|
ER CL TX TIB FX PROX W/O MAN
|
Facility
|
IP
|
$563.75
|
|
|
Service Code
|
HCPCS 27530
|
| Hospital Charge Code |
5700593
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.56 |
| Max. Negotiated Rate |
$84.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
|
|
ER CL TX TIB FX RPOX W/O MAN
|
Facility
|
IP
|
$1,268.90
|
|
|
Service Code
|
HCPCS 27550
|
| Hospital Charge Code |
5700594
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$190.34 |
| Max. Negotiated Rate |
$190.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$190.34
|
|
|
ER CL TX TIB FX RPOX W/O MAN
|
Facility
|
OP
|
$1,268.90
|
|
|
Service Code
|
HCPCS 27550
|
| Hospital Charge Code |
5700594
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$33.63 |
| Max. Negotiated Rate |
$1,057.82 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$364.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,057.82
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$380.67
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$190.34
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.63
|
|
|
ER CL TX TIB SH FX W/O MAN
|
Facility
|
OP
|
$563.75
|
|
|
Service Code
|
HCPCS 27750
|
| Hospital Charge Code |
5700595
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.94 |
| Max. Negotiated Rate |
$1,057.82 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$277.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,057.82
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.94
|
|
|
ER CL TX TIB SH FX W/O MAN
|
Facility
|
IP
|
$563.75
|
|
|
Service Code
|
HCPCS 27750
|
| Hospital Charge Code |
5700595
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.56 |
| Max. Negotiated Rate |
$84.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
|
|
ER CL TX TOE FX W/O MANI EACH
|
Facility
|
IP
|
$563.75
|
|
|
Service Code
|
HCPCS 28510
|
| Hospital Charge Code |
5700610
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.56 |
| Max. Negotiated Rate |
$84.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
|
|
ER CL TX TOE FX W/O MANI EACH
|
Facility
|
OP
|
$563.75
|
|
|
Service Code
|
HCPCS 28510
|
| Hospital Charge Code |
5700610
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.94 |
| Max. Negotiated Rate |
$1,057.82 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$73.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,057.82
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.94
|
|
|
ER CL TX TRIMAL ANKLE FX W/MAN
|
Facility
|
OP
|
$563.75
|
|
|
Service Code
|
HCPCS 27818
|
| Hospital Charge Code |
5700606
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.94 |
| Max. Negotiated Rate |
$6,895.75 |
| 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 |
$6,895.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,895.75
|
| 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 |
$412.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,895.75
|
| 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 |
$169.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| 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 |
$14.94
|
|
|
ER CL TX TRIMAL ANKLE FX W/MAN
|
Facility
|
IP
|
$563.75
|
|
|
Service Code
|
HCPCS 27818
|
| Hospital Charge Code |
5700606
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.56 |
| Max. Negotiated Rate |
$84.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
|
|
ER CL TX TRIMAL ANKLE FX W/O M
|
Facility
|
IP
|
$563.75
|
|
|
Service Code
|
HCPCS 27816
|
| Hospital Charge Code |
5700605
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.56 |
| Max. Negotiated Rate |
$84.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
|
|
ER CL TX TRIMAL ANKLE FX W/O M
|
Facility
|
OP
|
$563.75
|
|
|
Service Code
|
HCPCS 27816
|
| Hospital Charge Code |
5700605
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.94 |
| Max. Negotiated Rate |
$1,057.82 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$252.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,057.82
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.94
|
|
|
ER CL TX ULNAR FX PROX W/O ANE
|
Facility
|
IP
|
$563.75
|
|
|
Service Code
|
HCPCS 24670
|
| Hospital Charge Code |
5700564
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.56 |
| Max. Negotiated Rate |
$84.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
|
|
ER CL TX ULNAR FX PROX W/O ANE
|
Facility
|
OP
|
$563.75
|
|
|
Service Code
|
HCPCS 24670
|
| Hospital Charge Code |
5700564
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.94 |
| Max. Negotiated Rate |
$1,057.82 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$93.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,057.82
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.94
|
|
|
ER CL TX ULNAR SHAFT FX W/O AN
|
Facility
|
IP
|
$563.75
|
|
|
Service Code
|
HCPCS 25530
|
| Hospital Charge Code |
5700565
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$84.56 |
| Max. Negotiated Rate |
$84.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
|
|
ER CL TX ULNAR SHAFT FX W/O AN
|
Facility
|
OP
|
$563.75
|
|
|
Service Code
|
HCPCS 25530
|
| Hospital Charge Code |
5700565
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.94 |
| Max. Negotiated Rate |
$1,057.82 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,057.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$187.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,057.82
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$169.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$84.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.94
|
|
|
ER CMP RPR SCA/ARM/LEG 1.1-2.5
|
Facility
|
OP
|
$1,723.35
|
|
|
Service Code
|
HCPCS 13120
|
| Hospital Charge Code |
5700717
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$45.67 |
