|
ARTHROSC,KNEE,W MENISC-MED&LAT
|
Facility
|
IP
|
$35,454.57
|
|
|
Service Code
|
HCPCS 29880
|
| Hospital Charge Code |
16000178
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,318.19 |
| Max. Negotiated Rate |
$5,318.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,318.19
|
|
|
ARTHROSC,KNEE,W MENISC-MED&LAT
|
Facility
|
OP
|
$35,454.57
|
|
|
Service Code
|
HCPCS 29880
|
| Hospital Charge Code |
16000178
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$854.46 |
| 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 |
$10,636.37
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,318.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$854.46
|
| 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 |
$939.55
|
|
|
ARTHROSC,KNEE,W MEN REP-MED&LA
|
Facility
|
OP
|
$32,775.00
|
|
|
Service Code
|
HCPCS 29882
|
| Hospital Charge Code |
16000307
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$789.88 |
| 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 |
$9,832.50
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,916.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$789.88
|
| 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 |
$868.54
|
|
|
ARTHROSC,KNEE,W MEN REP-MED&LA
|
Facility
|
IP
|
$32,775.00
|
|
|
Service Code
|
HCPCS 29882
|
| Hospital Charge Code |
16000307
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,916.25 |
| Max. Negotiated Rate |
$4,916.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,916.25
|
|
|
ARTHROSCOPY
|
Facility
|
IP
|
$31,867.57
|
|
|
Service Code
|
MSDRG 509
|
| Min. Negotiated Rate |
$31,867.57 |
| Max. Negotiated Rate |
$31,867.57 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31,867.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31,867.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31,867.57
|
|
|
ARTHROSCOPY ACL IMPLANT TRANSF
|
Facility
|
OP
|
$1,445.00
|
|
| Hospital Charge Code |
270655964
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.82 |
| Max. Negotiated Rate |
$722.50 |
| Rate for Payer: Aetna Commercial |
$549.10
|
| Rate for Payer: Aetna Medicare Advantage |
$433.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$368.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$368.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$289.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$368.48
|
| Rate for Payer: Cigna Commercial |
$722.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$349.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$317.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$216.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$38.29
|
|
|
ARTHROSCOPY ACL IMPLANT TRANSF
|
Facility
|
IP
|
$1,445.00
|
|
| Hospital Charge Code |
270655965
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$216.75 |
| Max. Negotiated Rate |
$349.69 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$289.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$349.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$317.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$216.75
|
|
|
ARTHROSCOPY ACL IMPLANT TRANSF
|
Facility
|
OP
|
$1,445.00
|
|
| Hospital Charge Code |
270655965
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$34.82 |
| Max. Negotiated Rate |
$722.50 |
| Rate for Payer: Aetna Commercial |
$549.10
|
| Rate for Payer: Aetna Medicare Advantage |
$433.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$368.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$368.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$289.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$368.48
|
| Rate for Payer: Cigna Commercial |
$722.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$349.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$317.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$216.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$38.29
|
|
|
ARTHROSCOPY ACL IMPLANT TRANSF
|
Facility
|
IP
|
$1,445.00
|
|
| Hospital Charge Code |
270655964
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$216.75 |
| Max. Negotiated Rate |
$349.69 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$289.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$349.69
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$317.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$216.75
|
|
|
ARTHROSCOPY ANKLE,EXT DEBD
|
Facility
|
IP
|
$35,454.57
|
|
|
Service Code
|
HCPCS 29898
|
| Hospital Charge Code |
16000214
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,318.19 |
| Max. Negotiated Rate |
$5,318.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,318.19
|
|
|
ARTHROSCOPY ANKLE,EXT DEBD
|
Facility
|
OP
|
$35,454.57
|
|
|
Service Code
|
HCPCS 29898
|
| Hospital Charge Code |
16000214
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$854.46 |
| 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 |
$10,636.37
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,318.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$854.46
|
| 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 |
$939.55
|
|
|
ARTHROSCOPY,ANKLE,P_SYNOVECTOM
|
Facility
|
OP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29895
|
