|
EXCISE ANAL EXT TAG/PAPILLA
|
Facility
|
OP
|
$19,596.70
|
|
|
Service Code
|
HCPCS 46220
|
| Hospital Charge Code |
16000749
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$472.28 |
| Max. Negotiated Rate |
$5,879.01 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,131.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,131.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,131.69
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,879.01
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,939.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$472.28
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$519.31
|
|
|
EXCISE EXCESS SKIN TISSUE,ARM
|
Facility
|
IP
|
$13,615.50
|
|
|
Service Code
|
HCPCS 15836
|
| Hospital Charge Code |
16000600
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,042.33 |
| Max. Negotiated Rate |
$2,042.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,042.33
|
|
|
EXCISE EXCESS SKIN TISSUE,ARM
|
Facility
|
OP
|
$13,615.50
|
|
|
Service Code
|
HCPCS 15836
|
| Hospital Charge Code |
16000600
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$328.13 |
| 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 |
$1,355.00
|
| 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 |
$4,084.65
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,042.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$328.13
|
| 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 |
$360.81
|
|
|
EXCISE EXCESS SKIN TISSUE,OTH
|
Facility
|
IP
|
$16,853.95
|
|
|
Service Code
|
HCPCS 15839
|
| Hospital Charge Code |
16000250
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,528.09 |
| Max. Negotiated Rate |
$2,528.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,528.09
|
|
|
EXCISE EXCESS SKIN TISSUE,OTH
|
Facility
|
OP
|
$16,853.95
|
|
|
Service Code
|
HCPCS 15839
|
| Hospital Charge Code |
16000250
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$406.18 |
| 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 |
$1,355.00
|
| 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 |
$5,056.19
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,528.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$406.18
|
| 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 |
$446.63
|
|
|
EXCISE EXCESS SKIN TISSUE,THI
|
Facility
|
IP
|
$22,280.35
|
|
|
Service Code
|
HCPCS 15832
|
| Hospital Charge Code |
16000495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,342.05 |
| Max. Negotiated Rate |
$3,342.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,342.05
|
|
|
EXCISE EXCESS SKIN TISSUE,THI
|
Facility
|
OP
|
$22,280.35
|
|
|
Service Code
|
HCPCS 15832
|
| Hospital Charge Code |
16000495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$536.96 |
| 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 |
$1,355.00
|
| 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 |
$6,684.10
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,342.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$536.96
|
| 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 |
$590.43
|
|
|
EXCISE HYDROCELE; UNILATERAL
|
Facility
|
OP
|
$30,814.20
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
160000207
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$742.62 |
| Max. Negotiated Rate |
$15,354.26 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,354.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,354.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,355.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15,354.26
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,244.26
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,622.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$742.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$816.58
|
|
|
EXCISE HYDROCELE; UNILATERAL
|
Facility
|
IP
|
$30,814.20
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
160000207
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,622.13 |
| Max. Negotiated Rate |
$4,622.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,622.13
|
|
|
EXCISE INFEOR TURBINATE
|
Facility
|
OP
|
$22,083.40
|
|
|
Service Code
|
HCPCS 30130
|
| Hospital Charge Code |
1600000284
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$532.21 |
| Max. Negotiated Rate |
$14,218.07 |
| Rate for Payer: Aetna Commercial |
$10,713.67
|
| Rate for Payer: Aetna Medicare Advantage |
$12,761.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,218.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,218.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,938.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,355.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14,218.07
|
| Rate for Payer: Cigna Commercial |
$7,895.42
|
| Rate for Payer: Cigna Medicare Advantage |
$3,938.85
|
| Rate for Payer: Clover Medicare Advantage |
$3,741.91
|
| Rate for Payer: EmblemHealth Commercial |
$11,816.55
|
| Rate for Payer: Humana Medicare Advantage |
$4,057.02
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,938.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,625.02
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,312.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$532.21
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,938.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,938.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$585.21
|
|
|
EXCISE INFEOR TURBINATE
|
Facility
|
IP
|
$22,083.40
|
|
|
Service Code
|
HCPCS 30130
|
| Hospital Charge Code |
1600000284
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,312.51 |
| Max. Negotiated Rate |
$3,312.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,312.51
|
|
|
EXCISE INTESTINE 1+LESIONS(S)
|
Facility
|
IP
|
$9,477.40
|
|
|
Service Code
|
HCPCS 44110
|
| Hospital Charge Code |
160000206
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,421.61 |
| Max. Negotiated Rate |
$1,421.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,421.61
|
|
|
EXCISE INTESTINE 1+LESIONS(S)
|
Facility
|
OP
|
$9,477.40
|
|
|
Service Code
|
HCPCS 44110
|
| Hospital Charge Code |
160000206
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$228.41 |
| Max. Negotiated Rate |
$10,232.00 |
| Rate for Payer: Aetna Commercial |
$3,601.41
|
| Rate for Payer: Aetna Medicare Advantage |
$2,843.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,416.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,416.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,416.74
|
| Rate for Payer: Cigna Commercial |
$4,738.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,843.22
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,421.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$228.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$251.15
|
|
|
EXCISE LESION CORNEA NOT PTRGM
|
Facility
|
IP
|
$14,711.60
|
|
|
