|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$12,689.20
|
|
|
Service Code
|
APR-DRG 2483
|
| Min. Negotiated Rate |
$12,440.39 |
| Max. Negotiated Rate |
$12,689.20 |
| Rate for Payer: UnitedHealthcare Community & State |
$12,440.39
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$12,689.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12,440.39
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$6,589.10
|
|
|
Service Code
|
APR-DRG 2481
|
| Min. Negotiated Rate |
$6,459.90 |
| Max. Negotiated Rate |
$6,589.10 |
| Rate for Payer: UnitedHealthcare Community & State |
$6,459.90
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$6,589.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6,459.90
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC
|
Facility
|
IP
|
$35,134.48
|
|
|
Service Code
|
MSDRG 372
|
| Min. Negotiated Rate |
$10,698.00 |
| Max. Negotiated Rate |
$35,134.48 |
| Rate for Payer: Aetna Commercial |
$24,398.72
|
| Rate for Payer: Aetna Medicare Advantage |
$35,134.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24,191.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24,191.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11,261.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24,191.44
|
| Rate for Payer: Cigna Commercial |
$19,106.99
|
| Rate for Payer: Cigna Medicare Advantage |
$11,261.05
|
| Rate for Payer: Clover Medicare Advantage |
$10,698.00
|
| Rate for Payer: EmblemHealth Commercial |
$33,783.15
|
| Rate for Payer: Humana Medicare Advantage |
$11,598.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11,261.05
|
| Rate for Payer: Oxford Commercial |
$13,732.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$24,080.28
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11,261.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$11,261.05
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC
|
Facility
|
IP
|
$59,443.58
|
|
|
Service Code
|
MSDRG 371
|
| Min. Negotiated Rate |
$18,099.81 |
| Max. Negotiated Rate |
$59,443.58 |
| Rate for Payer: Aetna Commercial |
$41,101.86
|
| Rate for Payer: Aetna Medicare Advantage |
$59,443.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$40,706.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$40,706.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$19,052.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$40,706.75
|
| Rate for Payer: Cigna Commercial |
$33,181.79
|
| Rate for Payer: Cigna Medicare Advantage |
$19,052.43
|
| Rate for Payer: Clover Medicare Advantage |
$18,099.81
|
| Rate for Payer: EmblemHealth Commercial |
$57,157.29
|
| Rate for Payer: Humana Medicare Advantage |
$19,624.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$19,052.43
|
| Rate for Payer: Oxford Commercial |
$23,848.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$41,818.56
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$19,052.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$19,052.43
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$25,644.81
|
|
|
Service Code
|
MSDRG 373
|
| Min. Negotiated Rate |
$7,808.52 |
| Max. Negotiated Rate |
$25,644.81 |
| Rate for Payer: Aetna Commercial |
$17,878.22
|
| Rate for Payer: Aetna Medicare Advantage |
$25,644.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,747.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,747.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,219.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16,747.92
|
| Rate for Payer: Cigna Commercial |
$13,612.56
|
| Rate for Payer: Cigna Medicare Advantage |
$8,219.49
|
| Rate for Payer: Clover Medicare Advantage |
$7,808.52
|
| Rate for Payer: EmblemHealth Commercial |
$24,658.47
|
| Rate for Payer: Humana Medicare Advantage |
$8,466.07
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,219.49
|
| Rate for Payer: Oxford Commercial |
$9,783.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$17,155.73
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,219.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,219.49
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITH CC
|
Facility
|
IP
|
$72,630.89
|
|
|
Service Code
|
MSDRG 141
|
| Min. Negotiated Rate |
$22,115.17 |
| Max. Negotiated Rate |
$72,630.89 |
| Rate for Payer: Aetna Commercial |
$50,163.02
|
| Rate for Payer: Aetna Medicare Advantage |
$72,630.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48,150.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48,150.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$23,279.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48,150.27
|
| Rate for Payer: Cigna Commercial |
$40,817.11
|
| Rate for Payer: Cigna Medicare Advantage |
$23,279.13
|
| Rate for Payer: Clover Medicare Advantage |
$22,115.17
|
| Rate for Payer: EmblemHealth Commercial |
$69,837.39
|
| Rate for Payer: Humana Medicare Advantage |
$23,977.50
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$23,279.13
|
| Rate for Payer: Oxford Commercial |
$29,335.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$51,441.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$23,279.13
|
| Rate for Payer: Wellcare Medicare Advantage |
$23,279.13
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITH MCC
|
Facility
|
IP
|
$139,995.65
|
|
|
Service Code
|
MSDRG 140
|
| Min. Negotiated Rate |
$42,626.88 |
| Max. Negotiated Rate |
$139,995.65 |
| Rate for Payer: Aetna Commercial |
$96,450.30
|
| Rate for Payer: Aetna Medicare Advantage |
$139,995.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$87,926.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$87,926.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$44,870.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$87,926.58
|
| Rate for Payer: Cigna Commercial |
