|
CAROTENE
|
Facility
|
IP
|
$63.40
|
|
|
Service Code
|
HCPCS 82380
|
| Hospital Charge Code |
39900056
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.51 |
| Max. Negotiated Rate |
$9.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.51
|
|
|
CAROTENE
|
Facility
|
OP
|
$63.40
|
|
|
Service Code
|
HCPCS 82380
|
| Hospital Charge Code |
39900056
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$25.08
|
| Rate for Payer: Aetna Medicare Advantage |
$29.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.45
|
| Rate for Payer: Cigna Commercial |
$31.70
|
| Rate for Payer: Cigna Medicare Advantage |
$9.22
|
| Rate for Payer: Clover Medicare Advantage |
$8.76
|
| Rate for Payer: EmblemHealth Commercial |
$27.66
|
| Rate for Payer: Humana Medicare Advantage |
$9.50
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.48
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.38
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.80
|
|
|
CAROTENE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82380
|
| Hospital Charge Code |
38472170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CAROTENE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82380
|
| Hospital Charge Code |
38472170
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$25.08
|
| Rate for Payer: Aetna Medicare Advantage |
$29.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.45
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$9.22
|
| Rate for Payer: Clover Medicare Advantage |
$8.76
|
| Rate for Payer: EmblemHealth Commercial |
$27.66
|
| Rate for Payer: Humana Medicare Advantage |
$9.50
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.22
|
| 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 |
$7.38
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CAROTID ARTERY STENT PROCEDURES WITH CC
|
Facility
|
IP
|
$94,989.02
|
|
|
Service Code
|
MSDRG 035
|
| Min. Negotiated Rate |
$28,922.94 |
| Max. Negotiated Rate |
$94,989.02 |
| Rate for Payer: Aetna Medicare Advantage |
$94,989.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63,721.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63,721.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$30,445.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63,721.50
|
| Rate for Payer: Cigna Commercial |
$53,291.42
|
| Rate for Payer: Cigna Medicare Advantage |
$30,445.20
|
| Rate for Payer: Clover Medicare Advantage |
$28,922.94
|
| Rate for Payer: EmblemHealth Commercial |
$91,335.60
|
| Rate for Payer: Humana Medicare Advantage |
$31,358.56
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$30,445.20
|
| Rate for Payer: Oxford Commercial |
$42,120.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$56,379.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$30,445.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$30,445.20
|
|
|
CAROTID ARTERY STENT PROCEDURES WITH MCC
|
Facility
|
IP
|
$141,753.86
|
|
|
Service Code
|
MSDRG 034
|
| Min. Negotiated Rate |
$43,162.23 |
| Max. Negotiated Rate |
$141,753.86 |
| Rate for Payer: Aetna Medicare Advantage |
$141,753.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108,049.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108,049.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$45,433.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108,049.50
|
| Rate for Payer: Cigna Commercial |
$86,289.52
|
| Rate for Payer: Cigna Medicare Advantage |
$45,433.93
|
| Rate for Payer: Clover Medicare Advantage |
$43,162.23
|
| Rate for Payer: EmblemHealth Commercial |
$136,301.79
|
| Rate for Payer: Humana Medicare Advantage |
$46,796.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$45,433.93
|
| Rate for Payer: Oxford Commercial |
$68,201.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$91,290.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$45,433.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$45,433.93
|
|
|
CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$80,844.60
|
|
|
Service Code
|
MSDRG 036
|
| Min. Negotiated Rate |
$24,616.14 |
| Max. Negotiated Rate |
$80,844.60 |
| Rate for Payer: Aetna Medicare Advantage |
$80,844.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50,146.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50,146.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$25,911.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50,146.05
|
| Rate for Payer: Cigna Commercial |
$43,310.84
|
| Rate for Payer: Cigna Medicare Advantage |
$25,911.73
|
| Rate for Payer: Clover Medicare Advantage |
$24,616.14
|
| Rate for Payer: EmblemHealth Commercial |
$77,735.19
|
| Rate for Payer: Humana Medicare Advantage |
$26,689.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$25,911.73
|
| Rate for Payer: Oxford Commercial |
$34,232.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$45,820.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$25,911.73
|
| Rate for Payer: Wellcare Medicare Advantage |
$25,911.73
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
2692015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
2692015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$7,555.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$410.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,028.29
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,472.00
|
| Rate for Payer: Oxford Commercial |
$6,888.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$7,555.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$543.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$488.48
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
94053165
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$7,555.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$410.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,028.29
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,472.00
|
| Rate for Payer: Oxford Commercial |
$6,888.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$7,555.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$543.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$488.48