Service Code
|
HCPCS 65400
|
| Hospital Charge Code |
16000658
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,206.74 |
| Max. Negotiated Rate |
$2,206.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,206.74
|
|
|
EXCISE LESION CORNEA NOT PTRGM
|
Facility
|
OP
|
$14,711.60
|
|
|
Service Code
|
HCPCS 65400
|
| Hospital Charge Code |
16000658
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$354.55 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Aetna Commercial |
$3,221.35
|
| Rate for Payer: Aetna Medicare Advantage |
$3,837.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,275.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,275.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,184.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,275.04
|
| Rate for Payer: Cigna Commercial |
$2,373.97
|
| Rate for Payer: Cigna Medicare Advantage |
$1,184.32
|
| Rate for Payer: Clover Medicare Advantage |
$1,125.10
|
| Rate for Payer: EmblemHealth Commercial |
$3,552.96
|
| Rate for Payer: Humana Medicare Advantage |
$1,219.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,184.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,413.48
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,206.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$354.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,184.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,184.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$389.86
|
|
|
EXCISE LESION OF SPERMATIC COR
|
Facility
|
IP
|
$22,128.35
|
|
|
Service Code
|
HCPCS 55520
|
| Hospital Charge Code |
1600000269
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,319.25 |
| Max. Negotiated Rate |
$3,319.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,319.25
|
|
|
EXCISE LESION OF SPERMATIC COR
|
Facility
|
OP
|
$22,128.35
|
|
|
Service Code
|
HCPCS 55520
|
| Hospital Charge Code |
1600000269
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$533.29 |
| Max. Negotiated Rate |
$15,116.59 |
| Rate for Payer: Aetna Commercial |
$11,390.73
|
| Rate for Payer: Aetna Medicare Advantage |
$13,568.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,116.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,116.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,187.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15,116.59
|
| Rate for Payer: Cigna Commercial |
$8,394.37
|
| Rate for Payer: Cigna Medicare Advantage |
$4,187.77
|
| Rate for Payer: Clover Medicare Advantage |
$3,978.38
|
| Rate for Payer: EmblemHealth Commercial |
$12,563.31
|
| Rate for Payer: Humana Medicare Advantage |
$4,313.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,187.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,638.51
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,319.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$533.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$586.40
|
|
|
EXCISE LESION TESTIS
|
Facility
|
IP
|
$21,225.75
|
|
|
Service Code
|
HCPCS 54512
|
| Hospital Charge Code |
1600000817
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,183.86 |
| Max. Negotiated Rate |
$3,183.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,183.86
|
|
|
EXCISE LESION TESTIS
|
Facility
|
OP
|
$21,225.75
|
|
|
Service Code
|
HCPCS 54512
|
| Hospital Charge Code |
1600000817
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$511.54 |
| Max. Negotiated Rate |
$15,116.59 |
| Rate for Payer: Aetna Commercial |
$11,390.73
|
| Rate for Payer: Aetna Medicare Advantage |
$13,568.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,116.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,116.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,187.77
|
| 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 |
$15,116.59
|
| Rate for Payer: Cigna Commercial |
$8,394.37
|
| Rate for Payer: Cigna Medicare Advantage |
$4,187.77
|
| Rate for Payer: Clover Medicare Advantage |
$3,978.38
|
| Rate for Payer: EmblemHealth Commercial |
$12,563.31
|
| Rate for Payer: Humana Medicare Advantage |
$4,313.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,187.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,367.73
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,183.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$511.54
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$562.48
|
|
|
EXCISE OLECRANON BURSA LT
|
Facility
|
IP
|
$21,422.50
|
|
|
Service Code
|
HCPCS 24105
|
| Hospital Charge Code |
16000376
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,213.38 |
| Max. Negotiated Rate |
$3,213.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,213.38
|
|
|
EXCISE OLECRANON BURSA LT
|
Facility
|
OP
|
$21,422.50
|
|
|
Service Code
|
HCPCS 24105
|
| Hospital Charge Code |
16000376
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$516.28 |
| 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 |
$1,355.00
|
| 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 |
$6,426.75
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,213.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$516.28
|
| 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 |
$567.70
|
|
|
EXCISION DIAM 0.5CM OR LESS
|
Facility
|
OP
|
$7,903.25
|
|
|
Service Code
|
HCPCS 11420
|
| Hospital Charge Code |
412311420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$190.47 |
| 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 |
$862.00
|
| 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 |
$2,370.97
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,185.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$190.47
|
| 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 |
$209.44
|
|
|
EXCISION DIAM 0.5CM OR LESS
|
Facility
|
IP
|
$7,903.25
|
|
|
Service Code
|
HCPCS 11420
|
| Hospital Charge Code |
412311420
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,185.49 |
| Max. Negotiated Rate |
$1,185.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,185.49
|
|
|
EXCISION DIAM 0.6 - 1.0 CM
|
Facility
|
IP
|
$3,358.50
|
|
|
Service Code
|
HCPCS 11421
|
| Hospital Charge Code |
412311421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$503.77 |
| Max. Negotiated Rate |
$503.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$503.77
|
|
|
EXCISION DIAM 0.6 - 1.0 CM
|
Facility
|
OP
|
$3,358.50
|
|
|
Service Code
|
HCPCS 11421
|
| Hospital Charge Code |
412311421
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$80.94 |
| Max. Negotiated Rate |
$3,593.00 |
| 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 |
$1,016.00
|
| 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: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$503.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,593.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$80.94
|
| 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
|
|