$79,820.82
|
| Rate for Payer: Cigna Medicare Advantage |
$44,870.40
|
| Rate for Payer: Clover Medicare Advantage |
$42,626.88
|
| Rate for Payer: EmblemHealth Commercial |
$134,611.20
|
| Rate for Payer: Humana Medicare Advantage |
$46,216.51
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$44,870.40
|
| Rate for Payer: Oxford Commercial |
$57,368.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$100,597.10
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$44,870.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$44,870.40
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$53,732.36
|
|
|
Service Code
|
MSDRG 142
|
| Min. Negotiated Rate |
$16,360.81 |
| Max. Negotiated Rate |
$53,732.36 |
| Rate for Payer: Aetna Commercial |
$37,177.59
|
| Rate for Payer: Aetna Medicare Advantage |
$53,732.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36,054.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36,054.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,221.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36,054.55
|
| Rate for Payer: Cigna Commercial |
$29,875.03
|
| Rate for Payer: Cigna Medicare Advantage |
$17,221.91
|
| Rate for Payer: Clover Medicare Advantage |
$16,360.81
|
| Rate for Payer: EmblemHealth Commercial |
$51,665.73
|
| Rate for Payer: Humana Medicare Advantage |
$17,738.57
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,221.91
|
| Rate for Payer: Oxford Commercial |
$21,471.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$37,651.09
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,221.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,221.91
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC
|
Facility
|
IP
|
$43,050.07
|
|
|
Service Code
|
MSDRG 809
|
| Min. Negotiated Rate |
$13,108.19 |
| Max. Negotiated Rate |
$43,050.07 |
| Rate for Payer: Aetna Commercial |
$29,837.61
|
| Rate for Payer: Aetna Medicare Advantage |
$43,050.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27,913.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27,913.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,798.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27,913.20
|
| Rate for Payer: Cigna Commercial |
$23,690.05
|
| Rate for Payer: Cigna Medicare Advantage |
$13,798.10
|
| Rate for Payer: Clover Medicare Advantage |
$13,108.19
|
| Rate for Payer: EmblemHealth Commercial |
$41,394.30
|
| Rate for Payer: Humana Medicare Advantage |
$14,212.04
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,798.10
|
| Rate for Payer: Oxford Commercial |
$17,026.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$29,856.25
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,798.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,798.10
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC
|
Facility
|
IP
|
$73,497.06
|
|
|
Service Code
|
MSDRG 808
|
| Min. Negotiated Rate |
$22,378.91 |
| Max. Negotiated Rate |
$73,497.06 |
| Rate for Payer: Aetna Commercial |
$50,758.19
|
| Rate for Payer: Aetna Medicare Advantage |
$73,497.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50,941.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50,941.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$23,556.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50,941.59
|
| Rate for Payer: Cigna Commercial |
$41,318.64
|
| Rate for Payer: Cigna Medicare Advantage |
$23,556.75
|
| Rate for Payer: Clover Medicare Advantage |
$22,378.91
|
| Rate for Payer: EmblemHealth Commercial |
$70,670.25
|
| Rate for Payer: Humana Medicare Advantage |
$24,263.45
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$23,556.75
|
| Rate for Payer: Oxford Commercial |
$29,696.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$52,073.32
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$23,556.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$23,556.75
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$35,961.93
|
|
|
Service Code
|
MSDRG 810
|
| Min. Negotiated Rate |
$10,949.95 |
| Max. Negotiated Rate |
$35,961.93 |
| Rate for Payer: Aetna Commercial |
$24,967.28
|
| Rate for Payer: Aetna Medicare Advantage |
$35,961.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,261.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,261.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11,526.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,261.00
|
| Rate for Payer: Cigna Commercial |
$19,586.07
|
| Rate for Payer: Cigna Medicare Advantage |
$11,526.26
|
| Rate for Payer: Clover Medicare Advantage |
$10,949.95
|
| Rate for Payer: EmblemHealth Commercial |
$34,578.78
|
| Rate for Payer: Humana Medicare Advantage |
$11,872.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11,526.26
|
| Rate for Payer: Oxford Commercial |
$14,076.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$24,684.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11,526.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$11,526.26
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$8,968.86
|
|
|
Service Code
|
APR-DRG 6602
|
| Min. Negotiated Rate |
$8,793.00 |
| Max. Negotiated Rate |
$8,968.86 |
| Rate for Payer: UnitedHealthcare Community & State |
$8,793.00
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$8,968.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8,793.00
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$7,635.96
|
|
|
Service Code
|
APR-DRG 6601
|
| Min. Negotiated Rate |
$7,486.24 |
| Max. Negotiated Rate |
$7,635.96 |
| Rate for Payer: UnitedHealthcare Community & State |
$7,486.24
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$7,635.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7,486.24
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$13,687.64
|
|
|
Service Code
|
