|
ERIBULIN MESYLATE 0.5MG/ML INJ
|
Facility
|
OP
|
$7,863.12
|
|
|
Service Code
|
HCPCS J9179
|
| Hospital Charge Code |
60630227
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$72.92 |
| Max. Negotiated Rate |
$1,902.88 |
| Rate for Payer: Aetna Commercial |
$208.79
|
| Rate for Payer: Aetna Medicare Advantage |
$248.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$277.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$277.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$76.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$81.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$277.08
|
| Rate for Payer: Cigna Medicare Advantage |
$76.76
|
| Rate for Payer: Clover Medicare Advantage |
$72.92
|
| Rate for Payer: EmblemHealth Commercial |
$230.28
|
| Rate for Payer: Humana Medicare Advantage |
$79.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$76.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,902.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,179.47
|
| Rate for Payer: UnitedHealthcare Community & State |
$189.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$76.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$76.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$208.37
|
|
|
ER I&D ABSCESS COMPLCATED/MULT
|
Facility
|
OP
|
$796.20
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
5700502
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$21.10 |
| 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 |
$214.18
|
| 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 |
$238.86
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.43
|
| 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 |
$21.10
|
|
|
ER I&D ABSCESS COMPLCATED/MULT
|
Facility
|
IP
|
$796.20
|
|
|
Service Code
|
HCPCS 10061
|
| Hospital Charge Code |
5700502
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.43 |
| Max. Negotiated Rate |
$119.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.43
|
|
|
ER I&D ABS PERITONSILLAR
|
Facility
|
IP
|
$796.25
|
|
|
Service Code
|
HCPCS 42700
|
| Hospital Charge Code |
5700648
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.44 |
| Max. Negotiated Rate |
$119.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.44
|
|
|
ER I&D ABS PERITONSILLAR
|
Facility
|
OP
|
$796.25
|
|
|
Service Code
|
HCPCS 42700
|
| Hospital Charge Code |
5700648
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$21.10 |
| Max. Negotiated Rate |
$1,015.70 |
| Rate for Payer: Aetna Commercial |
$765.35
|
| Rate for Payer: Aetna Medicare Advantage |
$911.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,015.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,015.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$281.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$92.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,015.70
|
| Rate for Payer: Cigna Commercial |
$564.04
|
| Rate for Payer: Cigna Medicare Advantage |
$281.38
|
| Rate for Payer: Clover Medicare Advantage |
$267.31
|
| Rate for Payer: EmblemHealth Commercial |
$844.14
|
| Rate for Payer: Humana Medicare Advantage |
$289.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$281.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$238.88
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.44
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$281.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$281.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.10
|
|
|
ER I&D BARTHOLIN'S GLAND
|
Facility
|
OP
|
$942.15
|
|
|
Service Code
|
HCPCS 56420
|
| Hospital Charge Code |
5700800
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$866.98 |
| 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 |
$866.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$866.98
|
| 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) PPO |
$866.98
|
| 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 |
$282.64
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$141.32
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$240.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$240.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24.97
|
|
|
ER I&D BARTHOLIN'S GLAND
|
Facility
|
IP
|
$942.15
|
|
|
Service Code
|
HCPCS 56420
|
| Hospital Charge Code |
5700800
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$141.32 |
| Max. Negotiated Rate |
$141.32 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$141.32
|
|
|
ER I&D DENTAL ABSCESS
|
Facility
|
OP
|
$447.50
|
|
|
Service Code
|
HCPCS 41800
|
| Hospital Charge Code |
5700647
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$11.86 |
| 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) NJ Health |
$48.79
|
| 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 |
$134.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.12
|
| 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 |
$11.86
|
|
|
ER I&D DENTAL ABSCESS
|
Facility
|
IP
|
$447.50
|
|
|
Service Code
|
HCPCS 41800
|
| Hospital Charge Code |
5700647
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$67.12 |
| Max. Negotiated Rate |
$67.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.12
|
|
|
ER I&D EAR ABSCESS SIMPL
|
Facility
|
IP
|
$796.20
|
|
|
Service Code
|
HCPCS 69000
|
| Hospital Charge Code |
5700807
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.43 |
| Max. Negotiated Rate |
$119.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.43
|
|
|
ER I&D EAR ABSCESS SIMPL
|
Facility
|
OP
|
$796.20
|
|
|
Service Code
|
HCPCS 69000
|
| Hospital Charge Code |
5700807
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$21.10 |
| 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 |
$59.74
|
| 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 |
$238.86
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.43
|
| 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 |
$21.10
|
|
|
ER-I&D EAR ABSC HEMA-LT
|
Facility
|
IP
|
$530.00
|
|
