|
EXPLANT LDH PROVISION HEAD SIZ
|
Facility
|
IP
|
$1,440.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270698036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$216.00 |
| Max. Negotiated Rate |
$348.48 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$288.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$348.48
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$316.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$216.00
|
|
|
EXPL KNEE W DRAIN/REM FB
|
Facility
|
OP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27310
|
| Hospital Charge Code |
16000447
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$737.34 |
| 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 |
$1,626.00
|
| 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 |
$9,178.50
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$737.34
|
| 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 |
$810.77
|
|
|
EXPL KNEE W DRAIN/REM FB
|
Facility
|
IP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27310
|
| Hospital Charge Code |
16000447
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,589.25 |
| Max. Negotiated Rate |
$4,589.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
|
|
EXPL LAPAROTOMY EXPL CELIOTOMY
|
Facility
|
IP
|
$8,578.30
|
|
|
Service Code
|
HCPCS 49000
|
| Hospital Charge Code |
16000985
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,286.74 |
| Max. Negotiated Rate |
$1,286.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,286.74
|
|
|
EXPL LAPAROTOMY EXPL CELIOTOMY
|
Facility
|
OP
|
$8,578.30
|
|
|
Service Code
|
HCPCS 49000
|
| Hospital Charge Code |
16000985
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$206.74 |
| Max. Negotiated Rate |
$10,232.00 |
| Rate for Payer: Aetna Commercial |
$3,259.75
|
| Rate for Payer: Aetna Medicare Advantage |
$2,573.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,187.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,187.47
|
| 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 |
$2,187.47
|
| Rate for Payer: Cigna Commercial |
$4,289.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,573.49
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,286.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$206.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$227.32
|
|
|
EXPL N/FLWD SURG NECK ART
|
Facility
|
OP
|
$23,767.00
|
|
|
Service Code
|
HCPCS 35701
|
| Hospital Charge Code |
1600000721
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$572.78 |
| Max. Negotiated Rate |
$11,883.50 |
| Rate for Payer: Aetna Commercial |
$9,031.46
|
| Rate for Payer: Aetna Medicare Advantage |
$7,130.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,060.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,060.59
|
| 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 |
$6,060.59
|
| Rate for Payer: Cigna Commercial |
$11,883.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,130.10
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,565.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$572.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$629.83
|
|
|
EXPL N/FLWD SURG NECK ART
|
Facility
|
IP
|
$23,767.00
|
|
|
Service Code
|
HCPCS 35701
|
| Hospital Charge Code |
1600000721
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,565.05 |
| Max. Negotiated Rate |
$3,565.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,565.05
|
|
|
EXPLORE ADRENAL GLAND
|
Facility
|
OP
|
$23,063.00
|
|
|
Service Code
|
HCPCS 60540
|
| Hospital Charge Code |
1600000750
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$555.82 |
| Max. Negotiated Rate |
$11,531.50 |
| Rate for Payer: Aetna Commercial |
$8,763.94
|
| Rate for Payer: Aetna Medicare Advantage |
$6,918.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,881.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,881.06
|
| 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 |
$5,881.06
|
| Rate for Payer: Cigna Commercial |
$11,531.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,918.90
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,459.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$555.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$611.17
|
|
|
EXPLORE ADRENAL GLAND
|
Facility
|
IP
|
$23,063.00
|
|
|
Service Code
|
HCPCS 60540
|
| Hospital Charge Code |
1600000750
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,459.45 |
| Max. Negotiated Rate |
$3,459.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,459.45
|
|
|
EXPLORE PARATHYROID GLANDS
|
Facility
|
OP
|
$20,350.20
|
|
|
Service Code
|
HCPCS 60500
|
| Hospital Charge Code |
1600000352
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$490.44 |
| Max. Negotiated Rate |
$25,386.70 |
| Rate for Payer: Aetna Commercial |
$19,129.52
|
| Rate for Payer: Aetna Medicare Advantage |
$22,786.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,386.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,386.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,032.91
|
| 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 |
$25,386.70
|
| Rate for Payer: Cigna Commercial |
$14,097.46
|
| Rate for Payer: Cigna Medicare Advantage |
$7,032.91
|
| Rate for Payer: Clover Medicare Advantage |
$6,681.26
|
| Rate for Payer: EmblemHealth Commercial |
$21,098.73
|
| Rate for Payer: Humana Medicare Advantage |
$7,243.90
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,032.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,105.06
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,052.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$490.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,032.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,032.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$539.28
|
|
|
EXPLORE PARATHYROID GLANDS
|
Facility
|
IP
|
$20,350.20
|
|
|
Service Code
|
HCPCS 60500
|
| Hospital Charge Code |
1600000352
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,052.53 |
| Max. Negotiated Rate |
$3,052.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,052.53
|
|
|
EXPLORE SCROTUM
|
Facility
|
IP
|
$20,303.55
|
|
|
Service Code
|
HCPCS 55110
|
| Hospital Charge Code |
1600000480
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,045.53 |
