|
CH EOSINOPHILE COUNT
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 85048
|
| Hospital Charge Code |
397021036
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.98 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$6.91
|
| Rate for Payer: Aetna Medicare Advantage |
$8.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2.54
|
| 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 |
$9.21
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$2.54
|
| Rate for Payer: Clover Medicare Advantage |
$2.41
|
| Rate for Payer: EmblemHealth Commercial |
$7.62
|
| Rate for Payer: Humana Medicare Advantage |
$2.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2.54
|
| 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 |
$2.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$2.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CH EOSINOPHILE SMEAR NASAL
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 89190
|
| Hospital Charge Code |
397021077
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH EOSINOPHILE SMEAR NASAL
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 89190
|
| Hospital Charge Code |
397021077
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$15.75
|
| Rate for Payer: Aetna Medicare Advantage |
$18.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21.00
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.79
|
| Rate for Payer: Clover Medicare Advantage |
$5.50
|
| Rate for Payer: EmblemHealth Commercial |
$17.37
|
| Rate for Payer: Humana Medicare Advantage |
$5.96
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.79
|
| 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 |
$4.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CH ERA PARAFFIN BLOCK 1ST
|
Facility
|
OP
|
$1,082.30
|
|
|
Service Code
|
HCPCS 88342
|
| Hospital Charge Code |
397061014
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$734.21 |
| Rate for Payer: Aetna Commercial |
$550.53
|
| Rate for Payer: Aetna Medicare Advantage |
$655.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$734.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$734.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$202.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$734.21
|
| Rate for Payer: Cigna Commercial |
$405.73
|
| Rate for Payer: Cigna Medicare Advantage |
$202.40
|
| Rate for Payer: Clover Medicare Advantage |
$192.28
|
| Rate for Payer: EmblemHealth Commercial |
$607.20
|
| Rate for Payer: Humana Medicare Advantage |
$208.47
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$202.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$281.40
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$162.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$86.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$202.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$202.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30.74
|
|
|
CH ERA PARAFFIN BLOCK 1ST
|
Facility
|
IP
|
$1,082.30
|
|
|
Service Code
|
HCPCS 88342
|
| Hospital Charge Code |
397061014
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$162.34 |
| Max. Negotiated Rate |
$162.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$162.34
|
|
|
CHERRY SYRUP
|
Facility
|
OP
|
$111.02
|
|
|
Service Code
|
NDC 395266216
|
| Hospital Charge Code |
60628558
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$55.51 |
| Rate for Payer: Aetna Commercial |
$42.19
|
| Rate for Payer: Aetna Medicare Advantage |
$33.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.31
|
| Rate for Payer: Cigna Commercial |
$55.51
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$28.87
|
| Rate for Payer: Oxford Commercial |
$22.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$22.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.15
|
|
|
CHERRY SYRUP
|
Facility
|
IP
|
$111.02
|
|
|
Service Code
|
NDC 395266216
|
| Hospital Charge Code |
60628558
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$16.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.65
|
|
|
CHEST 3 VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71047
|
| Hospital Charge Code |
2003072
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$281.22
|
| Rate for Payer: Aetna Medicare Advantage |
$334.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$103.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$39.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$375.05
|
| Rate for Payer: Cigna Commercial |
$207.24
|
| Rate for Payer: Cigna Medicare Advantage |
$72.37
|
| Rate for Payer: Clover Medicare Advantage |
$98.22
|
| Rate for Payer: EmblemHealth Commercial |
$310.17
|
| Rate for Payer: Humana Medicare Advantage |
$106.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$103.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
CHEST 3 VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71047
|
| Hospital Charge Code |
2003072
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
CHEST 4 OR > VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71048
|
| Hospital Charge Code |
2003073
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
CHEST 4 OR > VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71048
|
| Hospital Charge Code |
94061041
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$42.59 |
| Max. Negotiated Rate |
$2,231.00 |
| 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 |
$42.59
|
| 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 |
$86.94
|
| 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 |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
CHEST 4 OR > VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71048
|
| Hospital Charge Code |
94061041
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
CHEST 4 OR > VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71048
|
| Hospital Charge Code |
2003073
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$42.59 |
| Max. Negotiated Rate |
$2,231.00 |
| 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 |
$42.59
|
| 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 |
$86.94
|
| 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 |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
CHEST DRAIN THOR-KLEX DUAL
|
Facility
|
OP
|
$697.00
|
|
| Hospital Charge Code |
270331048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.79 |
| Max. Negotiated Rate |
$348.50 |
| Rate for Payer: Aetna Commercial |
$264.86