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
421593880
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$7,555.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$410.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,028.29
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,472.00
|
| Rate for Payer: Oxford Commercial |
$6,888.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$7,555.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$543.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$488.48
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
74116027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
74116027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$7,555.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$410.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,028.29
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,472.00
|
| Rate for Payer: Oxford Commercial |
$6,888.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$7,555.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$543.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$488.48
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
74115027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
421593880
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
94053165
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
74115027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$7,555.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$410.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,028.29
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,472.00
|
| Rate for Payer: Oxford Commercial |
$6,888.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$7,555.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$543.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$488.48
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
74117027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.30 |
| Max. Negotiated Rate |
$7,555.00 |
| Rate for Payer: Aetna Commercial |
$771.04
|
| Rate for Payer: Aetna Medicare Advantage |
$918.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,028.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$283.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$410.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,028.29
|
| Rate for Payer: Cigna Commercial |
$568.20
|
| Rate for Payer: Cigna Medicare Advantage |
$283.47
|
| Rate for Payer: Clover Medicare Advantage |
$269.30
|
| Rate for Payer: EmblemHealth Commercial |
$850.41
|
| Rate for Payer: Humana Medicare Advantage |
$291.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$283.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,472.00
|
| Rate for Payer: Oxford Commercial |
$6,888.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$7,555.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$543.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$283.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$488.48
|
|
|
CAROTID DUPLEX SCAN
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93880
|
| Hospital Charge Code |
74117027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
CAROTID DUPLEX SCAN LIMIT
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93882
|
| Hospital Charge Code |
74115028
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
CAROTID DUPLEX SCAN LIMIT
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93882
|
| Hospital Charge Code |
2692020
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$106.02 |
| Max. Negotiated Rate |
$7,555.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$106.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$124.20
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,472.00
|
| Rate for Payer: Oxford Commercial |
$6,888.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$7,555.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$543.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$488.48
|
|
|
CAROTID DUPLEX SCAN LIMIT
|
Facility
|
OP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93882
|
| Hospital Charge Code |
74115028
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$106.02 |
| Max. Negotiated Rate |
$7,555.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$106.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$124.20
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,472.00
|
| Rate for Payer: Oxford Commercial |
$6,888.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$7,555.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$543.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$488.48
|
|
|
CAROTID DUPLEX SCAN LIMIT
|
Facility
|
IP
|
$17,200.00
|
|
|
Service Code
|
HCPCS 93882
|
| Hospital Charge Code |
2692020
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$2,580.00 |
| Max. Negotiated Rate |
$2,580.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,580.00
|
|
|
CAROTID PRUITT SHUNT
|
Facility
|
OP
|
$501.00
|
|
| Hospital Charge Code |
270335050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$14.23 |
| Max. Negotiated Rate |
$250.50 |
| Rate for Payer: Aetna Commercial |
$190.38
|
| Rate for Payer: Aetna Medicare Advantage |
$150.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$127.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$127.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$100.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$127.75
|
| Rate for Payer: Cigna Commercial |
$250.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$121.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.15
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.23
|
|
|
CAROTID PRUITT SHUNT
|
Facility
|
IP
|
$501.00
|
|
| Hospital Charge Code |
270335050
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$75.15 |
| Max. Negotiated Rate |
$121.24 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$100.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$121.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.15
|
|
