|
VEEG 12-26HRS UNMON
|
Facility
|
OP
|
$2,843.33
|
|
|
Service Code
|
HCPCS 95714
|
| Hospital Charge Code |
403395714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$80.75 |
| Max. Negotiated Rate |
$5,943.00 |
| Rate for Payer: Aetna Commercial |
$1,205.83
|
| Rate for Payer: Aetna Medicare Advantage |
$1,436.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$443.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,608.14
|
| Rate for Payer: Cigna Commercial |
$888.63
|
| Rate for Payer: Cigna Medicare Advantage |
$443.32
|
| Rate for Payer: Clover Medicare Advantage |
$421.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,329.96
|
| Rate for Payer: Humana Medicare Advantage |
$456.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$443.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$739.27
|
| Rate for Payer: Oxford Commercial |
$5,237.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$426.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,943.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$89.85
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$80.75
|
|
|
VEEG 12-26HRS UNMON
|
Facility
|
OP
|
$2,843.33
|
|
|
Service Code
|
HCPCS 95714
|
| Hospital Charge Code |
405295714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$80.75 |
| Max. Negotiated Rate |
$5,943.00 |
| Rate for Payer: Aetna Commercial |
$1,205.83
|
| Rate for Payer: Aetna Medicare Advantage |
$1,436.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$443.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,608.14
|
| Rate for Payer: Cigna Commercial |
$888.63
|
| Rate for Payer: Cigna Medicare Advantage |
$443.32
|
| Rate for Payer: Clover Medicare Advantage |
$421.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,329.96
|
| Rate for Payer: Humana Medicare Advantage |
$456.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$443.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$739.27
|
| Rate for Payer: Oxford Commercial |
$5,237.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$426.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,943.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$89.85
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$80.75
|
|
|
VEEG 12-26HRS UNMON
|
Facility
|
IP
|
$2,843.33
|
|
|
Service Code
|
HCPCS 95714
|
| Hospital Charge Code |
403395714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$426.50 |
| Max. Negotiated Rate |
$426.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$426.50
|
|
|
VEEG 12-26HRS UNMON
|
Facility
|
IP
|
$2,843.33
|
|
|
Service Code
|
HCPCS 95714
|
| Hospital Charge Code |
405295714
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$426.50 |
| Max. Negotiated Rate |
$426.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$426.50
|
|
|
VEEG 2-12HRS CONT MON
|
Facility
|
OP
|
$2,843.33
|
|
|
Service Code
|
HCPCS 95713
|
| Hospital Charge Code |
405295713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$80.75 |
| Max. Negotiated Rate |
$5,943.00 |
| Rate for Payer: Aetna Commercial |
$1,205.83
|
| Rate for Payer: Aetna Medicare Advantage |
$1,436.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$443.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,608.14
|
| Rate for Payer: Cigna Commercial |
$888.63
|
| Rate for Payer: Cigna Medicare Advantage |
$443.32
|
| Rate for Payer: Clover Medicare Advantage |
$421.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,329.96
|
| Rate for Payer: Humana Medicare Advantage |
$456.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$443.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$739.27
|
| Rate for Payer: Oxford Commercial |
$5,237.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$426.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,943.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$89.85
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$80.75
|
|
|
VEEG 2-12HRS CONT MON
|
Facility
|
IP
|
$2,843.33
|
|
|
Service Code
|
HCPCS 95713
|
| Hospital Charge Code |
405295713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$426.50 |
| Max. Negotiated Rate |
$426.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$426.50
|
|
|
VEEG 2-12HRS CONT MON
|
Facility
|
IP
|
$2,843.33
|
|
|
Service Code
|
HCPCS 95713
|
| Hospital Charge Code |
403395713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$426.50 |
| Max. Negotiated Rate |
$426.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$426.50
|
|
|
VEEG 2-12HRS CONT MON
|
Facility
|
OP
|
$2,843.33
|
|
|
Service Code
|
HCPCS 95713
|
| Hospital Charge Code |
403395713
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$80.75 |
| Max. Negotiated Rate |
$5,943.00 |
| Rate for Payer: Aetna Commercial |
$1,205.83
|
| Rate for Payer: Aetna Medicare Advantage |
$1,436.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$443.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,608.14
|
| Rate for Payer: Cigna Commercial |
$888.63
|
| Rate for Payer: Cigna Medicare Advantage |
$443.32
|
| Rate for Payer: Clover Medicare Advantage |
$421.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,329.96
|
| Rate for Payer: Humana Medicare Advantage |
$456.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$443.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$739.27
|
| Rate for Payer: Oxford Commercial |
$5,237.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$426.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,943.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$89.85