| Max. Negotiated Rate |
$1,743.30 |
| Rate for Payer: Aetna Commercial |
$1,313.62
|
| Rate for Payer: Aetna Medicare Advantage |
$1,564.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,743.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,743.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$482.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$195.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,743.30
|
| Rate for Payer: Cigna Commercial |
$968.07
|
| Rate for Payer: Cigna Medicare Advantage |
$482.95
|
| Rate for Payer: Clover Medicare Advantage |
$458.80
|
| Rate for Payer: EmblemHealth Commercial |
$1,448.85
|
| Rate for Payer: Humana Medicare Advantage |
$497.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$482.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$517.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45.67
|
|
|
ER CMP RPR SCA/ARM/LEG 1.1-2.5
|
Facility
|
IP
|
$1,723.35
|
|
|
Service Code
|
HCPCS 13120
|
| Hospital Charge Code |
5700717
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$258.50 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$258.50
|
|
|
ER CMP RPR SCA/ARM/LEG 2.6-7.5
|
Facility
|
IP
|
$2,974.62
|
|
|
Service Code
|
HCPCS 13121
|
| Hospital Charge Code |
5700455
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$446.19 |
| Max. Negotiated Rate |
$446.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$446.19
|
|
|
ER CMP RPR SCA/ARM/LEG 2.6-7.5
|
Facility
|
OP
|
$2,974.62
|
|
|
Service Code
|
HCPCS 13121
|
| Hospital Charge Code |
5700455
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$78.83 |
| Max. Negotiated Rate |
$1,743.30 |
| Rate for Payer: Aetna Commercial |
$1,313.62
|
| Rate for Payer: Aetna Medicare Advantage |
$1,564.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,743.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,743.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$482.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$307.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,743.30
|
| Rate for Payer: Cigna Commercial |
$968.07
|
| Rate for Payer: Cigna Medicare Advantage |
$482.95
|
| Rate for Payer: Clover Medicare Advantage |
$458.80
|
| Rate for Payer: EmblemHealth Commercial |
$1,448.85
|
| Rate for Payer: Humana Medicare Advantage |
$497.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$482.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$892.39
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$446.19
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$482.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$78.83
|
|
|
ER COLL BLOOD VAD IMPLANT
|
Facility
|
OP
|
$694.20
|
|
|
Service Code
|
HCPCS 36591
|
| Hospital Charge Code |
5700781
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$850.00 |
| 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 |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$570.55
|
| 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) PPO |
$570.55
|
| 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 |
$208.26
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.40
|
|
|
ER COLL BLOOD VAD IMPLANT
|
Facility
|
IP
|
$694.20
|
|
|
Service Code
|
HCPCS 36591
|
| Hospital Charge Code |
5700781
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$104.13 |
| Max. Negotiated Rate |
$104.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.13
|
|
|
ER COLLECTION CAP BLOOD SPEC
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
HCPCS 36416
|
| Hospital Charge Code |
5700831
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$0.37 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$5.32
|
| Rate for Payer: Aetna Medicare Advantage |
$4.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.57
|
| Rate for Payer: Cigna Commercial |
$7.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.37
|
|
|
ER COLLECTION CAP BLOOD SPEC
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
HCPCS 36416
|
| Hospital Charge Code |
5700831
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2.10 |
| Max. Negotiated Rate |
$2.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.10
|
|
|
ER-COMPLEX ANYAREA>7.5CM
|
Facility
|
IP
|
$5,095.00
|
|
|
Service Code
|
HCPCS 13160
|
| Hospital Charge Code |
5790015
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$764.25 |
| Max. Negotiated Rate |
$764.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$764.25
|
|
|
ER-COMPLEX ANYAREA>7.5CM
|
Facility
|
OP
|
$5,095.00
|
|
|
Service Code
|
HCPCS 13160
|
| Hospital Charge Code |
5790015
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$135.02 |
| Max. Negotiated Rate |
$15,196.98 |
| Rate for Payer: Aetna Commercial |
$11,451.31
|
| Rate for Payer: Aetna Medicare Advantage |
$13,640.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,196.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,196.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,210.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$491.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15,196.98
|
| Rate for Payer: Cigna Commercial |
$8,439.01
|
| Rate for Payer: Cigna Medicare Advantage |
$4,210.04
|
| Rate for Payer: Clover Medicare Advantage |
$3,999.54
|
| Rate for Payer: EmblemHealth Commercial |
$12,630.12
|
| Rate for Payer: Humana Medicare Advantage |
$4,336.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,210.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,528.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$764.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,210.04
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,210.04
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$5,165.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$135.02
|
|