|
ER PRIMARY TENDON REPAIR
|
Facility
|
OP
|
$3,290.85
|
|
|
Service Code
|
HCPCS 26433
|
| Hospital Charge Code |
5700234
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$87.21 |
| Max. Negotiated Rate |
$14,031.70 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,031.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,031.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$242.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14,031.70
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$987.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$493.63
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$87.21
|
|
|
ER-PROCED SKIN/SUBCUT-OTH
|
Facility
|
OP
|
$397.00
|
|
|
Service Code
|
HCPCS 17999
|
| Hospital Charge Code |
5790050
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$10.52 |
| 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) 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 |
$119.10
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.55
|
| 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 |
$10.52
|
|
|
ER-PROCED SKIN/SUBCUT-OTH
|
Facility
|
IP
|
$397.00
|
|
|
Service Code
|
HCPCS 17999
|
| Hospital Charge Code |
5790050
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$59.55 |
| Max. Negotiated Rate |
$59.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.55
|
|
|
ER PSYC DX EVAL W/MED SERVICES
|
Facility
|
IP
|
$642.10
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
5792255
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$96.31 |
| Max. Negotiated Rate |
$96.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.31
|
|
|
ER PSYC DX EVAL W/MED SERVICES
|
Facility
|
OP
|
$642.10
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
5792255
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$3,081.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$663.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$192.63
|
| Rate for Payer: Oxford Commercial |
$1,757.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,081.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.02
|
|
|
ER PSYCHIATRIC DIAGNOSTIC EVAL
|
Facility
|
IP
|
$623.75
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
5792250
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$93.56 |
| Max. Negotiated Rate |
$93.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.56
|
|
|
ER PSYCHIATRIC DIAGNOSTIC EVAL
|
Facility
|
OP
|
$623.75
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
5792250
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$16.53 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$761.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$761.18
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$187.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.53
|
|
|
ER PULSE OXIMETRY-CONTINOUS
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
HCPCS 94761
|
| Hospital Charge Code |
5780305
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$46.95 |
| Max. Negotiated Rate |
$46.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.95
|
|
|
ER PULSE OXIMETRY-CONTINOUS
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
HCPCS 94761
|
| Hospital Charge Code |
5780305
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$7.54 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$118.94
|
| Rate for Payer: Aetna Medicare Advantage |
$93.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.81
|
| Rate for Payer: Cigna Commercial |
$156.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$93.90
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.29
|
|
|
ER PULSE OXIMETRY CONT OVERNIG
|
Facility
|
IP
|
$393.00
|
|
|
Service Code
|
HCPCS 94762
|
| Hospital Charge Code |
5780310
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$58.95 |
| Max. Negotiated Rate |
$58.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.95
|
|
|
ER PULSE OXIMETRY CONT OVERNIG
|
Facility
|
OP
|
$393.00
|
|
|
Service Code
|
HCPCS 94762
|
| Hospital Charge Code |
5780310
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$415.81
|
| Rate for Payer: Aetna Medicare Advantage |
$495.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$551.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$551.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$152.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$106.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$551.81
|
| Rate for Payer: Cigna Commercial |
$306.43
|
| Rate for Payer: Cigna Medicare Advantage |
$152.87
|
| Rate for Payer: Clover Medicare Advantage |
$145.23
|
| Rate for Payer: EmblemHealth Commercial |
$458.61
|
| Rate for Payer: Humana Medicare Advantage |
$157.46
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$152.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.90
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$152.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$152.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.41
|
|
|
ER QUICKVUE INFLUENZA A
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
HCPCS 87804
|
| Hospital Charge Code |
5700680
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$45.02
|
| Rate for Payer: Aetna Medicare Advantage |
$53.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.74
|
| Rate for Payer: Cigna Commercial |
$62.50
|
| Rate for Payer: Cigna Medicare Advantage |
$16.55
|
| Rate for Payer: Clover Medicare Advantage |
$15.72
|
| Rate for Payer: EmblemHealth Commercial |
$49.65
|
| Rate for Payer: Humana Medicare Advantage |
$17.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.55
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.31
|
|
|
ER QUICKVUE INFLUENZA A
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
HCPCS 87804
|
| Hospital Charge Code |
5700680
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
|
|
ER QUICKVUE INFLUENZA B
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
HCPCS 87804
|
| Hospital Charge Code |
5700681
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$45.02
|
| Rate for Payer: Aetna Medicare Advantage |
$53.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.74
|
| Rate for Payer: Cigna Commercial |
$62.50
|
| Rate for Payer: Cigna Medicare Advantage |
$16.55
|
| Rate for Payer: Clover Medicare Advantage |
$15.72
|
| Rate for Payer: EmblemHealth Commercial |
$49.65
|
| Rate for Payer: Humana Medicare Advantage |
$17.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.55
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.31
|
|
|
ER QUICKVUE INFLUENZA B
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
HCPCS 87804
|
| Hospital Charge Code |
5700681
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
|
|
ER RABIES VACCINE, IM
|
Facility
|
OP
|
$762.50
|
|
|
Service Code
|
HCPCS 90675
|
