|
CHEST PAIN
|
Facility
|
IP
|
$9,728.17
|
|
|
Service Code
|
APR-DRG 2033
|
| Min. Negotiated Rate |
$9,537.42 |
| Max. Negotiated Rate |
$9,728.17 |
| Rate for Payer: UnitedHealthcare Community & State |
$9,537.42
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$9,728.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9,537.42
|
|
|
CHEST PAIN
|
Facility
|
IP
|
$7,732.54
|
|
|
Service Code
|
APR-DRG 2032
|
| Min. Negotiated Rate |
$7,580.92 |
| Max. Negotiated Rate |
$7,732.54 |
| Rate for Payer: UnitedHealthcare Community & State |
$7,580.92
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$7,732.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7,580.92
|
|
|
CHEST PAIN
|
Facility
|
IP
|
$15,674.30
|
|
|
Service Code
|
APR-DRG 2034
|
| Min. Negotiated Rate |
$15,366.96 |
| Max. Negotiated Rate |
$15,674.30 |
| Rate for Payer: UnitedHealthcare Community & State |
$15,366.96
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$15,674.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15,366.96
|
|
|
CHEST PHYSIOTHERAPY SUBSEQUENT
|
Facility
|
OP
|
$171.00
|
|
|
Service Code
|
HCPCS 94668
|
| Hospital Charge Code |
9500555
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$1,440.00 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: Aetna Medicare Advantage |
$512.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$158.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.36
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$158.06
|
| Rate for Payer: Clover Medicare Advantage |
$150.16
|
| Rate for Payer: EmblemHealth Commercial |
$474.18
|
| Rate for Payer: Humana Medicare Advantage |
$162.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$158.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$44.46
|
| Rate for Payer: Oxford Commercial |
$1,367.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,440.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.40
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.86
|
|
|
CHEST PHYSIOTHERAPY SUBSEQUENT
|
Facility
|
IP
|
$171.00
|
|
|
Service Code
|
HCPCS 94668
|
| Hospital Charge Code |
9500555
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$25.65 |
| Max. Negotiated Rate |
$25.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.65
|
|
|
CHEST PT INITIAL OR EVAL
|
Facility
|
IP
|
$171.00
|
|
|
Service Code
|
HCPCS 94667
|
| Hospital Charge Code |
9500554
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$25.65 |
| Max. Negotiated Rate |
$25.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.65
|
|
|
CHEST PT INITIAL OR EVAL
|
Facility
|
OP
|
$171.00
|
|
|
Service Code
|
HCPCS 94667
|
| Hospital Charge Code |
9500554
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$1,440.00 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: Aetna Medicare Advantage |
$512.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$573.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$573.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$158.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$85.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$573.36
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$158.06
|
| Rate for Payer: Clover Medicare Advantage |
$150.16
|
| Rate for Payer: EmblemHealth Commercial |
$474.18
|
| Rate for Payer: Humana Medicare Advantage |
$162.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$158.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$44.46
|
| Rate for Payer: Oxford Commercial |
$1,367.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,440.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.40
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.86
|
|
|
CH ESTRADIOL E2
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
HCPCS 82670
|
| Hospital Charge Code |
397072061
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna Commercial |
$76.00
|
| Rate for Payer: Aetna Medicare Advantage |
$90.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$101.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$101.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$27.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$101.35
|
| Rate for Payer: Cigna Commercial |
$225.00
|
| Rate for Payer: Cigna Medicare Advantage |
$27.94
|
| Rate for Payer: Clover Medicare Advantage |
$26.54
|
| Rate for Payer: EmblemHealth Commercial |
$83.82
|
| Rate for Payer: Humana Medicare Advantage |
$28.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$27.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.00
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$27.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$27.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.78
|
|
|
CH ESTRADIOL E2
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
HCPCS 82670
|
| Hospital Charge Code |
397072061
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.50 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.50
|
|
|
CH ESTRIOL
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82677
|
| Hospital Charge Code |
397073241
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH ESTRIOL
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82677
|
| Hospital Charge Code |
397073241
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$65.77
|
| Rate for Payer: Aetna Medicare Advantage |
$78.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$87.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$87.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$87.71
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$24.18
|
| Rate for Payer: Clover Medicare Advantage |
$22.97
|
| Rate for Payer: EmblemHealth Commercial |
$72.54
|
| Rate for Payer: Humana Medicare Advantage |
$24.91
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24.18
|
