|
CT SINUS W/ CONTRAST
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70487
|
| Hospital Charge Code |
2205426
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$145.87 |
| Max. Negotiated Rate |
$3,916.00 |
| Rate for Payer: Aetna Commercial |
$566.79
|
| Rate for Payer: Aetna Medicare Advantage |
$675.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$755.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$755.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$208.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$206.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$755.90
|
| Rate for Payer: Cigna Commercial |
$417.70
|
| Rate for Payer: Cigna Medicare Advantage |
$145.87
|
| Rate for Payer: Clover Medicare Advantage |
$197.96
|
| Rate for Payer: EmblemHealth Commercial |
$625.14
|
| Rate for Payer: Humana Medicare Advantage |
$214.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$208.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,470.00
|
| Rate for Payer: Oxford Commercial |
$3,774.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,916.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$269.80
|
|
|
CT SINUS W/ CONTRAST
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70487
|
| Hospital Charge Code |
2205426
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT SINUS W HEADSET
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70486
|
| Hospital Charge Code |
2250423
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$86.94 |
| Max. Negotiated Rate |
$3,916.00 |
| 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 |
$226.88
|
| 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 |
$2,470.00
|
| Rate for Payer: Oxford Commercial |
$3,774.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,916.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$269.80
|
|
|
CT SINUS W HEADSET
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70486
|
| Hospital Charge Code |
2250423
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT SINUS W/O HEADSET
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70486
|
| Hospital Charge Code |
2250422
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT SINUS W/O HEADSET
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70486
|
| Hospital Charge Code |
2250422
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$86.94 |
| Max. Negotiated Rate |
$3,916.00 |
| 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 |
$226.88
|
| 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 |
$2,470.00
|
| Rate for Payer: Oxford Commercial |
$3,774.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,916.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$269.80
|
|
|
CT SOFT TIISUE NECK W CONT
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70491
|
| Hospital Charge Code |
2205288
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT SOFT TIISUE NECK W CONT
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70491
|
| Hospital Charge Code |
2205288
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$145.87 |
| Max. Negotiated Rate |
$3,916.00 |
| Rate for Payer: Aetna Commercial |
$566.79
|
| Rate for Payer: Aetna Medicare Advantage |
$675.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$755.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$755.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$208.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$243.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$755.90
|
| Rate for Payer: Cigna Commercial |
$417.70
|
| Rate for Payer: Cigna Medicare Advantage |
$145.87
|
| Rate for Payer: Clover Medicare Advantage |
$197.96
|
| Rate for Payer: EmblemHealth Commercial |
$625.14
|
| Rate for Payer: Humana Medicare Advantage |
$214.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$208.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,470.00
|
| Rate for Payer: Oxford Commercial |
$3,774.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,916.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$269.80
|
|
|
CT SOFT TISSUE NECK W & WO CON
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70492
|
| Hospital Charge Code |
2205290
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT SOFT TISSUE NECK W & WO CON
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 70492
|
| Hospital Charge Code |
2205290
|
|
Hospital Revenue Code
|
351
|
| Min. Negotiated Rate |
$145.87 |
| Max. Negotiated Rate |
$3,916.00 |
| Rate for Payer: Aetna Commercial |
$566.79
|
| Rate for Payer: Aetna Medicare Advantage |
$675.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$755.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$755.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$208.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$288.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$755.90
|
| Rate for Payer: Cigna Commercial |
$417.70
|
| Rate for Payer: Cigna Medicare Advantage |
$145.87
|
| Rate for Payer: Clover Medicare Advantage |
$197.96
|
| Rate for Payer: EmblemHealth Commercial |
$625.14
|
| Rate for Payer: Humana Medicare Advantage |
$214.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$208.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,470.00
|
| Rate for Payer: Oxford Commercial |
$3,774.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,916.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$269.80
|
|
|
CT THORACENTESIS FOR ASP INIT
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2205144
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$269.80 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,703.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,703.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| 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 |
$2,703.39
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,470.00
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$269.80
|
|
|
CT THORACENTESIS FOR ASP INIT
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
2205144
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT THORACIC SPINE W/CONTR
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 72129
|
| Hospital Charge Code |
2205151
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$145.87 |
| Max. Negotiated Rate |
$3,916.00 |
| Rate for Payer: Aetna Commercial |
$566.79
|
| Rate for Payer: Aetna Medicare Advantage |
$675.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$755.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$755.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$208.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$280.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$755.90
|
| Rate for Payer: Cigna Commercial |
$417.70
|
| Rate for Payer: Cigna Medicare Advantage |
$145.87
|
| Rate for Payer: Clover Medicare Advantage |
$197.96
|
| Rate for Payer: EmblemHealth Commercial |
$625.14
|
| Rate for Payer: Humana Medicare Advantage |