|
| Rate for Payer: Aetna Medicare Advantage |
$209.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$177.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$177.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$177.74
|
| Rate for Payer: Cigna Commercial |
$348.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.22
|
| Rate for Payer: Oxford Commercial |
$139.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$139.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.79
|
|
|
CHEST DRAIN THOR-KLEX DUAL
|
Facility
|
IP
|
$697.00
|
|
| Hospital Charge Code |
270331048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$104.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.55
|
|
|
CHEST/MEDIASTINUM
|
Facility
|
IP
|
$6,700.00
|
|
|
Service Code
|
HCPCS 76604
|
| Hospital Charge Code |
94061159
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,005.00 |
| Max. Negotiated Rate |
$1,005.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.00
|
|
|
CHEST/MEDIASTINUM
|
Facility
|
OP
|
$6,700.00
|
|
|
Service Code
|
HCPCS 76604
|
| Hospital Charge Code |
94061159
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$57.75 |
| Max. Negotiated Rate |
$2,904.00 |
| 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 |
$57.75
|
| 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 |
$1,742.00
|
| Rate for Payer: Oxford Commercial |
$2,697.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,904.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$211.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$190.28
|
|
|
CHEST ONE VIEW
|
Facility
|
OP
|
$5,870.36
|
|
|
Service Code
|
HCPCS 71045
|
| Hospital Charge Code |
2000537
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$20.21 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$281.22
|
| Rate for Payer: Aetna Medicare Advantage |
$334.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$103.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$375.05
|
| Rate for Payer: Cigna Commercial |
$207.24
|
| Rate for Payer: Cigna Medicare Advantage |
$72.37
|
| Rate for Payer: Clover Medicare Advantage |
$98.22
|
| Rate for Payer: EmblemHealth Commercial |
$310.17
|
| Rate for Payer: Humana Medicare Advantage |
$106.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$103.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,526.29
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$880.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$185.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$166.72
|
|
|
CHEST ONE VIEW
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71045
|
| Hospital Charge Code |
94061037
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$20.21 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$281.22
|
| Rate for Payer: Aetna Medicare Advantage |
$334.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$103.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$375.05
|
| Rate for Payer: Cigna Commercial |
$207.24
|
| Rate for Payer: Cigna Medicare Advantage |
$72.37
|
| Rate for Payer: Clover Medicare Advantage |
$98.22
|
| Rate for Payer: EmblemHealth Commercial |
$310.17
|
| Rate for Payer: Humana Medicare Advantage |
$106.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$103.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
CHEST ONE VIEW
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71045
|
| Hospital Charge Code |
94061037
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
CHEST ONE VIEW
|
Facility
|
IP
|
$5,870.36
|
|
|
Service Code
|
HCPCS 71045
|
| Hospital Charge Code |
2000537
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$880.55 |
| Max. Negotiated Rate |
$880.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$880.55
|
|
|
CHEST ONE VIEW PORTABLE
|
Facility
|
IP
|
$6,095.93
|
|
|
Service Code
|
HCPCS 71045
|
| Hospital Charge Code |
2003069
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$914.39 |
| Max. Negotiated Rate |
$914.39 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$914.39
|
|
|
CHEST ONE VIEW PORTABLE
|
Facility
|
OP
|
$6,095.93
|
|
|
Service Code
|
HCPCS 71045
|
| Hospital Charge Code |
2003069
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$20.21 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$281.22
|
| Rate for Payer: Aetna Medicare Advantage |
$334.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$103.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$375.05
|
| Rate for Payer: Cigna Commercial |
$207.24
|
| Rate for Payer: Cigna Medicare Advantage |
$72.37
|
| Rate for Payer: Clover Medicare Advantage |
$98.22
|
| Rate for Payer: EmblemHealth Commercial |
$310.17
|
| Rate for Payer: Humana Medicare Advantage |
$106.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$103.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,584.94
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$914.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$192.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$173.12
|
|
|
CHEST PAIN
|
Facility
|
IP
|
$6,516.34
|
|
|
Service Code
|
APR-DRG 2031
|
| Min. Negotiated Rate |
$6,388.57 |
| Max. Negotiated Rate |
$6,516.34 |
| Rate for Payer: UnitedHealthcare Community & State |
$6,388.57
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$6,516.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6,388.57
|
|
|
CHEST PAIN
|
Facility
|
IP
|
$42,212.07
|
|
|
Service Code
|
MSDRG 313
|
| Min. Negotiated Rate |
$12,686.40 |
| Max. Negotiated Rate |
$42,212.07 |
| Rate for Payer: Aetna Commercial |
$31,922.43
|
| Rate for Payer: Aetna Medicare Advantage |
$42,212.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19,947.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19,947.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,529.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19,947.60
|
| Rate for Payer: Cigna Commercial |
$16,050.96
|
| Rate for Payer: Cigna Medicare Advantage |
$13,529.51
|
| Rate for Payer: Clover Medicare Advantage |
$12,853.03
|
| Rate for Payer: EmblemHealth Commercial |
$40,588.53
|
| Rate for Payer: Humana Medicare Advantage |
$13,935.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,529.51
|
| Rate for Payer: Oxford Commercial |
$12,686.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,981.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,529.51
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,529.51
|
|
