|
COLONOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE
|
Facility
|
OP
|
$5,347.00
|
|
|
Service Code
|
CPT 45385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$298.10 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$298.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,157.00
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
|
|
COLONOSCOPY FLEX W BX,SGL/MULT
|
Facility
|
OP
|
$8,751.70
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
16000185
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$248.55 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| 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 |
$5,157.00
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,275.44
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$276.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$248.55
|
|
|
COLONOSCOPY FLEX W BX,SGL/MULT
|
Facility
|
IP
|
$8,751.70
|
|
|
Service Code
|
HCPCS 45380
|
| Hospital Charge Code |
16000185
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,312.76 |
| Max. Negotiated Rate |
$1,312.76 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,312.76
|
|
|
COLONOSCOPY SHEATH FOR SNARE
|
Facility
|
IP
|
$319.00
|
|
| Hospital Charge Code |
270332349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.85 |
| Max. Negotiated Rate |
$47.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.85
|
|
|
COLONOSCOPY SHEATH FOR SNARE
|
Facility
|
OP
|
$319.00
|
|
| Hospital Charge Code |
270332349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.06 |
| Max. Negotiated Rate |
$159.50 |
| Rate for Payer: Aetna Commercial |
$121.22
|
| Rate for Payer: Aetna Medicare Advantage |
$95.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.34
|
| Rate for Payer: Cigna Commercial |
$159.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.94
|
| Rate for Payer: Oxford Commercial |
$63.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.06
|
|
|
COLONOSCOPY THROUGH STOMA; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$5,347.00
|
|
|
Service Code
|
CPT 44388
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$132.44 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$3,005.08
|
| Rate for Payer: Aetna Medicare Advantage |
$3,579.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,007.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,007.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,104.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$132.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,007.70
|
| Rate for Payer: Cigna Commercial |
$2,214.60
|
| Rate for Payer: Cigna Medicare Advantage |
$1,104.81
|
| Rate for Payer: Clover Medicare Advantage |
$1,049.57
|
| Rate for Payer: EmblemHealth Commercial |
$3,314.43
|
| Rate for Payer: Humana Medicare Advantage |
$1,137.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,104.81
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,104.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,104.81
|
|
|
COLONOSCOPY THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE
|
Facility
|
OP
|
$5,347.00
|
|
|
Service Code
|
CPT 44389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$164.90 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$164.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,157.00
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
|
|
COLONOSCOPY W/ABLATION LESION
|
Facility
|
OP
|
$4,391.94
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
16000589
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$124.73 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| 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 |
$5,157.00
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,141.90
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$658.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$138.79
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$124.73
|
|
|
COLONOSCOPY W/ABLATION LESION
|
Facility
|
IP
|
$4,391.94
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
16000589
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$658.79 |
| Max. Negotiated Rate |
$658.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$658.79
|
|
|
COLONOSCOPY W/CONTROL BLEED
|
Facility
|
OP
|
$7,639.30
|
|
|
Service Code
|
HCPCS 45382
|
| Hospital Charge Code |
16000459
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$216.96 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| 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 |
$5,157.00
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,986.22
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,145.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$241.40
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$216.96
|
|
|
COLONOSCOPY W/CONTROL BLEED
|
Facility
|
IP
|
$7,639.30
|
|
|
Service Code
|
HCPCS 45382
|
| Hospital Charge Code |
16000459
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,145.89 |
| Max. Negotiated Rate |
$1,145.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,145.89
|
|
|
COLONOSCOPY W/FB REMOVAL
|
Facility
|
OP
|
$13,705.00
|
|
|
Service Code
|
HCPCS 45379
|
| Hospital Charge Code |
16000588
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$389.22 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| 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 |
$5,157.00
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,563.30
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,055.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$433.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$389.22
|
|
|
COLONOSCOPY W/FB REMOVAL
|
Facility
|
IP
|
$13,705.00
|
|
|
Service Code
|
HCPCS 45379
|
| Hospital Charge Code |
16000588
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,055.75 |
| Max. Negotiated Rate |
$2,055.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,055.75
|
|
|
COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL AT HIGH RISK
|
Facility
|
OP
|
$4,007.70
|
|
|
Service Code
|
CPT G0105
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,049.57 |
| Max. Negotiated Rate |
$4,007.70 |
| Rate for Payer: Aetna Commercial |
$3,005.08
|
| Rate for Payer: Aetna Medicare Advantage |
$3,579.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,007.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,007.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,104.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,007.70
|
| Rate for Payer: Cigna Commercial |
$2,214.60
|
| Rate for Payer: Cigna Medicare Advantage |
$1,104.81
|
| Rate for Payer: Clover Medicare Advantage |
$1,049.57
|
| Rate for Payer: EmblemHealth Commercial |
$3,314.43
|
| Rate for Payer: Humana Medicare Advantage |
$1,137.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,104.81
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,104.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,104.81
