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$74.40
|
| 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
|
|
|
RW CRYO PREML LESION, 1ST
|
Facility
|
IP
|
$372.00
|
|
|
Service Code
|
HCPCS 17000
|
| Hospital Charge Code |
84206065
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.80 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
|
|
RW CRYO PREML LESION, 1ST
|
Facility
|
OP
|
$372.00
|
|
|
Service Code
|
HCPCS 17000
|
| Hospital Charge Code |
84206065
|
|
Hospital Revenue Code
|
761
|
| 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: Oxford Commercial |
$74.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$74.40
|
| 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
|
|
|
RW CRYO PREML LESION,1ST
|
Facility
|
OP
|
$372.00
|
|
|
Service Code
|
HCPCS 17000
|
| Hospital Charge Code |
87502075
|
|
Hospital Revenue Code
|
761
|
| 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: Oxford Commercial |
$74.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$74.40
|
| 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
|
|
|
RW CRYO PREML LESION,1ST
|
Facility
|
IP
|
$372.00
|
|
|
Service Code
|
HCPCS 17000
|
| Hospital Charge Code |
87502075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$55.80 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.80
|
|
|
RW DEBRID SKIN & SUBC TISSUE
|
Facility
|
IP
|
$499.00
|
|
|
Service Code
|
HCPCS 11042
|
| Hospital Charge Code |
84206020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.85 |
| Max. Negotiated Rate |
$74.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.85
|
|
|
RW DEBRID SKIN & SUBC TISSUE
|
Facility
|
OP
|
$499.00
|
|
|
Service Code
|
HCPCS 11042
|
| Hospital Charge Code |
84206020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$14.17 |
| 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 |
$42.93
|
| 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 |
$129.74
|
| Rate for Payer: Oxford Commercial |
$99.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$99.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.77
|
| 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 |
$14.17
|
|
|
RW DEBRID SKIN & SUB TIS
|
Facility
|
IP
|
$499.00
|
|
|
Service Code
|
HCPCS 11042
|
| Hospital Charge Code |
87502085
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.85 |
| Max. Negotiated Rate |
$74.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.85
|
|
|
RW DEBRID SKIN & SUB TIS
|
Facility
|
OP
|
$499.00
|
|
|
Service Code
|
HCPCS 11042
|
| Hospital Charge Code |
87502085
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$14.17 |
| 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 |
$42.93
|
| 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 |
$129.74
|
| Rate for Payer: Oxford Commercial |
$99.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$99.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.77
|
| 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 |
$14.17
|
|
|
RW DTAP-HIB-IPV INTRAMUSCULAR
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
HCPCS 90698
|
| Hospital Charge Code |
84206395
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$33.88 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.00
|
|
|
RW DTAP-HIB-IPV INTRAMUSCULAR
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
HCPCS 90698
|
| Hospital Charge Code |
84206395
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$70.00 |
| Rate for Payer: Aetna Commercial |
$53.20
|
| Rate for Payer: Aetna Medicare Advantage |
$42.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.70
|
| Rate for Payer: Cigna Commercial |
$70.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.98
|
|
|
RW EKG 12 LEADS
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
84206285
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
|
|
RW EKG 12 LEADS
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
84206285
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$4.43 |
| Max. Negotiated Rate |
$879.00 |
| Rate for Payer: Aetna Commercial |
$190.62
|
| Rate for Payer: Aetna Medicare Advantage |
$227.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$254.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$254.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$70.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$67.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$254.22
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: Cigna Medicare Advantage |
$70.08
|
| Rate for Payer: Clover Medicare Advantage |
$66.58
|
| Rate for Payer: EmblemHealth Commercial |
$210.24
|
| Rate for Payer: Humana Medicare Advantage |
$72.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$70.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.56
|
| Rate for Payer: Oxford Commercial |
$659.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$879.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.93
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.43
|
|
|
RW EKG 12 LEADS
|
Facility
|
IP
|
$2,050.00
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
87502195
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$307.50 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$307.50
|
|
|
RW EKG 12 LEADS
|
Facility
|
OP
|
$2,050.00
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
87502195
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$58.22 |
| Max. Negotiated Rate |
$879.00 |
| Rate for Payer: Aetna Commercial |
$190.62
|
| Rate for Payer: Aetna Medicare Advantage |
$227.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$254.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$254.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$70.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$67.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$254.22
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: Cigna Medicare Advantage |
$70.08
|
| Rate for Payer: Clover Medicare Advantage |
$66.58
|
| Rate for Payer: EmblemHealth Commercial |
$210.24
|
| Rate for Payer: Humana Medicare Advantage |
$72.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$70.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$533.00
|
| Rate for Payer: Oxford Commercial |
$659.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$307.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$879.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$64.78
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$58.22
|
|
|
RW ENDOMETRIAL BIOPSY
|
Facility
|
IP
|
$669.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
87502190
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$100.35 |
| Max. Negotiated Rate |
$100.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.35
|
|
|
RW ENDOMETRIAL BIOPSY
|
Facility
|
OP
|
$669.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
87502190
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$653.29
|
| Rate for Payer: Aetna Medicare Advantage |
$778.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$871.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$871.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$240.18
|
| 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 |
$871.25
|
| Rate for Payer: Cigna Commercial |
$481.45
|
| Rate for Payer: Cigna Medicare Advantage |
$240.18
|
| Rate for Payer: Clover Medicare Advantage |
$228.17
|
| Rate for Payer: EmblemHealth Commercial |
$720.54
|
| Rate for Payer: Humana Medicare Advantage |
$247.39
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$240.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$173.94
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$240.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$240.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.00
|
|
|
RW ENDOMETRIAL BIOPSY
|
Facility
|
OP
|
$669.00
|
|
|
Service Code
|
HCPCS 58100
|
| Hospital Charge Code |
84206115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$653.29
|
| Rate for Payer: Aetna Medicare Advantage |
$778.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$871.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$871.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$240.18
|
| 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 |
$871.25
|
| Rate for Payer: Cigna Commercial |
$481.45
|
| Rate for Payer: Cigna Medicare Advantage |
$240.18
|
| Rate for Payer: Clover Medicare Advantage |
$228.17
|
| Rate for Payer: EmblemHealth Commercial |
$720.54
|
| Rate for Payer: Humana Medicare Advantage |
$247.39
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$240.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$173.94
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$240.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$240.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.00
|
|