| Max. Negotiated Rate |
$3,045.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,045.53
|
|
|
EXPLORE SCROTUM
|
Facility
|
OP
|
$20,303.55
|
|
|
Service Code
|
HCPCS 55110
|
| Hospital Charge Code |
1600000480
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$489.32 |
| 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 |
$6,091.06
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,045.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$489.32
|
| 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 |
$538.04
|
|
|
EXPLORE SMALL INTESTINE
|
Facility
|
OP
|
$20,827.80
|
|
|
Service Code
|
HCPCS 44020
|
| Hospital Charge Code |
1600000761
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$501.95 |
| Max. Negotiated Rate |
$10,413.90 |
| Rate for Payer: Aetna Commercial |
$7,914.56
|
| Rate for Payer: Aetna Medicare Advantage |
$6,248.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,311.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,311.09
|
| 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 |
$5,311.09
|
| Rate for Payer: Cigna Commercial |
$10,413.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,248.34
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,124.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$501.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$551.94
|
|
|
EXPLORE SMALL INTESTINE
|
Facility
|
IP
|
$20,827.80
|
|
|
Service Code
|
HCPCS 44020
|
| Hospital Charge Code |
1600000761
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,124.17 |
| Max. Negotiated Rate |
$3,124.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,124.17
|
|
|
EXPLORE SPINAL FUSION
|
Facility
|
IP
|
$12,938.72
|
|
|
Service Code
|
HCPCS 22830
|
| Hospital Charge Code |
160000230
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,940.81 |
| Max. Negotiated Rate |
$1,940.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,940.81
|
|
|
EXPLORE SPINAL FUSION
|
Facility
|
OP
|
$12,938.72
|
|
|
Service Code
|
HCPCS 22830
|
| Hospital Charge Code |
160000230
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$311.82 |
| Max. Negotiated Rate |
$31,117.67 |
| Rate for Payer: Aetna Commercial |
$23,447.95
|
| Rate for Payer: Aetna Medicare Advantage |
$27,930.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31,117.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31,117.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,620.57
|
| 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 |
$31,117.67
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: Cigna Medicare Advantage |
$8,620.57
|
| Rate for Payer: Clover Medicare Advantage |
$8,189.54
|
| Rate for Payer: EmblemHealth Commercial |
$25,861.71
|
| Rate for Payer: Humana Medicare Advantage |
$8,879.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,620.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,881.62
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,940.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$311.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$342.88
|
|
|
EXPLORE/TREAT ANKLE JOINT-LT
|
Facility
|
IP
|
$32,127.31
|
|
|
Service Code
|
HCPCS 27610
|
| Hospital Charge Code |
16000890
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,819.10 |
| Max. Negotiated Rate |
$4,819.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,819.10
|
|
|
EXPLORE/TREAT ANKLE JOINT-LT
|
Facility
|
OP
|
$32,127.31
|
|
|
Service Code
|
HCPCS 27610
|
| Hospital Charge Code |
16000890
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$774.27 |
| 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 |
$1,016.00
|
| 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 |
$9,638.19
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,819.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$774.27
|
| 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 |
$851.37
|
|
|
EXPLORE/TREAT ELBOW JOINT
|
Facility
|
IP
|
$12,406.91
|
|
|
Service Code
|
HCPCS 24101
|
| Hospital Charge Code |
16000820
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,861.04 |
| Max. Negotiated Rate |
$1,861.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,861.04
|
|
|
EXPLORE/TREAT ELBOW JOINT
|
Facility
|
OP
|
$12,406.91
|
|
|
Service Code
|
HCPCS 24101
|
| Hospital Charge Code |
16000820
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$299.01 |
| 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 |
$1,626.00
|
| 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 |
$3,722.07
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,861.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$299.01
|
| 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 |
$328.78
|
|
|
EXPLOR/TREAT ANKLE JOINT
|
Facility
|
IP
|
$12,832.72
|
|
|
Service Code
|
HCPCS 27620
|
| Hospital Charge Code |
1600000796
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,924.91 |
| Max. Negotiated Rate |
$1,924.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.91
|
|
|
EXPLOR/TREAT ANKLE JOINT
|
Facility
|
OP
|
$12,832.72
|
|
|
Service Code
|
HCPCS 27620
|
| Hospital Charge Code |
1600000796
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$309.27 |
| 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 |
$1,626.00
|
| 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 |
$3,849.82
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$309.27
|
| 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 |
$340.07
|
|
|
EXPL P WND,ABD/FLANK
|
Facility
|
OP
|
$20,772.85
|
|
|
Service Code
|
HCPCS 20102
|
| Hospital Charge Code |
16000791
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$500.63 |
| 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 |
$1,626.00
|
| 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 |
$6,231.85
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,115.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$500.63
|
| 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 |
$550.48
|
|
|
EXPL P WND,ABD/FLANK
|
Facility
|
IP
|
$20,772.85
|
|
|
Service Code
|
HCPCS 20102
|
| Hospital Charge Code |
16000791
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,115.93 |
| Max. Negotiated Rate |
$3,115.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,115.93
|
|
