|
CFH SCREENING PELVIC EXAM
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
HCPCS G0101
|
| Hospital Charge Code |
83652525
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
|
|
CFH SHAVE BIOPSY DERMAL LESION
|
Facility
|
IP
|
$69.00
|
|
|
Service Code
|
HCPCS 11300
|
| Hospital Charge Code |
83652035
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$10.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.35
|
|
|
CFH SHAVE BIOPSY DERMAL LESION
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
HCPCS 11300
|
| Hospital Charge Code |
83652035
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1.96 |
| 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 |
$28.73
|
| 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 |
$17.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.96
|
|
|
CFH STREP SCREEN
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
83652283
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$17.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
|
|
CFH STREP SCREEN
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
83652283
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$31.39
|
| Rate for Payer: Aetna Medicare Advantage |
$37.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.86
|
| Rate for Payer: Cigna Commercial |
$57.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.54
|
| Rate for Payer: Clover Medicare Advantage |
$10.96
|
| Rate for Payer: EmblemHealth Commercial |
$34.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.90
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.27
|
|
|
CFH TRIGGER POINT INJECTION
|
Facility
|
OP
|
$121.00
|
|
|
Service Code
|
HCPCS 20552
|
| Hospital Charge Code |
83652091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3.44 |
| Max. Negotiated Rate |
$1,322.84 |
| 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 |
$33.14
|
| 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 |
$31.46
|
| Rate for Payer: Oxford Commercial |
$24.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$24.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$364.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.44
|
|
|
CFH TRIGGER POINT INJECTION
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
HCPCS 20552
|
| Hospital Charge Code |
83652091
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$18.15 |
| Max. Negotiated Rate |
$18.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.15
|
|
|
CFH WC CERV/VAG BX-SINGLE-MULT
|
Facility
|
OP
|
$290.00
|
|
|
Service Code
|
HCPCS 57500
|
| Hospital Charge Code |
83652145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$3,969.32 |
| Rate for Payer: Aetna Commercial |
$2,976.31
|
| Rate for Payer: Aetna Medicare Advantage |
$3,545.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,969.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,969.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,094.23
|
| 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 |
$3,969.32
|
| Rate for Payer: Cigna Commercial |
$2,193.38
|
| Rate for Payer: Cigna Medicare Advantage |
$1,094.23
|
| Rate for Payer: Clover Medicare Advantage |
$1,039.52
|
| Rate for Payer: EmblemHealth Commercial |
$3,282.69
|
| Rate for Payer: Humana Medicare Advantage |
$1,127.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,094.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.40
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,094.23
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,094.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.24
|
|
|
CFH WC CERV/VAG BX-SINGLE-MULT
|
Facility
|
IP
|
$290.00
|
|
|
Service Code
|
HCPCS 57500
|
| Hospital Charge Code |
83652145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.50
|
|
|
CFH WC COLPOSCOPY OF CERVIX
|
Facility
|
IP
|
$669.00
|
|
|
Service Code
|
HCPCS 57452
|
| Hospital Charge Code |
83652137
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$100.35 |
| Max. Negotiated Rate |
$100.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.35
|
|
|
CFH WC COLPOSCOPY OF CERVIX
|
Facility
|
OP
|
$669.00
|
|
|
Service Code
|
HCPCS 57452
|
| Hospital Charge Code |
83652137
|
|
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
|
|
|
CFH WC COLPOSCOPY WITH BIOPSY
|
Facility
|
OP
|
$863.00
|
|
|
Service Code
|
HCPCS 57454
|
| Hospital Charge Code |
83652139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$24.51 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$984.72
|
| Rate for Payer: Aetna Medicare Advantage |
$1,172.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,313.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,313.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$362.03
|
| 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 |
$1,313.26
|
| Rate for Payer: Cigna Commercial |
$725.69
|
| Rate for Payer: Cigna Medicare Advantage |
$362.03
|
| Rate for Payer: Clover Medicare Advantage |
$343.93
|
| Rate for Payer: EmblemHealth Commercial |
$1,086.09
|
| Rate for Payer: Humana Medicare Advantage |
$372.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$362.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$224.38
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$27.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$362.03
|
| Rate for Payer: Wellcare Medicare Advantage |
$362.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.51
|
|
|
CFH WC COLPOSCOPY WITH BIOPSY
|
Facility
|
IP
|
$863.00
|
|
|
Service Code
|
HCPCS 57454
|
| Hospital Charge Code |
83652139
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$129.45 |
| Max. Negotiated Rate |
$129.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.45
|
|
|
CFH WC C SECTION ONLY
|
Professional
|
Both
|
$8,085.00
|
|
|
Service Code
|
HCPCS 59514
|
| Hospital Charge Code |
83652233
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$358.20 |
| Max. Negotiated Rate |
$2,742.00 |
| Rate for Payer: Aetna Commercial |
$1,165.83
|
| Rate for Payer: Aetna Medicare Advantage |