|
|
|
COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK
|
Facility
|
OP
|
$4,007.70
|
|
|
Service Code
|
CPT G0121
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,049.57 |
| Max. Negotiated Rate |
$4,007.70 |
| Rate for Payer: Aetna Commercial |
$3,005.08
|
| Rate for Payer: Aetna Medicare Advantage |
$3,579.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,007.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,007.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,104.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,007.70
|
| Rate for Payer: Cigna Commercial |
$2,214.60
|
| Rate for Payer: Cigna Medicare Advantage |
$1,104.81
|
| Rate for Payer: Clover Medicare Advantage |
$1,049.57
|
| Rate for Payer: EmblemHealth Commercial |
$3,314.43
|
| Rate for Payer: Humana Medicare Advantage |
$1,137.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,104.81
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,104.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,104.81
|
|
|
COLOSTOMY
|
Facility
|
OP
|
$134,093.30
|
|
|
Service Code
|
HCPCS 44320
|
| Hospital Charge Code |
16000976
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,536.00 |
| Max. Negotiated Rate |
$67,046.65 |
| Rate for Payer: Aetna Commercial |
$50,955.45
|
| Rate for Payer: Aetna Medicare Advantage |
$40,227.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34,193.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34,193.79
|
| 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 |
$34,193.79
|
| Rate for Payer: Cigna Commercial |
$67,046.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34,864.26
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20,113.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4,237.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3,808.25
|
|
|
COLOSTOMY
|
Facility
|
IP
|
$134,093.30
|
|
|
Service Code
|
HCPCS 44320
|
| Hospital Charge Code |
16000976
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$20,113.99 |
| Max. Negotiated Rate |
$20,113.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20,113.99
|
|
|
COLP CERVIX W BX & CURETT
|
Facility
|
IP
|
$3,375.20
|
|
|
Service Code
|
HCPCS 57454
|
| Hospital Charge Code |
160000232
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$506.28 |
| Max. Negotiated Rate |
$506.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$506.28
|
|
|
COLP CERVIX W BX & CURETT
|
Facility
|
OP
|
$3,375.20
|
|
|
Service Code
|
HCPCS 57454
|
| Hospital Charge Code |
160000232
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$95.86 |
| 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 |
$877.55
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$506.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$106.66
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$362.03
|
| Rate for Payer: Wellcare Medicare Advantage |
$362.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$95.86
|
|
|
COLPOPEXY INTRAPERITONEAL
|
Facility
|
IP
|
$42,389.30
|
|
|
Service Code
|
HCPCS 57283
|
| Hospital Charge Code |
1600000762
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,358.40 |
| Max. Negotiated Rate |
$6,358.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,358.40
|
|
|
COLPOPEXY INTRAPERITONEAL
|
Facility
|
OP
|
$42,389.30
|
|
|
Service Code
|
HCPCS 57283
|
| Hospital Charge Code |
1600000762
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,203.86 |
| Max. Negotiated Rate |
$31,957.30 |
| Rate for Payer: Aetna Commercial |
$23,962.47
|
| Rate for Payer: Aetna Medicare Advantage |
$28,543.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31,957.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31,957.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,809.73
|
| 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 |
$31,957.30
|
| Rate for Payer: Cigna Commercial |
$17,659.09
|
| Rate for Payer: Cigna Medicare Advantage |
$8,809.73
|
| Rate for Payer: Clover Medicare Advantage |
$8,369.24
|
| Rate for Payer: EmblemHealth Commercial |
$26,429.19
|
| Rate for Payer: Humana Medicare Advantage |
$9,074.02
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,809.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,021.22
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,358.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,339.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,809.73
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,809.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,203.86
|
|
|
COLPOPEXY LAPAROSCOPY
|
Facility
|
OP
|
$44,535.70
|
|
|
Service Code
|
HCPCS 57425
|
| Hospital Charge Code |
1600000793
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,264.81 |
| Max. Negotiated Rate |
$45,809.96 |
| Rate for Payer: Aetna Commercial |
$34,349.57
|
| Rate for Payer: Aetna Medicare Advantage |
$40,916.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$45,809.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$45,809.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12,628.52
|
| 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 |
$45,809.96
|
| Rate for Payer: Cigna Commercial |
$25,313.84
|
| Rate for Payer: Cigna Medicare Advantage |
$12,628.52
|
| Rate for Payer: Clover Medicare Advantage |
$11,997.09
|
| Rate for Payer: EmblemHealth Commercial |
$37,885.56
|
| Rate for Payer: Humana Medicare Advantage |
$13,007.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12,628.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,579.28
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,680.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,407.33
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12,628.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$12,628.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,264.81
|
|
|
COLPOPEXY LAPAROSCOPY
|
Facility
|
IP
|
$44,535.70
|
|
|
Service Code
|
HCPCS 57425
|
| Hospital Charge Code |
1600000793
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,680.35 |
| Max. Negotiated Rate |
$6,680.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,680.35
|
|
|
COLPOSCOPY
|
Facility
|
IP
|
$669.00
|
|
|
Service Code
|
HCPCS 57452
|
| Hospital Charge Code |
87502580
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$100.35 |
| Max. Negotiated Rate |
$100.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.35
|
|
|
COLPOSCOPY
|
Facility
|
OP
|
$669.00
|
|
|
Service Code
|
HCPCS 57452
|
| Hospital Charge Code |
87502580
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.00 |
| 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 |
$67.42
|
| 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 |
$133.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$133.80
|
| 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
|
|
