|
ER REMOVAL INTRAURINE DEVICE
|
Facility
|
OP
|
$1,621.70
|
|
|
Service Code
|
HCPCS 58301
|
| Hospital Charge Code |
5701004
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$42.98 |
| Max. Negotiated Rate |
$1,306.82 |
| Rate for Payer: Aetna Commercial |
$984.72
|
| Rate for Payer: Aetna Medicare Advantage |
$1,172.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,306.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,306.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$362.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,306.82
|
| Rate for Payer: Cigna Commercial |
$725.69
|
| Rate for Payer: Cigna Medicare Advantage |
$362.03
|
| Rate for Payer: Clover Medicare Advantage |
$343.93
|
| Rate for Payer: EmblemHealth Commercial |
$1,086.09
|
| Rate for Payer: Humana Medicare Advantage |
$372.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$362.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$486.51
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$243.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$362.03
|
| Rate for Payer: Wellcare Medicare Advantage |
$362.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.98
|
|
|
ER REMOVAL NAIL PLATE
|
Facility
|
OP
|
$415.00
|
|
|
Service Code
|
HCPCS 11730
|
| Hospital Charge Code |
5700465
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$11.00 |
| 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 |
$104.68
|
| 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 |
$124.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.25
|
| 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 |
$11.00
|
|
|
ER REMOVAL NAIL PLATE
|
Facility
|
IP
|
$415.00
|
|
|
Service Code
|
HCPCS 11730
|
| Hospital Charge Code |
5700465
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$62.25 |
| Max. Negotiated Rate |
$62.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.25
|
|
|
ER REMOV COREAL FB W/ SLIT LMP
|
Facility
|
IP
|
$522.50
|
|
|
Service Code
|
HCPCS 65222
|
| Hospital Charge Code |
5700806
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$78.38 |
| Max. Negotiated Rate |
$78.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.38
|
|
|
ER REMOV COREAL FB W/ SLIT LMP
|
Facility
|
OP
|
$522.50
|
|
|
Service Code
|
HCPCS 65222
|
| Hospital Charge Code |
5700806
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$13.85 |
| 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 |
$92.93
|
| 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 |
$156.75
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.38
|
| 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 |
$13.85
|
|
|
ER-REMOVE EYELID F/B-RT
|
Facility
|
OP
|
$553.00
|
|
| Hospital Charge Code |
5792145
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.65 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$210.14
|
| Rate for Payer: Aetna Medicare Advantage |
$165.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$141.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$141.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$141.01
|
| Rate for Payer: Cigna Commercial |
$276.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$165.90
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.95
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.65
|
|
|
ER-REMOVE EYELID F/B-RT
|
Facility
|
IP
|
$553.00
|
|
| Hospital Charge Code |
5792145
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$82.95 |
| Max. Negotiated Rate |
$82.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.95
|
|
|
ER-REMOV F/B FOOT SUBQ-BI
|
Facility
|
OP
|
$2,316.00
|
|
| Hospital Charge Code |
5790630
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$61.37 |
| Max. Negotiated Rate |
$1,158.00 |
| Rate for Payer: Aetna Commercial |
$880.08
|
| Rate for Payer: Aetna Medicare Advantage |
$694.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$590.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$590.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$590.58
|
| Rate for Payer: Cigna Commercial |
$1,158.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$694.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$347.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$61.37
|
|
|
ER-REMOV F/B FOOT SUBQ-BI
|
Facility
|
IP
|
$2,316.00
|
|
| Hospital Charge Code |
5790630
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$347.40 |
| Max. Negotiated Rate |
$347.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$347.40
|
|
|
ER-REM STENT URETER-BI
|
Facility
|
OP
|
$324.00
|
|
| Hospital Charge Code |
5790840
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$8.59 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$123.12
|
| Rate for Payer: Aetna Medicare Advantage |
$97.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$82.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$82.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$82.62
|
| Rate for Payer: Cigna Commercial |
$162.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.20
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.59
|
|
|
ER-REM STENT URETER-BI
|
Facility
|
IP
|
$324.00
|
|
| Hospital Charge Code |
5790840
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$48.60 |
| Max. Negotiated Rate |
$48.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.60
|
|
|
ER REM TUNN CV CATH W/O PO/PUM
|
Facility
|
IP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 36589
|
| Hospital Charge Code |
5701002
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$544.61 |
| Max. Negotiated Rate |
$544.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
|
|
ER REM TUNN CV CATH W/O PO/PUM
|
Facility
|
OP
|
$3,630.70
|
|
|
Service Code
|
HCPCS 36589
|
| Hospital Charge Code |
5701002
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$96.21 |
| Max. Negotiated Rate |
$2,690.13 |
| Rate for Payer: Aetna Commercial |
$2,027.08
|
| Rate for Payer: Aetna Medicare Advantage |
$2,414.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,690.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$745.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$181.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,690.13
|
| Rate for Payer: Cigna Commercial |
$1,493.86
|
| Rate for Payer: Cigna Medicare Advantage |
