|
ERCP W/REM FB/CHANGE OF TUBE**
|
Facility
|
IP
|
$1,289.00
|
|
| Hospital Charge Code |
2300016
|
|
Hospital Revenue Code
|
759
|
| Min. Negotiated Rate |
$193.35 |
| Max. Negotiated Rate |
$193.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$193.35
|
|
|
ERCP W/REM FB/CHANGE OF TUBE**
|
Facility
|
OP
|
$1,289.00
|
|
| Hospital Charge Code |
2300016
|
|
Hospital Revenue Code
|
759
|
| Min. Negotiated Rate |
$31.06 |
| Max. Negotiated Rate |
$644.50 |
| Rate for Payer: Aetna Commercial |
$489.82
|
| Rate for Payer: Aetna Medicare Advantage |
$386.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$328.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$328.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$328.69
|
| Rate for Payer: Cigna Commercial |
$644.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$386.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$193.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$34.16
|
|
|
ERCP W/REMOVAL OF STONE***
|
Facility
|
OP
|
$218.00
|
|
|
Service Code
|
HCPCS 53265
|
| Hospital Charge Code |
2300879
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$8,964.44 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,016.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,964.44
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.40
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.25
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.78
|
|
|
ERCP W/REMOVAL OF STONE***
|
Facility
|
IP
|
$218.00
|
|
|
Service Code
|
HCPCS 53265
|
| Hospital Charge Code |
2300879
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$32.70 |
| Max. Negotiated Rate |
$32.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.70
|
|
|
ERCP W/SPECIMEN COLLECTION
|
Facility
|
OP
|
$10,176.05
|
|
|
Service Code
|
HCPCS 43260
|
| Hospital Charge Code |
1600000613
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$245.24 |
| Max. Negotiated Rate |
$16,533.87 |
| Rate for Payer: Aetna Commercial |
$12,458.69
|
| Rate for Payer: Aetna Medicare Advantage |
$14,840.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,533.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,533.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,580.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,016.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16,533.87
|
| Rate for Payer: Cigna Commercial |
$9,181.40
|
| Rate for Payer: Cigna Medicare Advantage |
$4,580.40
|
| Rate for Payer: Clover Medicare Advantage |
$4,351.38
|
| Rate for Payer: EmblemHealth Commercial |
$13,741.20
|
| Rate for Payer: Humana Medicare Advantage |
$4,717.81
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,580.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,052.82
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,526.41
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$245.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,580.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,580.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$269.67
|
|
|
ERCP W/SPECIMEN COLLECTION
|
Facility
|
IP
|
$10,176.05
|
|
|
Service Code
|
HCPCS 43260
|
| Hospital Charge Code |
1600000613
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,526.41 |
| Max. Negotiated Rate |
$1,526.41 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,526.41
|
|
|
ER CRITICAL CARE 1ST HOUR
|
Facility
|
OP
|
$10,659.26
|
|
|
Service Code
|
HCPCS 99291
|
| Hospital Charge Code |
5700030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$3,833.00 |
| Rate for Payer: Aetna Commercial |
$2,669.24
|
| Rate for Payer: Aetna Medicare Advantage |
$3,179.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,542.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,542.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$981.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$486.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,542.34
|
| Rate for Payer: Cigna Commercial |
$1,967.11
|
| Rate for Payer: Cigna Medicare Advantage |
$981.34
|
| Rate for Payer: Clover Medicare Advantage |
$932.27
|
| Rate for Payer: EmblemHealth Commercial |
$2,944.02
|
| Rate for Payer: Humana Medicare Advantage |
$1,010.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$981.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,197.78
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Oxford Commercial |
$2,186.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,598.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,833.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$981.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$981.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$450.00
|
|
|
ER CRITICAL CARE 1ST HOUR
|
Facility
|
IP
|
$10,659.26
|
|
|
Service Code
|
HCPCS 99291
|
| Hospital Charge Code |
5700030
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,598.89 |
| Max. Negotiated Rate |
$1,598.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,598.89
|
|
|
ER CRITICAL CARE 1ST HR WO MF
|
Facility
|
OP
|
$17,139.05
|
|
|
Service Code
|
HCPCS 99291
|
| Hospital Charge Code |
5700029
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$5,141.72 |
| Rate for Payer: Aetna Commercial |
$2,669.24
|
| Rate for Payer: Aetna Medicare Advantage |
$3,179.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,542.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,542.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$981.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$486.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,542.34
|
| Rate for Payer: Cigna Commercial |
$1,967.11
|
| Rate for Payer: Cigna Medicare Advantage |
$981.34
|
| Rate for Payer: Clover Medicare Advantage |
$932.27
|
| Rate for Payer: EmblemHealth Commercial |
$2,944.02
|
| Rate for Payer: Humana Medicare Advantage |
$1,010.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$981.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,141.72
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Oxford Commercial |
$2,186.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,570.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,833.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$981.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$981.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$450.00
|
|
|
ER CRITICAL CARE 1ST HR WO MF
|
Facility
|
IP
|
$17,139.05
|
|
|
Service Code
|
HCPCS 99291
|
| Hospital Charge Code |
5700029
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,570.86 |
| Max. Negotiated Rate |
$2,570.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,570.86
|
|
|
ER CRITICAL CARE ADDL 30 MINS
|
Facility
|
OP
|
$837.50
|
|
|
Service Code
|
HCPCS 99292
|
| Hospital Charge Code |
5700031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.62 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$318.25
|
| Rate for Payer: Aetna Medicare Advantage |
$251.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$213.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$213.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$213.56
|
| Rate for Payer: Cigna Commercial |