$1,165.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,742.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,742.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,742.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,742.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,742.00
|
| Rate for Payer: Cigna Commercial |
$1,437.29
|
| Rate for Payer: Cigna Medicare Advantage |
$1,437.29
|
| Rate for Payer: Fidelis All Plans |
$748.91
|
| Rate for Payer: Tricare Tricare |
$1,250.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$358.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$358.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$358.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$768.33
|
|
|
CFH WC CURETTAGE,POSTPARTUM
|
Professional
|
Both
|
$1,300.00
|
|
|
Service Code
|
HCPCS 59160
|
| Hospital Charge Code |
83652209
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$418.92 |
| Max. Negotiated Rate |
$587.70 |
| Rate for Payer: Aetna Medicare Advantage |
$418.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$587.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$587.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$587.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$587.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$587.70
|
| Rate for Payer: Cigna Commercial |
$418.92
|
| Rate for Payer: Cigna Medicare Advantage |
$418.92
|
|
|
CFH WC EST.PT E&M MINIMAL
|
Facility
|
OP
|
$311.00
|
|
|
Service Code
|
HCPCS 99211
|
| Hospital Charge Code |
83652403
|
|
Hospital Revenue Code
|
514
|
| Min. Negotiated Rate |
$8.83 |
| Max. Negotiated Rate |
$155.50 |
| Rate for Payer: Aetna Commercial |
$118.18
|
| Rate for Payer: Aetna Medicare Advantage |
$93.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.31
|
| Rate for Payer: Cigna Commercial |
$155.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$80.86
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.83
|
|
|
CFH WC EST.PT E&M MINIMAL
|
Facility
|
IP
|
$311.00
|
|
|
Service Code
|
HCPCS 99211
|
| Hospital Charge Code |
83652403
|
|
Hospital Revenue Code
|
514
|
| Min. Negotiated Rate |
$46.65 |
| Max. Negotiated Rate |
$46.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
|
|
CFH WC FAILED BAC ONLY
|
Professional
|
Both
|
$9,489.90
|
|
|
Service Code
|
HCPCS 59620
|
| Hospital Charge Code |
83652245
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$1,512.61 |
| Max. Negotiated Rate |
$1,512.61 |
| Rate for Payer: Aetna Medicare Advantage |
$1,512.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,512.61
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,512.61
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,512.61
|
|
|
CFH WC FETAL NON STRESS TEST
|
Facility
|
OP
|
$1,898.40
|
|
|
Service Code
|
HCPCS 59025
|
| Hospital Charge Code |
83652197
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.91 |
| Max. Negotiated Rate |
$871.25 |
| 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 |
$286.00
|
| 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 |
$493.58
|
| Rate for Payer: Oxford Commercial |
$379.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$284.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$379.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$59.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$240.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$240.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$53.91
|
|
|
CFH WC FETAL NON STRESS TEST
|
Facility
|
IP
|
$1,898.40
|
|
|
Service Code
|
HCPCS 59025
|
| Hospital Charge Code |
83652197
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$284.76 |
| Max. Negotiated Rate |
$284.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$284.76
|
|
|
CFH WC HEMOCULT-BLOOD OCULT-
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
HCPCS 82270
|
| Hospital Charge Code |
83652277
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.45 |
| Max. Negotiated Rate |
$3.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.45
|
|
|
CFH WC HEMOCULT-BLOOD OCULT-
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
HCPCS 82270
|
| Hospital Charge Code |
83652277
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$11.91
|
| Rate for Payer: Aetna Medicare Advantage |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.89
|
| Rate for Payer: Cigna Commercial |
$11.50
|
| Rate for Payer: Cigna Medicare Advantage |
$4.38
|
| Rate for Payer: Clover Medicare Advantage |
$4.16
|
| Rate for Payer: EmblemHealth Commercial |
$13.14
|
| Rate for Payer: Humana Medicare Advantage |
$4.51
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.98
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.65
|
|
|
CFH WC I&D BARTHOLINS ABSCESS
|
Facility
|
OP
|
$942.15
|
|
|
Service Code
|
HCPCS 56420
|
| Hospital Charge Code |
83652121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$26.76 |
| Max. Negotiated Rate |
$871.25 |
| 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) 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 |
$244.96
|
| Rate for Payer: Oxford Commercial |
$188.43
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$141.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$188.43
|
| Rate for Payer: UnitedHealthcare Community & State |
$29.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$240.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$240.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.76
|
|
|
CFH WC I&D BARTHOLINS ABSCESS
|
Facility
|
IP
|
$942.15
|
|
|
Service Code
|
HCPCS 56420
|
| Hospital Charge Code |
83652121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.32 |
| Max. Negotiated Rate |
$141.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$141.32
|
|
|
CFH WC IUD INSERTION
|
Facility
|
IP
|
$376.00
|
|
|
Service Code
|
HCPCS 58300
|
| Hospital Charge Code |
83652163
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$56.40 |
| Max. Negotiated Rate |
$56.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.40
|
|
