|
DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$33,334.20
|
|
|
Service Code
|
MSDRG 442
|
| Min. Negotiated Rate |
$10,149.84 |
| Max. Negotiated Rate |
$33,334.20 |
| Rate for Payer: Aetna Commercial |
$23,161.72
|
| Rate for Payer: Aetna Medicare Advantage |
$33,334.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22,097.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22,097.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10,684.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22,097.95
|
| Rate for Payer: Cigna Commercial |
$18,064.62
|
| Rate for Payer: Cigna Medicare Advantage |
$10,684.04
|
| Rate for Payer: Clover Medicare Advantage |
$10,149.84
|
| Rate for Payer: EmblemHealth Commercial |
$32,052.12
|
| Rate for Payer: Humana Medicare Advantage |
$11,004.56
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10,684.04
|
| Rate for Payer: Oxford Commercial |
$12,983.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$22,766.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10,684.04
|
| Rate for Payer: Wellcare Medicare Advantage |
$10,684.04
|
|
|
DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$60,141.74
|
|
|
Service Code
|
MSDRG 441
|
| Min. Negotiated Rate |
$18,312.39 |
| Max. Negotiated Rate |
$60,141.74 |
| Rate for Payer: Aetna Commercial |
$41,581.56
|
| Rate for Payer: Aetna Medicare Advantage |
$60,141.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42,567.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42,567.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$19,276.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42,567.63
|
| Rate for Payer: Cigna Commercial |
$33,586.02
|
| Rate for Payer: Cigna Medicare Advantage |
$19,276.20
|
| Rate for Payer: Clover Medicare Advantage |
$18,312.39
|
| Rate for Payer: EmblemHealth Commercial |
$57,828.60
|
| Rate for Payer: Humana Medicare Advantage |
$19,854.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$19,276.20
|
| Rate for Payer: Oxford Commercial |
$24,138.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$42,328.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$19,276.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$19,276.20
|
|
|
DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$24,749.59
|
|
|
Service Code
|
MSDRG 443
|
| Min. Negotiated Rate |
$7,535.93 |
| Max. Negotiated Rate |
$24,749.59 |
| Rate for Payer: Aetna Commercial |
$17,263.11
|
| Rate for Payer: Aetna Medicare Advantage |
$24,749.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,515.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,515.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,932.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16,515.31
|
| Rate for Payer: Cigna Commercial |
$13,094.19
|
| Rate for Payer: Cigna Medicare Advantage |
$7,932.56
|
| Rate for Payer: Clover Medicare Advantage |
$7,535.93
|
| Rate for Payer: EmblemHealth Commercial |
$23,797.68
|
| Rate for Payer: Humana Medicare Advantage |
$8,170.54
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,932.56
|
| Rate for Payer: Oxford Commercial |
$9,410.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,502.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,932.56
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,932.56
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$6,573.81
|
|
|
Service Code
|
APR-DRG 2821
|
| Min. Negotiated Rate |
$6,444.91 |
| Max. Negotiated Rate |
$6,573.81 |
| Rate for Payer: UnitedHealthcare Community & State |
$6,444.91
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$6,573.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6,444.91
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$8,502.90
|
|
|
Service Code
|
APR-DRG 2822
|
| Min. Negotiated Rate |
$8,336.18 |
| Max. Negotiated Rate |
$8,502.90 |
| Rate for Payer: UnitedHealthcare Community & State |
$8,336.18
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$8,502.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8,336.18
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$28,717.03
|
|
|
Service Code
|
APR-DRG 2824
|
| Min. Negotiated Rate |
$28,153.95 |
| Max. Negotiated Rate |
$28,717.03 |
| Rate for Payer: UnitedHealthcare Community & State |
$28,153.95
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$28,717.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28,153.95
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$13,137.37
|
|
|
Service Code
|
APR-DRG 2823
|
| Min. Negotiated Rate |
$12,879.77 |
| Max. Negotiated Rate |
$13,137.37 |
| Rate for Payer: UnitedHealthcare Community & State |
$12,879.77
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$13,137.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12,879.77
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC
|
Facility
|
IP
|
$29,323.04
|
|
|
Service Code
|
MSDRG 439
|
| Min. Negotiated Rate |
$8,928.49 |
| Max. Negotiated Rate |
$29,323.04 |
| Rate for Payer: Aetna Commercial |
$20,405.60
|
| Rate for Payer: Aetna Medicare Advantage |
$29,323.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20,004.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20,004.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9,398.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20,004.46
|
| Rate for Payer: Cigna Commercial |
$15,742.22
|
| Rate for Payer: Cigna Medicare Advantage |
$9,398.41
|
| Rate for Payer: Clover Medicare Advantage |
$8,928.49
|
| Rate for Payer: EmblemHealth Commercial |
$28,195.23
|
| Rate for Payer: Humana Medicare Advantage |
$9,680.36
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9,398.41
|
| Rate for Payer: Oxford Commercial |
$11,314.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$19,839.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9,398.41
|
| Rate for Payer: Wellcare Medicare Advantage |
$9,398.41
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC
|
Facility
|
IP
|
$54,824.83
|
|
|
Service Code
|
MSDRG 438
|
| Min. Negotiated Rate |
$16,693.46 |
| Max. Negotiated Rate |