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$80.75
|
|
|
VEEG 2-12HRS INT MON
|
Facility
|
IP
|
$1,481.95
|
|
|
Service Code
|
HCPCS 95712
|
| Hospital Charge Code |
405295712
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$222.29 |
| Max. Negotiated Rate |
$222.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.29
|
|
|
VEEG 2-12HRS INT MON
|
Facility
|
OP
|
$1,481.95
|
|
|
Service Code
|
HCPCS 95712
|
| Hospital Charge Code |
405295712
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$42.09 |
| Max. Negotiated Rate |
$5,943.00 |
| Rate for Payer: Aetna Commercial |
$1,205.83
|
| Rate for Payer: Aetna Medicare Advantage |
$1,436.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$443.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,608.14
|
| Rate for Payer: Cigna Commercial |
$888.63
|
| Rate for Payer: Cigna Medicare Advantage |
$443.32
|
| Rate for Payer: Clover Medicare Advantage |
$421.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,329.96
|
| Rate for Payer: Humana Medicare Advantage |
$456.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$443.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$385.31
|
| Rate for Payer: Oxford Commercial |
$5,237.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,943.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.09
|
|
|
VEEG 2-12HRS INT MON
|
Facility
|
IP
|
$1,481.95
|
|
|
Service Code
|
HCPCS 95712
|
| Hospital Charge Code |
403395712
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$222.29 |
| Max. Negotiated Rate |
$222.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.29
|
|
|
VEEG 2-12HRS INT MON
|
Facility
|
OP
|
$1,481.95
|
|
|
Service Code
|
HCPCS 95712
|
| Hospital Charge Code |
403395712
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$42.09 |
| Max. Negotiated Rate |
$5,943.00 |
| Rate for Payer: Aetna Commercial |
$1,205.83
|
| Rate for Payer: Aetna Medicare Advantage |
$1,436.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,608.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$443.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,608.14
|
| Rate for Payer: Cigna Commercial |
$888.63
|
| Rate for Payer: Cigna Medicare Advantage |
$443.32
|
| Rate for Payer: Clover Medicare Advantage |
$421.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,329.96
|
| Rate for Payer: Humana Medicare Advantage |
$456.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$443.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$385.31
|
| Rate for Payer: Oxford Commercial |
$5,237.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,943.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$443.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.09
|
|
|
VEEG 2-12HRS UNMON
|
Facility
|
IP
|
$1,481.95
|
|
|
Service Code
|
HCPCS 95711
|
| Hospital Charge Code |
405295711
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$222.29 |
| Max. Negotiated Rate |
$222.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.29
|
|
|
VEEG 2-12HRS UNMON
|
Facility
|
OP
|
$1,481.95
|
|
|
Service Code
|
HCPCS 95711
|
| Hospital Charge Code |
405295711
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$42.09 |
| Max. Negotiated Rate |
$5,943.00 |
| Rate for Payer: Aetna Commercial |
$697.73
|
| Rate for Payer: Aetna Medicare Advantage |
$831.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$930.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$930.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$256.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$930.53
|
| Rate for Payer: Cigna Commercial |
$514.20
|
| Rate for Payer: Cigna Medicare Advantage |
$256.52
|
| Rate for Payer: Clover Medicare Advantage |
$243.69
|
| Rate for Payer: EmblemHealth Commercial |
$769.56
|
| Rate for Payer: Humana Medicare Advantage |
$264.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$256.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$385.31
|
| Rate for Payer: Oxford Commercial |
$5,237.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,943.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.09
|
|
|
VEEG 2-12HRS UNMON
|
Facility
|
OP
|
$1,481.95
|
|
|
Service Code
|
HCPCS 95711
|
| Hospital Charge Code |
403395711
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$42.09 |
| Max. Negotiated Rate |
$5,943.00 |
| Rate for Payer: Aetna Commercial |
$697.73
|
| Rate for Payer: Aetna Medicare Advantage |
$831.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$930.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$930.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$256.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$930.53
|
| Rate for Payer: Cigna Commercial |
$514.20
|
| Rate for Payer: Cigna Medicare Advantage |
$256.52
|
| Rate for Payer: Clover Medicare Advantage |
$243.69
|
| Rate for Payer: EmblemHealth Commercial |
$769.56
|
| Rate for Payer: Humana Medicare Advantage |
$264.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$256.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$385.31
|
| Rate for Payer: Oxford Commercial |
$5,237.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,943.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$46.83
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$256.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.09
|
|
|
VEEG 2-12HRS UNMON
|
Facility
|
IP
|
$1,481.95
|
|
|