| 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 |
$19.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$24.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CH ESTROGEN PROGESTERON
|
Facility
|
IP
|
$961.00
|
|
|
Service Code
|
HCPCS 84233
|
| Hospital Charge Code |
397061019
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$144.15 |
| Max. Negotiated Rate |
$144.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$144.15
|
|
|
CH ESTROGEN PROGESTERON
|
Facility
|
OP
|
$961.00
|
|
|
Service Code
|
HCPCS 84233
|
| Hospital Charge Code |
397061019
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.29 |
| Max. Negotiated Rate |
$480.50 |
| Rate for Payer: Aetna Commercial |
$239.03
|
| Rate for Payer: Aetna Medicare Advantage |
$284.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$318.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$318.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$87.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$318.78
|
| Rate for Payer: Cigna Commercial |
$480.50
|
| Rate for Payer: Cigna Medicare Advantage |
$87.88
|
| Rate for Payer: Clover Medicare Advantage |
$83.49
|
| Rate for Payer: EmblemHealth Commercial |
$263.64
|
| Rate for Payer: Humana Medicare Advantage |
$90.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$87.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$249.86
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$144.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$70.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$87.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$87.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.29
|
|
|
CHEST TUBE INSERTION
|
Facility
|
OP
|
$2,275.00
|
|
|
Service Code
|
HCPCS 32550
|
| Hospital Charge Code |
83091001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$64.61 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$591.50
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$341.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$71.89
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$64.61
|
|
|
CHEST TUBE INSERTION
|
Facility
|
OP
|
$2,275.00
|
|
|
Service Code
|
HCPCS 32550
|
| Hospital Charge Code |
83080001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$64.61 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$591.50
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$341.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$71.89
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$64.61
|
|
|
CHEST TUBE INSERTION
|
Facility
|
IP
|
$2,275.00
|
|
|
Service Code
|
HCPCS 32550
|
| Hospital Charge Code |
83091001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$341.25 |
| Max. Negotiated Rate |
$341.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$341.25
|
|
|
CHEST TUBE INSERTION
|
Facility
|
IP
|
$2,275.00
|
|
|
Service Code
|
HCPCS 32550
|
| Hospital Charge Code |
83080001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$341.25 |
| Max. Negotiated Rate |
$341.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$341.25
|
|
|
CHEST TUBE INSERTION
|
Facility
|
IP
|
$2,275.00
|
|
|
Service Code
|
HCPCS 32550
|
| Hospital Charge Code |
83092001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$341.25 |
| Max. Negotiated Rate |
$341.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$341.25
|
|
|
CHEST TUBE INSERTION
|
Facility
|
OP
|
$2,275.00
|
|
|
Service Code
|
HCPCS 32550
|
| Hospital Charge Code |
83092001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$64.61 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$591.50
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$341.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$71.89
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$64.61
|
|
|
CHEST TWO VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71046
|
| Hospital Charge Code |
94061039
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$31.04 |
| 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 |
$31.04
|
| 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 TWO VIEWS
|
Facility
|
IP
|
$6,439.57
|
|
|
Service Code
|
HCPCS 71046
|
| Hospital Charge Code |
2000545
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$965.94 |
| Max. Negotiated Rate |
$965.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$965.94
|
|
|
CHEST TWO VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 71046
|
| Hospital Charge Code |
94061039
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
CHEST TWO VIEWS
|
Facility
|
OP
|
$6,439.57
|
|
|
Service Code
|
HCPCS 71046
|
| Hospital Charge Code |
2000545
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$31.04 |
| 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 |
$31.04
|
| 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 |
$1,674.29
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$965.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$203.49
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$182.88
|
|
|
CHEST VALVE HEIMLICH
|
Facility
|
OP
|
$70.88
|
|
| Hospital Charge Code |
270649366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.01 |
| Max. Negotiated Rate |
$35.44 |
| Rate for Payer: Aetna Commercial |
$26.93
|
| Rate for Payer: Aetna Medicare Advantage |
$21.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.07
|
| Rate for Payer: Cigna Commercial |
$35.44
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.43
|
| Rate for Payer: Oxford Commercial |
$14.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.18
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.01
|
|
|
CHEST VALVE HEIMLICH
|
Facility
|
IP
|
$70.88
|
|
| Hospital Charge Code |
270649366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$10.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.63
|
|