| Hospital Charge Code |
16000313
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$617.05 |
| 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 |
$7,681.14
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$617.05
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$662.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$649.28
|
|
|
ARTHROSCOPY,ANKLE,P_SYNOVECTOM
|
Facility
|
IP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29895
|
| Hospital Charge Code |
16000313
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,840.57 |
| Max. Negotiated Rate |
$3,840.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
|
|
ARTHROSCOPY,ANKLE,SMPL DEBD
|
Facility
|
IP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29897
|
| Hospital Charge Code |
16000246
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,840.57 |
| Max. Negotiated Rate |
$3,840.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
|
|
ARTHROSCOPY,ANKLE,SMPL DEBD
|
Facility
|
OP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29897
|
| Hospital Charge Code |
16000246
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$617.05 |
| 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 |
$7,681.14
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$617.05
|
| 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 |
$678.50
|
|
|
ARTHROSCOPY ANKLE,W REM FB RT
|
Facility
|
IP
|
$27,939.50
|
|
|
Service Code
|
HCPCS 29894
|
| Hospital Charge Code |
16000520
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,190.93 |
| Max. Negotiated Rate |
$4,190.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,190.93
|
|
|
ARTHROSCOPY ANKLE,W REM FB RT
|
Facility
|
OP
|
$27,939.50
|
|
|
Service Code
|
HCPCS 29894
|
| Hospital Charge Code |
16000520
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$673.34 |
| 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 |
$1,355.00
|
| 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 |
$8,381.85
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,190.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$673.34
|
| 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 |
$740.40
|
|
|
ARTHROSCOPY BICEPS TENODESS B
|
Facility
|
OP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29828
|
| Hospital Charge Code |
16000211
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,219.12 |
| 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 |
$15,175.80
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,587.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,219.12
|
| 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 |
$1,340.53
|
|
|
ARTHROSCOPY BICEPS TENODESS B
|
Facility
|
IP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29828
|
| Hospital Charge Code |
16000211
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,587.90 |
| Max. Negotiated Rate |
$7,587.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,587.90
|
|
|
ARTHROSCOPY ELB,P SYNOVECTOMY
|
Facility
|
IP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29835
|
| Hospital Charge Code |
16000637
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,587.90 |
| Max. Negotiated Rate |
$7,587.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,587.90
|
|
|
ARTHROSCOPY ELB,P SYNOVECTOMY
|
Facility
|
OP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29835
|
| Hospital Charge Code |
16000637
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,219.12 |
| Max. Negotiated Rate |
$15,175.80 |
| 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 |
$15,175.80
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,587.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,219.12
|
| 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 |
$1,340.53
|
|
|
ARTHROSCOPY INFLOW SET
|
Facility
|
IP
|
$150.00
|
|
| Hospital Charge Code |
270706174
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.50 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
|
|
ARTHROSCOPY INFLOW SET
|
Facility
|
OP
|
$150.00
|
|
| Hospital Charge Code |
270706174
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Aetna Commercial |
$57.00
|
| Rate for Payer: Aetna Medicare Advantage |
$45.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.25
|
| Rate for Payer: Cigna Commercial |
$75.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.00
|
| Rate for Payer: Oxford Commercial |
$30.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$30.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.98
|
|
|
ARTHROSCOPY KNEE,DEBD/SHV AC
|
Facility
|
IP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29877
|
| Hospital Charge Code |
16000519
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,840.57 |
| Max. Negotiated Rate |
$3,840.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
|
|
ARTHROSCOPY KNEE,DEBD/SHV AC
|
Facility
|
OP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29877
|
| Hospital Charge Code |
16000519
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$617.05 |
| 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 |
$7,681.14
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$617.05
|
| 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 |
$678.50
|
|