Service Code
|
HCPCS 95711
|
| Hospital Charge Code |
403395711
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$222.29 |
| Max. Negotiated Rate |
$222.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$222.29
|
|
|
VEGF ELISA
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
3003100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
VEGF ELISA
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
3003100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: Aetna Medicare Advantage |
$55.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.65
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$17.27
|
| Rate for Payer: Clover Medicare Advantage |
$16.41
|
| Rate for Payer: EmblemHealth Commercial |
$51.81
|
| Rate for Payer: Humana Medicare Advantage |
$17.79
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.27
|
| 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 |
$13.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
VEIN CYTO
|
Facility
|
OP
|
$37,000.00
|
|
| Hospital Charge Code |
270676622
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,050.80 |
| Max. Negotiated Rate |
$18,500.00 |
| Rate for Payer: Aetna Commercial |
$14,060.00
|
| Rate for Payer: Aetna Medicare Advantage |
$11,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,435.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,435.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,400.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,435.00
|
| Rate for Payer: Cigna Commercial |
$18,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,954.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,550.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,169.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,050.80
|
|
|
VEIN CYTO
|
Facility
|
IP
|
$37,000.00
|
|
| Hospital Charge Code |
270676622
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,550.00 |
| Max. Negotiated Rate |
$8,954.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,400.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,954.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,550.00
|
|
|
VEIN IMPLANT
|
Facility
|
OP
|
$36,750.00
|
|
| Hospital Charge Code |
270668663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,043.70 |
| Max. Negotiated Rate |
$18,375.00 |
| Rate for Payer: Aetna Commercial |
$13,965.00
|
| Rate for Payer: Aetna Medicare Advantage |
$11,025.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,371.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,371.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,371.25
|
| Rate for Payer: Cigna Commercial |
$18,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,893.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,512.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,161.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,043.70
|
|
|
VEIN IMPLANT
|
Facility
|
IP
|
$36,750.00
|
|
| Hospital Charge Code |
270668663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,512.50 |
| Max. Negotiated Rate |
$8,893.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,893.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,512.50
|
|
|
VEIN LIGATION AND STRIPPING
|
Facility
|
IP
|
$116,058.79
|
|
|
Service Code
|
MSDRG 263
|
| Min. Negotiated Rate |
$35,338.41 |
| Max. Negotiated Rate |
$116,058.79 |
| Rate for Payer: Aetna Commercial |
$84,516.94
|
| Rate for Payer: Aetna Medicare Advantage |
$116,058.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$78,405.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$78,405.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$37,198.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$78,405.15
|
| Rate for Payer: Cigna Commercial |
$68,158.62
|
| Rate for Payer: Cigna Medicare Advantage |
$37,198.33
|
| Rate for Payer: Clover Medicare Advantage |
$35,338.41
|
| Rate for Payer: EmblemHealth Commercial |
$111,594.99
|
| Rate for Payer: Humana Medicare Advantage |
$38,314.28
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$37,198.33
|
| Rate for Payer: Oxford Commercial |
$53,871.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$72,108.78
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$37,198.33
|
| Rate for Payer: Wellcare Medicare Advantage |
$37,198.33
|
|
|
VEIN SAPHENOUS
|
Facility
|
IP
|
$39,750.00
|
|
| Hospital Charge Code |
270680373
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,962.50 |
| Max. Negotiated Rate |
$9,619.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,950.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,619.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,962.50
|
|
|
VEIN SAPHENOUS
|
Facility
|
OP
|
$39,750.00
|
|
| Hospital Charge Code |
270680373
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,128.90 |
| Max. Negotiated Rate |
$19,875.00 |
| Rate for Payer: Aetna Commercial |
$15,105.00
|
| Rate for Payer: Aetna Medicare Advantage |
$11,925.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10,136.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10,136.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7,950.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10,136.25
|
| Rate for Payer: Cigna Commercial |
$19,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,619.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,962.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,256.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,128.90
|
|