| Hospital Charge Code |
5792150
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$79.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.50
|
|
|
ER-I&D EAR ABSC HEMA-LT
|
Facility
|
OP
|
$530.00
|
|
| Hospital Charge Code |
5792150
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.04 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$201.40
|
| Rate for Payer: Aetna Medicare Advantage |
$159.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$135.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$135.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$135.15
|
| Rate for Payer: Cigna Commercial |
$265.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.04
|
|
|
ER-I&D EAR ABSC HEMATO-RT
|
Facility
|
IP
|
$530.00
|
|
| Hospital Charge Code |
5792155
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$79.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.50
|
|
|
ER-I&D EAR ABSC HEMATO-RT
|
Facility
|
OP
|
$530.00
|
|
| Hospital Charge Code |
5792155
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.04 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$201.40
|
| Rate for Payer: Aetna Medicare Advantage |
$159.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$135.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$135.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$135.15
|
| Rate for Payer: Cigna Commercial |
$265.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.04
|
|
|
ER I&D FINGER ABSCESS COMPLX
|
Facility
|
OP
|
$6,903.75
|
|
|
Service Code
|
HCPCS 26011
|
| Hospital Charge Code |
5700749
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$7,082.74 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$169.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,082.74
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,071.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,035.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$182.95
|
|
|
ER I&D FINGER ABSCESS COMPLX
|
Facility
|
IP
|
$6,903.75
|
|
|
Service Code
|
HCPCS 26011
|
| Hospital Charge Code |
5700749
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,035.56 |
| Max. Negotiated Rate |
$1,035.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,035.56
|
|
|
ER I&D FINGER ABSCESS SIMPLE
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
HCPCS 26010
|
| Hospital Charge Code |
5700574
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$11.93 |
| 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 |
$73.18
|
| 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 |
$135.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.50
|
| 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 |
$11.93
|
|
|
ER I&D FINGER ABSCESS SIMPLE
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
HCPCS 26010
|
| Hospital Charge Code |
5700574
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$67.50 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.50
|
|
|
ER I&D HAND BURSA
|
Facility
|
IP
|
$10,614.65
|
|
|
Service Code
|
HCPCS 23931
|
| Hospital Charge Code |
5700737
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,592.20 |
| Max. Negotiated Rate |
$1,592.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,592.20
|
|
|
ER I&D HAND BURSA
|
Facility
|
OP
|
$10,614.65
|
|
|
Service Code
|
HCPCS 23931
|
| Hospital Charge Code |
5700737
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$45.69 |
| Max. Negotiated Rate |
$7,082.74 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$45.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,082.74
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,184.39
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,592.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$281.29
|
|
|
ER I&D HAND DEEP ABSC HEMATOMA
|
Facility
|
IP
|
$10,614.65
|
|
|
Service Code
|
HCPCS 23930
|
| Hospital Charge Code |
5700736
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,592.20 |
| Max. Negotiated Rate |
$1,592.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,592.20
|
|
|
ER I&D HAND DEEP ABSC HEMATOMA
|
Facility
|
OP
|
$10,614.65
|
|
|
Service Code
|
HCPCS 23930
|
| Hospital Charge Code |
5700736
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$12,456.64 |
| Rate for Payer: Aetna Commercial |
$9,386.39
|
| Rate for Payer: Aetna Medicare Advantage |
$11,180.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,456.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,456.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,450.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$389.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12,456.64
|
| Rate for Payer: Cigna Commercial |
$6,917.28
|
| Rate for Payer: Cigna Medicare Advantage |
$3,450.88
|
| Rate for Payer: Clover Medicare Advantage |
$3,278.34
|
| Rate for Payer: EmblemHealth Commercial |
$10,352.64
|
| Rate for Payer: Humana Medicare Advantage |
$3,554.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,450.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,184.39
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,592.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$281.29
|
|
|
ER I&D HEMATOMA/SEROMA/FLD COL
|
Facility
|
OP
|
$3,553.75
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
5700506
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$73.18 |
| Max. Negotiated Rate |
$7,082.74 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| 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 |
$7,082.74
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,066.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$533.06
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$94.17
|
|
|
ER I&D HEMATOMA/SEROMA/FLD COL
|
Facility
|
IP
|
$3,553.75
|
|
|
Service Code
|
HCPCS 10140
|
| Hospital Charge Code |
5700506
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$533.06 |
| Max. Negotiated Rate |
$533.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$533.06
|
|