$745.25
|
| Rate for Payer: Clover Medicare Advantage |
$707.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,235.75
|
| Rate for Payer: Humana Medicare Advantage |
$767.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$745.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,089.21
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$544.61
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$745.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$96.21
|
|
|
ER-REPAIR BLD VESS UP EXT
|
Facility
|
OP
|
$10,555.00
|
|
|
Service Code
|
HCPCS 35206
|
| Hospital Charge Code |
5790090
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$793.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,166.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,583.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$279.71
|
|
|
ER-REPAIR BLD VESS UP EXT
|
Facility
|
IP
|
$10,555.00
|
|
|
Service Code
|
HCPCS 35206
|
| Hospital Charge Code |
5790090
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,583.25 |
| Max. Negotiated Rate |
$1,583.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,583.25
|
|
|
ER REPAIR FOOT TENDON
|
Facility
|
IP
|
$17,434.95
|
|
|
Service Code
|
HCPCS 28200
|
| Hospital Charge Code |
5700824
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,615.24 |
| Max. Negotiated Rate |
$2,615.24 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,615.24
|
|
|
ER REPAIR FOOT TENDON
|
Facility
|
OP
|
$17,434.95
|
|
|
Service Code
|
HCPCS 28200
|
| Hospital Charge Code |
5700824
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| 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 |
$333.98
|
| 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 |
$5,230.48
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,615.24
|
| 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 |
$462.03
|
|
|
ER REPAIR MOUTH/TONG UP TO 2.5
|
Facility
|
IP
|
$346.00
|
|
|
Service Code
|
HCPCS 41250
|
| Hospital Charge Code |
5700276
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$51.90 |
| Max. Negotiated Rate |
$51.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.90
|
|
|
ER REPAIR MOUTH/TONG UP TO 2.5
|
Facility
|
OP
|
$346.00
|
|
|
Service Code
|
HCPCS 41250
|
| Hospital Charge Code |
5700276
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$1,915.74 |
| Rate for Payer: Aetna Commercial |
$1,443.56
|
| Rate for Payer: Aetna Medicare Advantage |
$1,719.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,915.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,915.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$530.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$97.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,915.74
|
| Rate for Payer: Cigna Commercial |
$1,063.82
|
| Rate for Payer: Cigna Medicare Advantage |
$530.72
|
| Rate for Payer: Clover Medicare Advantage |
$504.18
|
| Rate for Payer: EmblemHealth Commercial |
$1,592.16
|
| Rate for Payer: Humana Medicare Advantage |
$546.64
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$530.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.90
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$530.72
|
| Rate for Payer: Wellcare Medicare Advantage |
$530.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.17
|
|
|
ER REPAIR OF NAIL BED
|
Facility
|
OP
|
$675.00
|
|
|
Service Code
|
HCPCS 11760
|
| Hospital Charge Code |
5700466
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$17.89 |
| Max. Negotiated Rate |
$3,169.46 |
| Rate for Payer: Aetna Commercial |
$2,388.27
|
| Rate for Payer: Aetna Medicare Advantage |
$2,844.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,169.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,169.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$878.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$134.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,169.46
|
| Rate for Payer: Cigna Commercial |
$1,760.02
|
| Rate for Payer: Cigna Medicare Advantage |
$878.04
|
| Rate for Payer: Clover Medicare Advantage |
$834.14
|
| Rate for Payer: EmblemHealth Commercial |
$2,634.12
|
| Rate for Payer: Humana Medicare Advantage |
$904.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$878.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$202.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$101.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$878.04
|
| Rate for Payer: Wellcare Medicare Advantage |
$878.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.89
|
|
|
ER REPAIR OF NAIL BED
|
Facility
|
IP
|
$675.00
|
|
|
Service Code
|
HCPCS 11760
|
| Hospital Charge Code |
5700466
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$101.25 |
| Max. Negotiated Rate |
$101.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$101.25
|
|
|
ER REPAIR SUPERFCL WOUND-SUTUR
|
Facility
|
OP
|
$1,248.49
|
|
|
Service Code
|
HCPCS 12001
|
| Hospital Charge Code |
5700280
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$33.08 |
| 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 |
$73.57
|
| 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 |
$374.55
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$187.27
|
| 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 |
$33.08
|
|
|
ER REPAIR SUPERFCL WOUND-SUTUR
|
Facility
|
IP
|
$273.72
|
|
|
Service Code
|
HCPCS 12001
|
| Hospital Charge Code |
5700270
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$41.06 |
| Max. Negotiated Rate |
$41.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.06
|
|
|
ER REPAIR SUPERFCL WOUND-SUTUR
|
Facility
|
OP
|
$273.72
|
|
|
Service Code
|
HCPCS 12001
|
| Hospital Charge Code |
5700270
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$7.25 |
| 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 |
$73.57
|
| 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 |
$82.12
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.06
|
| 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 |
$7.25
|
|
|
ER REPAIR SUPERFCL WOUND-SUTUR
|
Facility
|
IP
|
$1,248.49
|
|
|
Service Code
|
HCPCS 12001
|
| Hospital Charge Code |
5700280
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$187.27 |
| Max. Negotiated Rate |
$187.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$187.27
|
|