$54,824.83 |
| Rate for Payer: Aetna Commercial |
$37,928.22
|
| Rate for Payer: Aetna Medicare Advantage |
$54,824.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38,845.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38,845.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,572.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38,845.87
|
| Rate for Payer: Cigna Commercial |
$30,507.56
|
| Rate for Payer: Cigna Medicare Advantage |
$17,572.06
|
| Rate for Payer: Clover Medicare Advantage |
$16,693.46
|
| Rate for Payer: EmblemHealth Commercial |
$52,716.18
|
| Rate for Payer: Humana Medicare Advantage |
$18,099.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,572.06
|
| Rate for Payer: Oxford Commercial |
$21,926.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$38,448.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,572.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,572.06
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$22,218.77
|
|
|
Service Code
|
MSDRG 440
|
| Min. Negotiated Rate |
$6,765.33 |
| Max. Negotiated Rate |
$22,218.77 |
| Rate for Payer: Aetna Commercial |
$15,524.16
|
| Rate for Payer: Aetna Medicare Advantage |
$22,218.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,421.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,421.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,121.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14,421.82
|
| Rate for Payer: Cigna Commercial |
$11,628.88
|
| Rate for Payer: Cigna Medicare Advantage |
$7,121.40
|
| Rate for Payer: Clover Medicare Advantage |
$6,765.33
|
| Rate for Payer: EmblemHealth Commercial |
$21,364.20
|
| Rate for Payer: Humana Medicare Advantage |
$7,335.04
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,121.40
|
| Rate for Payer: Oxford Commercial |
$8,357.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,655.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,121.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,121.40
|
|
|
DISORDERS OF PERSONALITY AND IMPULSE CONTROL
|
Facility
|
IP
|
$65,688.17
|
|
|
Service Code
|
MSDRG 883
|
| Min. Negotiated Rate |
$3,330.00 |
| Max. Negotiated Rate |
$65,688.17 |
| Rate for Payer: Aetna Commercial |
$45,392.58
|
| Rate for Payer: Aetna Medicare Advantage |
$65,688.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43,730.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,606.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,330.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43,730.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,053.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43,730.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,606.00
|
| Rate for Payer: Cigna Commercial |
$36,797.34
|
| Rate for Payer: Cigna Medicare Advantage |
$21,053.90
|
| Rate for Payer: Clover Medicare Advantage |
$20,001.21
|
| Rate for Payer: EmblemHealth Commercial |
$63,161.70
|
| Rate for Payer: Humana Medicare Advantage |
$21,685.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,053.90
|
| Rate for Payer: Oxford Commercial |
$26,446.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$46,375.19
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,053.90
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,053.90
|
|
|
DISORDERS OF THE BILIARY TRACT WITH CC
|
Facility
|
IP
|
$37,506.92
|
|
|
Service Code
|
MSDRG 445
|
| Min. Negotiated Rate |
$11,420.38 |
| Max. Negotiated Rate |
$37,506.92 |
| Rate for Payer: Aetna Commercial |
$26,028.88
|
| Rate for Payer: Aetna Medicare Advantage |
$37,506.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,354.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,354.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12,021.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25,354.49
|
| Rate for Payer: Cigna Commercial |
$20,480.60
|
| Rate for Payer: Cigna Medicare Advantage |
$12,021.45
|
| Rate for Payer: Clover Medicare Advantage |
$11,420.38
|
| Rate for Payer: EmblemHealth Commercial |
$36,064.35
|
| Rate for Payer: Humana Medicare Advantage |
$12,382.09
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12,021.45
|
| Rate for Payer: Oxford Commercial |
$14,719.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$25,811.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12,021.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$12,021.45
|
|
|
DISORDERS OF THE BILIARY TRACT WITH MCC
|
Facility
|
IP
|
$56,140.28
|
|
|
Service Code
|
MSDRG 444
|
| Min. Negotiated Rate |
$17,094.00 |
| Max. Negotiated Rate |
$56,140.28 |
| Rate for Payer: Aetna Commercial |
$38,832.09
|
| Rate for Payer: Aetna Medicare Advantage |
$56,140.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37,915.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37,915.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,993.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37,915.43
|
| Rate for Payer: Cigna Commercial |
$31,269.22
|
| Rate for Payer: Cigna Medicare Advantage |
$17,993.68
|
| Rate for Payer: Clover Medicare Advantage |
$17,094.00
|
| Rate for Payer: EmblemHealth Commercial |
$53,981.04
|
| Rate for Payer: Humana Medicare Advantage |
$18,533.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,993.68
|
| Rate for Payer: Oxford Commercial |
$22,473.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$39,408.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,993.68
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,993.68
|
|
|
DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC
|
Facility
|
IP
|
$28,873.76
|
|
|
Service Code
|
MSDRG 446
|
| Min. Negotiated Rate |
$8,791.69 |
| Max. Negotiated Rate |
$28,873.76 |
| Rate for Payer: Aetna Commercial |
$20,096.90
|
| Rate for Payer: Aetna Medicare Advantage |
$28,873.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18,608.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18,608.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9,254.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18,608.80