$418.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$251.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.62
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$450.00
|
|
|
ER CRITICAL CARE ADDL 30 MINS
|
Facility
|
IP
|
$837.50
|
|
|
Service Code
|
HCPCS 99292
|
| Hospital Charge Code |
5700031
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.62 |
| Max. Negotiated Rate |
$125.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.62
|
|
|
ER DEBRID ECZEMA INFECTED 10%
|
Facility
|
OP
|
$843.05
|
|
|
Service Code
|
HCPCS 11000
|
| Hospital Charge Code |
5700701
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$22.34 |
| 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 |
$54.17
|
| 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 |
$252.91
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.46
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$1,639.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.34
|
|
|
ER DEBRID ECZEMA INFECTED 10%
|
Facility
|
IP
|
$843.05
|
|
|
Service Code
|
HCPCS 11000
|
| Hospital Charge Code |
5700701
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$126.46 |
| Max. Negotiated Rate |
$126.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$126.46
|
|
|
ER DEBRID ECZEMA INFECTED ADD
|
Facility
|
OP
|
$480.70
|
|
|
Service Code
|
HCPCS 11001
|
| Hospital Charge Code |
5700702
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$182.67
|
| Rate for Payer: Aetna Medicare Advantage |
$144.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$122.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$122.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$122.58
|
| Rate for Payer: Cigna Commercial |
$240.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.21
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.74
|
|
|
ER DEBRID ECZEMA INFECTED ADD
|
Facility
|
IP
|
$480.70
|
|
|
Service Code
|
HCPCS 11001
|
| Hospital Charge Code |
5700702
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$72.11 |
| Max. Negotiated Rate |
$72.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.11
|
|
|
ER DEBRIDE DRESS BURN SMALL
|
Facility
|
IP
|
$354.45
|
|
|
Service Code
|
HCPCS 16020
|
| Hospital Charge Code |
5700410
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$53.17 |
| Max. Negotiated Rate |
$53.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.17
|
|
|
ER DEBRIDE DRESS BURN SMALL
|
Facility
|
OP
|
$354.45
|
|
|
Service Code
|
HCPCS 16020
|
| Hospital Charge Code |
5700410
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$860.41 |
| Rate for Payer: Aetna Commercial |
$648.34
|
| Rate for Payer: Aetna Medicare Advantage |
$772.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$860.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$860.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$238.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$88.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$860.41
|
| Rate for Payer: Cigna Commercial |
$477.79
|
| Rate for Payer: Cigna Medicare Advantage |
$238.36
|
| Rate for Payer: Clover Medicare Advantage |
$226.44
|
| Rate for Payer: EmblemHealth Commercial |
$715.08
|
| Rate for Payer: Humana Medicare Advantage |
$245.51
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$238.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.33
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.39
|
|
|
ER DEBRIDEMENT NAIL 1-5
|
Facility
|
IP
|
$327.35
|
|
|
Service Code
|
HCPCS 11720
|
| Hospital Charge Code |
5700509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$49.10 |
| Max. Negotiated Rate |
$49.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.10
|
|
|
ER DEBRIDEMENT NAIL 1-5
|
Facility
|
OP
|
$327.35
|
|
|
Service Code
|
HCPCS 11720
|
| Hospital Charge Code |
5700509
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$8.67 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$190.62
|
| Rate for Payer: Aetna Medicare Advantage |
$227.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$70.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$252.97
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: Cigna Medicare Advantage |
$70.08
|
| Rate for Payer: Clover Medicare Advantage |
$66.58
|
| Rate for Payer: EmblemHealth Commercial |
$210.24
|
| Rate for Payer: Humana Medicare Advantage |
$72.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$70.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.10
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.67
|
|
|
ER DEBRIDEMENT NAILS 6 OR MORE
|
Facility
|
IP
|
$480.70
|
|
|
Service Code
|
HCPCS 11721
|
| Hospital Charge Code |
5700705
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$72.11 |
| Max. Negotiated Rate |
$72.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.11
|
|
|
ER DEBRIDEMENT NAILS 6 OR MORE
|
Facility
|
OP
|
$480.70
|
|
|
Service Code
|
HCPCS 11721
|
| Hospital Charge Code |
5700705
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$190.62
|
| Rate for Payer: Aetna Medicare Advantage |
$227.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$70.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$252.97
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: Cigna Medicare Advantage |
$70.08
|
| Rate for Payer: Clover Medicare Advantage |
$66.58
|
| Rate for Payer: EmblemHealth Commercial |
$210.24
|
| Rate for Payer: Humana Medicare Advantage |
$72.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$70.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$144.21
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$72.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$197.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.74
|
|
|
ER DEBRIDEMENT SKIN&SUBCU TISS
|
Facility
|
IP
|
$706.05
|
|
|
Service Code
|
HCPCS 11042
|
| Hospital Charge Code |
5700454
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$105.91 |
| Max. Negotiated Rate |
$105.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.91
|
|
|
ER DEBRIDEMENT SKIN&SUBCU TISS
|
Facility
|
OP
|
$706.05
|
|
|
Service Code
|
HCPCS 11042
|
| Hospital Charge Code |
5700454
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$18.71 |
| 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 |
$75.56
|
| 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 |
$211.81
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.91
|
| 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: Wellcare New Jersey Medicaid/Family Care |
$1,058.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.71
|
|
|
ER DEBRIDE W/RMV FB W/OPEN FRA
|
Facility
|
OP
|
$3,358.50
|
|
|
Service Code
|
HCPCS 11011
|
| Hospital Charge Code |
5700670
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$89.00 |
| Max. Negotiated Rate |
$3,036.77 |
| 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 |
$3,036.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,036.77
|
| 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 |
$537.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,036.77
|
| 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 |
$1,007.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$503.77
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$841.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$89.00
|
|