$214.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$208.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,470.00
|
| Rate for Payer: Oxford Commercial |
$3,774.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,916.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$958.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$269.80
|
|
|
CT THORACIC SPINE W/CONTR
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 72129
|
| Hospital Charge Code |
2205151
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT THORACIC SPINE W/O CONTR
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 72128
|
| Hospital Charge Code |
2200129
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$86.94 |
| Max. Negotiated Rate |
$3,916.00 |
| 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 |
$206.25
|
| 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 |
$2,470.00
|
| Rate for Payer: Oxford Commercial |
$3,774.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,916.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$407.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$269.80
|
|
|
CT THORACIC SPINE W/O CONTR
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 72128
|
| Hospital Charge Code |
2200129
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT THORACIC SPINE W & WO CONT
|
Facility
|
OP
|
$1,984.00
|
|
|
Service Code
|
HCPCS 72130
|
| Hospital Charge Code |
2205286
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$56.35 |
| Max. Negotiated Rate |
$3,916.00 |
| Rate for Payer: Aetna Commercial |
$566.79
|
| Rate for Payer: Aetna Medicare Advantage |
$675.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$755.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$755.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$208.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$288.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$755.90
|
| Rate for Payer: Cigna Commercial |
$417.70
|
| Rate for Payer: Cigna Medicare Advantage |
$145.87
|
| Rate for Payer: Clover Medicare Advantage |
$197.96
|
| Rate for Payer: EmblemHealth Commercial |
$625.14
|
| Rate for Payer: Humana Medicare Advantage |
$214.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$208.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$515.84
|
| Rate for Payer: Oxford Commercial |
$3,774.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$297.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,916.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$62.69
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$208.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$56.35
|
|
|
CT THORACIC SPINE W & WO CONT
|
Facility
|
IP
|
$1,984.00
|
|
|
Service Code
|
HCPCS 72130
|
| Hospital Charge Code |
2205286
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$297.60 |
| Max. Negotiated Rate |
$297.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$297.60
|
|
|
CT THORAX LUNG CA SCR
|
Facility
|
OP
|
$488.65
|
|
|
Service Code
|
HCPCS 71271
|
| Hospital Charge Code |
404371271
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$13.88 |
| Max. Negotiated Rate |
$3,916.00 |
| 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 |
$131.44
|
| 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 |
$127.05
|
| Rate for Payer: Oxford Commercial |
$3,774.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$73.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,916.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.88
|
|
|
CT THORAX LUNG CA SCR
|
Facility
|
IP
|
$488.65
|
|
|
Service Code
|
HCPCS 71271
|
| Hospital Charge Code |
404371271
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$73.30 |
| Max. Negotiated Rate |
$73.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$73.30
|
|
|
CT THYROID BIOPSY PERC CORE
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
2101142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$269.80 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,288.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,725.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,051.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$841.28
|
| 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 |
$3,051.74
|
| Rate for Payer: Cigna Commercial |
$1,686.34
|
| Rate for Payer: Cigna Medicare Advantage |
$841.28
|
| Rate for Payer: Clover Medicare Advantage |
$799.22
|
| Rate for Payer: EmblemHealth Commercial |
$2,523.84
|
| Rate for Payer: Humana Medicare Advantage |
$866.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$841.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,470.00
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$269.80
|
|
|
CT THYROID BIOPSY PERC CORE
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 60100
|
| Hospital Charge Code |
2101142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
CT TISSUE ABLATION MONITORING
|
Facility
|
IP
|
$1,605.00
|
|
|
Service Code
|
HCPCS 77013
|
| Hospital Charge Code |
2690275
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$240.75 |
| Max. Negotiated Rate |
$240.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.75
|
|
|
CT TISSUE ABLATION MONITORING
|
Facility
|
OP
|
$1,605.00
|
|
|
Service Code
|
HCPCS 77013
|
| Hospital Charge Code |
2690275
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$3,916.00 |
| Rate for Payer: Aetna Commercial |
$609.90
|
| Rate for Payer: Aetna Medicare Advantage |
$481.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$409.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$409.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$71.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$409.27
|
| Rate for Payer: Cigna Commercial |
$802.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$417.30
|
| Rate for Payer: Oxford Commercial |
$3,774.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$240.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,916.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.58
|
|
|
CT TX PROX HUMERAL FX,W MANIP
|
Facility
|
OP
|
$14,872.30
|
|
|
Service Code
|
HCPCS 23605
|
| Hospital Charge Code |
1600000531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$422.37 |
| Max. Negotiated Rate |
$8,192.00 |
| Rate for Payer: Aetna Commercial |
$5,196.12
|
| Rate for Payer: Aetna Medicare Advantage |
$6,189.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,910.34
|
| 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 |
$6,929.76
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: Cigna Medicare Advantage |
$1,910.34
|
| Rate for Payer: Clover Medicare Advantage |
$1,814.82
|
| Rate for Payer: EmblemHealth Commercial |
$5,731.02
|
| Rate for Payer: Humana Medicare Advantage |
$1,967.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,910.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,866.80
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,230.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$469.96
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$422.37
|
|