| Hospital Charge Code |
5700448
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.38 |
| Max. Negotiated Rate |
$1,137.85 |
| Rate for Payer: Aetna Commercial |
$857.40
|
| Rate for Payer: Aetna Medicare Advantage |
$1,021.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,137.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,137.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$315.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$334.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,137.85
|
| Rate for Payer: Cigna Medicare Advantage |
$315.22
|
| Rate for Payer: Clover Medicare Advantage |
$299.46
|
| Rate for Payer: EmblemHealth Commercial |
$945.66
|
| Rate for Payer: Humana Medicare Advantage |
$324.68
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$315.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$184.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.38
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.38
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$315.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$315.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.21
|
|
|
ER RABIES VACCINE, IM
|
Facility
|
IP
|
$762.50
|
|
|
Service Code
|
HCPCS 90675
|
| Hospital Charge Code |
5700448
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$114.38 |
| Max. Negotiated Rate |
$184.53 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$184.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.38
|
|
|
ER-RADIAL HEAD DISLOC-BIL
|
Facility
|
OP
|
$612.00
|
|
| Hospital Charge Code |
5790410
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$16.22 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$232.56
|
| Rate for Payer: Aetna Medicare Advantage |
$183.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$156.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$156.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$156.06
|
| Rate for Payer: Cigna Commercial |
$306.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$183.60
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$91.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.22
|
|
|
ER-RADIAL HEAD DISLOC-BIL
|
Facility
|
IP
|
$612.00
|
|
| Hospital Charge Code |
5790410
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$91.80
|
|
|
ER-RECON NAIL BED W/GRAFT
|
Facility
|
OP
|
$4,227.00
|
|
|
Service Code
|
HCPCS 11762
|
| Hospital Charge Code |
5790010
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$112.02 |
| Max. Negotiated Rate |
$8,848.20 |
| Rate for Payer: Aetna Commercial |
$6,667.35
|
| Rate for Payer: Aetna Medicare Advantage |
$7,941.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,848.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,848.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,451.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$198.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,848.20
|
| Rate for Payer: Cigna Commercial |
$4,913.48
|
| Rate for Payer: Cigna Medicare Advantage |
$2,451.23
|
| Rate for Payer: Clover Medicare Advantage |
$2,328.67
|
| Rate for Payer: EmblemHealth Commercial |
$7,353.69
|
| Rate for Payer: Humana Medicare Advantage |
$2,524.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,451.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,268.10
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$634.05
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,451.23
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,451.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$112.02
|
|
|
ER-RECON NAIL BED W/GRAFT
|
Facility
|
IP
|
$4,227.00
|
|
|
Service Code
|
HCPCS 11762
|
| Hospital Charge Code |
5790010
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$634.05 |
| Max. Negotiated Rate |
$634.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$634.05
|
|
|
ER-RECTUM PROCED OTHER
|
Facility
|
IP
|
$2,462.25
|
|
|
Service Code
|
HCPCS 45999
|
| Hospital Charge Code |
5790150
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$369.34 |
| Max. Negotiated Rate |
$369.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$369.34
|
|
|
ER-RECTUM PROCED OTHER
|
Facility
|
OP
|
$2,462.25
|
|
|
Service Code
|
HCPCS 45999
|
| Hospital Charge Code |
5790150
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$65.25 |
| Max. Negotiated Rate |
$3,988.03 |
| Rate for Payer: Aetna Commercial |
$3,005.08
|
| Rate for Payer: Aetna Medicare Advantage |
$3,579.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,988.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,988.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,104.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,988.03
|
| Rate for Payer: Cigna Commercial |
$2,214.60
|
| Rate for Payer: Cigna Medicare Advantage |
$1,104.81
|
| Rate for Payer: Clover Medicare Advantage |
$1,049.57
|
| Rate for Payer: EmblemHealth Commercial |
$3,314.43
|
| Rate for Payer: Humana Medicare Advantage |
$1,137.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,104.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$738.67
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$369.34
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,104.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,104.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$65.25
|
|
|
ER RED RECTAL PROLAPSE
|
Facility
|
OP
|
$2,904.15
|
|
|
Service Code
|
HCPCS 45900
|
| Hospital Charge Code |
5792281
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$35.24 |
| Max. Negotiated Rate |
$3,988.03 |
| Rate for Payer: Aetna Commercial |
$3,005.08
|
| Rate for Payer: Aetna Medicare Advantage |
$3,579.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,988.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,988.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,104.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,988.03
|
| Rate for Payer: Cigna Commercial |
$2,214.60
|
| Rate for Payer: Cigna Medicare Advantage |
$1,104.81
|
| Rate for Payer: Clover Medicare Advantage |
$1,049.57
|
| Rate for Payer: EmblemHealth Commercial |
$3,314.43
|
| Rate for Payer: Humana Medicare Advantage |
$1,137.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,104.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$871.25
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$435.62
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,104.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,104.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$76.96
|
|
|
ER RED RECTAL PROLAPSE
|
Facility
|
IP
|
$2,904.15
|
|
|
Service Code
|
HCPCS 45900
|
| Hospital Charge Code |
5792281
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$435.62 |
| Max. Negotiated Rate |
$435.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$435.62
|
|