|
| Rate for Payer: Cigna Commercial |
$15,482.09
|
| Rate for Payer: Cigna Medicare Advantage |
$9,254.41
|
| Rate for Payer: Clover Medicare Advantage |
$8,791.69
|
| Rate for Payer: EmblemHealth Commercial |
$27,763.23
|
| Rate for Payer: Humana Medicare Advantage |
$9,532.04
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9,254.41
|
| Rate for Payer: Oxford Commercial |
$11,127.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$19,511.87
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9,254.41
|
| Rate for Payer: Wellcare Medicare Advantage |
$9,254.41
|
|
|
DISOSABLE I&A HAND PIECE
|
Facility
|
IP
|
$311.00
|
|
| Hospital Charge Code |
270331531
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.65 |
| Max. Negotiated Rate |
$46.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
|
|
DISOSABLE I&A HAND PIECE
|
Facility
|
OP
|
$311.00
|
|
| Hospital Charge Code |
270331531
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.50 |
| Max. Negotiated Rate |
$155.50 |
| Rate for Payer: Aetna Commercial |
$118.18
|
| Rate for Payer: Aetna Medicare Advantage |
$93.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.31
|
| Rate for Payer: Cigna Commercial |
$155.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$93.30
|
| Rate for Payer: Oxford Commercial |
$62.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.24
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
IP
|
$1,519.25
|
|
| Hospital Charge Code |
270704864
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$227.89 |
| Max. Negotiated Rate |
$227.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
OP
|
$1,416.25
|
|
| Hospital Charge Code |
270704865
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$34.13 |
| Max. Negotiated Rate |
$708.12 |
| Rate for Payer: Aetna Commercial |
$538.17
|
| Rate for Payer: Aetna Medicare Advantage |
$424.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$361.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$361.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$361.14
|
| Rate for Payer: Cigna Commercial |
$708.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$424.88
|
| Rate for Payer: Oxford Commercial |
$283.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$212.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$283.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$37.53
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
IP
|
$1,416.25
|
|
| Hospital Charge Code |
270704865
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$212.44 |
| Max. Negotiated Rate |
$212.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$212.44
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
OP
|
$1,519.25
|
|
| Hospital Charge Code |
270704864
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$36.61 |
| Max. Negotiated Rate |
$759.62 |
| Rate for Payer: Aetna Commercial |
$577.32
|
| Rate for Payer: Aetna Medicare Advantage |
$455.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$387.41
|
| Rate for Payer: Cigna Commercial |
$759.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$455.77
|
| Rate for Payer: Oxford Commercial |
$303.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$303.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$36.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40.26
|
|
|
DISP MASK 7429
|
Facility
|
IP
|
$1,102.75
|
|
| Hospital Charge Code |
270656311
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$165.41 |
| Max. Negotiated Rate |
$165.41 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.41
|
|
|
DISP MASK 7429
|
Facility
|
OP
|
$1,102.75
|
|
| Hospital Charge Code |
270656311
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$26.58 |
| Max. Negotiated Rate |
$551.38 |
| Rate for Payer: Aetna Commercial |
$419.05
|
| Rate for Payer: Aetna Medicare Advantage |
$330.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$281.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$281.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$281.20
|
| Rate for Payer: Cigna Commercial |
$551.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$330.82
|
| Rate for Payer: Oxford Commercial |
$220.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.41
|
| Rate for Payer: UnitedHealthcare Commercial |
$220.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$26.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29.22
|
|
|
DISP.MIXING BOWL W/SPATULA
|
Facility
|
IP
|
$75.00
|
|
| Hospital Charge Code |
270331843
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$11.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.25
|
|
|
DISP.MIXING BOWL W/SPATULA
|
Facility
|
OP
|
$75.00
|
|
| Hospital Charge Code |
270331843
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.81 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Aetna Commercial |
$28.50
|
| Rate for Payer: Aetna Medicare Advantage |
$22.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.12
|
| Rate for Payer: Cigna Commercial |
$37.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.50
|
| Rate for Payer: Oxford Commercial |
$15.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.99
|
|
|
DISPOSABLE ACCESSORY KIT,3 ARM
|
Facility
|
OP
|
$5,000.00
|
|
| Hospital Charge Code |
270664012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$120.50 |
| Max. Negotiated Rate |
$2,500.00 |
| Rate for Payer: Aetna Commercial |
$1,900.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,500.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,275.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,275.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,275.00
|
| Rate for Payer: Cigna Commercial |
$2,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,500.00
|
| Rate for Payer: Oxford Commercial |
$1,000.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$750.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,000.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$120.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$132.50
|
|
