|
THROMBOLYTIC VENOUS THEARPY
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 37212
|
| Hospital Charge Code |
5600230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
THROMBOLYTIC VENOUS THEARPY
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 37212
|
| Hospital Charge Code |
5600230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$439.31 |
| Max. Negotiated Rate |
$13,607.37 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,607.37
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,021.81
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$488.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$439.31
|
|
|
THROMBOLYTIC VENOUS THERAPY
|
Facility
|
OP
|
$5,081.82
|
|
|
Service Code
|
HCPCS 37212
|
| Hospital Charge Code |
2692243
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$144.32 |
| Max. Negotiated Rate |
$13,607.37 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,607.37
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,321.27
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$762.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$160.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.32
|
|
|
THROMBOLYTIC VENOUS THERAPY
|
Facility
|
IP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 37212
|
| Hospital Charge Code |
366837212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,869.43 |
| Max. Negotiated Rate |
$1,869.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
|
|
THROMBOLYTIC VENOUS THERAPY
|
Facility
|
OP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 37212
|
| Hospital Charge Code |
366837212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$353.94 |
| Max. Negotiated Rate |
$13,607.37 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,607.37
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,240.34
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$393.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$353.94
|
|
|
THROMBOLYTIC VENOUS THERAPY
|
Facility
|
IP
|
$5,081.82
|
|
|
Service Code
|
HCPCS 37212
|
| Hospital Charge Code |
2692243
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$762.27 |
| Max. Negotiated Rate |
$762.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$762.27
|
|
|
THROMBOLYTIC VENOUS THERAPY
|
Facility
|
IP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 37212
|
| Hospital Charge Code |
411037212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,869.43 |
| Max. Negotiated Rate |
$1,869.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
|
|
THROMBOLYTIC VENOUS THERAPY
|
Facility
|
OP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 37212
|
| Hospital Charge Code |
411037212
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$353.94 |
| Max. Negotiated Rate |
$13,607.37 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,607.37
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,240.34
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$393.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$353.94
|
|
|
THROMBOPLASTIN INHIBTN,TISSUE
|
Facility
|
IP
|
$53.00
|
|
|
Service Code
|
HCPCS 85705
|
| Hospital Charge Code |
38477051
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$7.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.95
|
|
|
THROMBOPLASTIN INHIBTN,TISSUE
|
Facility
|
OP
|
$53.00
|
|
|
Service Code
|
HCPCS 85705
|
| Hospital Charge Code |
38477051
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.51 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$26.19
|
| Rate for Payer: Aetna Medicare Advantage |
$31.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.93
|
| Rate for Payer: Cigna Commercial |
$26.50
|
| Rate for Payer: Cigna Medicare Advantage |
$9.63
|
| Rate for Payer: Clover Medicare Advantage |
$9.15
|
| Rate for Payer: EmblemHealth Commercial |
$28.89
|
| Rate for Payer: Humana Medicare Advantage |
$9.92
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.78
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.51
|
|
|
THROMBOPLASTIN TIME PARTIAL
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 85730
|
| Hospital Charge Code |
401485730
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.81 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$16.35
|
| Rate for Payer: Aetna Medicare Advantage |
$19.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21.80
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6.01
|
| Rate for Payer: Clover Medicare Advantage |
$5.71
|
| Rate for Payer: EmblemHealth Commercial |
$18.03
|
| Rate for Payer: Humana Medicare Advantage |
$6.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.40
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.81
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
THROMBOPLASTIN TIME PARTIAL
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 85730
|
| Hospital Charge Code |
401485730
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
OP
|
$73,789.50
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
366836906
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,095.62 |
| Max. Negotiated Rate |
$79,001.40 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| 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 |
$79,001.40
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19,185.27
|
| Rate for Payer: Oxford Commercial |
$18,024.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,068.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$20,109.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,331.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,095.62
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
OP
|
$89,914.40
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
2692132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,553.57 |
| Max. Negotiated Rate |
$79,001.40 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| 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 |
$79,001.40
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23,377.74
|
| Rate for Payer: Oxford Commercial |
$18,024.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13,487.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$20,109.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,841.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,553.57
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
OP
|
$89,914.40
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
321036906
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,553.57 |
| Max. Negotiated Rate |
$79,001.40 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| 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 |
$79,001.40
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23,377.74
|
| Rate for Payer: Oxford Commercial |
$18,024.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13,487.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$20,109.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,841.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,553.57
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
IP
|
$73,789.50
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
366836906
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,068.42 |
| Max. Negotiated Rate |
$11,068.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,068.42
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
IP
|
$89,914.40
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
2692132
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,487.16 |
| Max. Negotiated Rate |
$13,487.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13,487.16
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
OP
|
$73,789.50
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
5100840
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,095.62 |
| Max. Negotiated Rate |
$79,001.40 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| 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 |
$79,001.40
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19,185.27
|
| Rate for Payer: Oxford Commercial |
$18,024.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,068.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$20,109.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,331.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,095.62
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
IP
|
$73,789.50
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
7412061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,068.42 |
| Max. Negotiated Rate |
$11,068.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,068.42
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
IP
|
$73,789.50
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
2709027
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,068.42 |
| Max. Negotiated Rate |
$11,068.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,068.42
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
IP
|
$73,789.50
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
5100840
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,068.42 |
| Max. Negotiated Rate |
$11,068.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,068.42
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
OP
|
$73,789.50
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
2709027
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,095.62 |
| Max. Negotiated Rate |
$79,001.40 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| 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 |
$79,001.40
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19,185.27
|
| Rate for Payer: Oxford Commercial |
$18,024.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,068.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$20,109.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,331.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,095.62
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
IP
|
$89,914.40
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
321036906
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$13,487.16 |
| Max. Negotiated Rate |
$13,487.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13,487.16
|
|
|
THROMB+STENT PERIPH DIALYS SEG
|
Facility
|
OP
|
$73,789.50
|
|
|
Service Code
|
HCPCS 36906
|
| Hospital Charge Code |
7412061
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,095.62 |
| Max. Negotiated Rate |
$79,001.40 |
| Rate for Payer: Aetna Commercial |
$59,237.44
|
| Rate for Payer: Aetna Medicare Advantage |
$70,562.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,778.47
|
| 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 |
$79,001.40
|
| Rate for Payer: Cigna Commercial |
$43,654.87
|
| Rate for Payer: Cigna Medicare Advantage |
$21,778.47
|
| Rate for Payer: Clover Medicare Advantage |
$20,689.55
|
| Rate for Payer: EmblemHealth Commercial |
$65,335.41
|
| Rate for Payer: Humana Medicare Advantage |
$22,431.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,778.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19,185.27
|
| Rate for Payer: Oxford Commercial |
$18,024.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,068.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$20,109.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,331.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,778.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,095.62
|
|
|
THROMB+TBA PERIPH DIALYSIS SEG
|
Facility
|
IP
|
$48,741.55
|
|
|
Service Code
|
HCPCS 36905
|
| Hospital Charge Code |
366836905
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,311.23 |
| Max. Negotiated Rate |
$7,311.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,311.23
|
|