APR-DRG 6603
|
| Min. Negotiated Rate |
$13,419.25 |
| Max. Negotiated Rate |
$13,687.64 |
| Rate for Payer: UnitedHealthcare Community & State |
$13,419.25
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$13,687.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13,419.25
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$28,810.21
|
|
|
Service Code
|
APR-DRG 6604
|
| Min. Negotiated Rate |
$28,245.30 |
| Max. Negotiated Rate |
$28,810.21 |
| Rate for Payer: UnitedHealthcare Community & State |
$28,245.30
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$28,810.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28,245.30
|
|
|
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
|
Facility
|
IP
|
$100,172.09
|
|
|
Service Code
|
MSDRG 469
|
| Min. Negotiated Rate |
$30,501.12 |
| Max. Negotiated Rate |
$100,172.09 |
| Rate for Payer: Aetna Commercial |
$69,086.96
|
| Rate for Payer: Aetna Medicare Advantage |
$100,172.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$77,459.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$77,459.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$32,106.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$77,459.13
|
| Rate for Payer: Cigna Commercial |
$56,763.30
|
| Rate for Payer: Cigna Medicare Advantage |
$32,106.44
|
| Rate for Payer: Clover Medicare Advantage |
$30,501.12
|
| Rate for Payer: EmblemHealth Commercial |
$96,319.32
|
| Rate for Payer: Humana Medicare Advantage |
$33,069.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$32,106.44
|
| Rate for Payer: Oxford Commercial |
$40,796.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$71,538.02
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$32,106.44
|
| Rate for Payer: Wellcare Medicare Advantage |
$32,106.44
|
|
|
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$64,479.36
|
|
|
Service Code
|
MSDRG 470
|
| Min. Negotiated Rate |
$19,633.14 |
| Max. Negotiated Rate |
$64,479.36 |
| Rate for Payer: Aetna Commercial |
$44,561.99
|
| Rate for Payer: Aetna Medicare Advantage |
$64,479.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43,730.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43,730.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20,666.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43,730.68
|
| Rate for Payer: Cigna Commercial |
$36,097.43
|
| Rate for Payer: Cigna Medicare Advantage |
$20,666.46
|
| Rate for Payer: Clover Medicare Advantage |
$19,633.14
|
| Rate for Payer: EmblemHealth Commercial |
$61,999.38
|
| Rate for Payer: Humana Medicare Advantage |
$21,286.45
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20,666.46
|
| Rate for Payer: Oxford Commercial |
$25,943.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$45,493.11
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20,666.46
|
| Rate for Payer: Wellcare Medicare Advantage |
$20,666.46
|
|
|
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES
|
Facility
|
IP
|
$91,726.47
|
|
|
Service Code
|
MSDRG 483
|
| Min. Negotiated Rate |
$27,929.53 |
| Max. Negotiated Rate |
$91,726.47 |
| Rate for Payer: Aetna Commercial |
$63,283.88
|
| Rate for Payer: Aetna Medicare Advantage |
$91,726.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57,687.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57,687.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$29,399.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57,687.28
|
| Rate for Payer: Cigna Commercial |
$51,873.34
|
| Rate for Payer: Cigna Medicare Advantage |
$29,399.51
|
| Rate for Payer: Clover Medicare Advantage |
$27,929.53
|
| Rate for Payer: EmblemHealth Commercial |
$88,198.53
|
| Rate for Payer: Humana Medicare Advantage |
$30,281.50
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$29,399.51
|
| Rate for Payer: Oxford Commercial |
$37,282.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$65,375.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$29,399.51
|
| Rate for Payer: Wellcare Medicare Advantage |
$29,399.51
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$23,076.53
|
|
|
Service Code
|
APR-DRG 2312
|
| Min. Negotiated Rate |
$22,624.05 |
| Max. Negotiated Rate |
$23,076.53 |
| Rate for Payer: UnitedHealthcare Community & State |
$22,624.05
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$23,076.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22,624.05
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$51,898.25
|
|
|
Service Code
|
APR-DRG 2314
|
| Min. Negotiated Rate |
$50,880.64 |
| Max. Negotiated Rate |
$51,898.25 |
| Rate for Payer: UnitedHealthcare Community & State |
$50,880.64
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$51,898.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$50,880.64
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$18,881.23
|
|
|
Service Code
|
APR-DRG 2311
|
| Min. Negotiated Rate |
$18,511.01 |
| Max. Negotiated Rate |
$18,881.23 |
| Rate for Payer: UnitedHealthcare Community & State |
$18,511.01
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$18,881.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18,511.01
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$32,367.15
|
|
|
Service Code
|
APR-DRG 2313
|
| Min. Negotiated Rate |
$31,732.50 |
| Max. Negotiated Rate |
$32,367.15 |
| Rate for Payer: UnitedHealthcare Community & State |
$31,732.50
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$32,367.15
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31,732.50
|
|
|
MAJOR MALE PELVIC PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$66,787.16
|
|
|
Service Code
|
MSDRG 707
|
| Min. Negotiated Rate |
$20,335.83 |
| Max. Negotiated Rate |
$66,787.16 |
| Rate for Payer: Aetna Commercial |
$46,147.70
|
| Rate for Payer: Aetna Medicare Advantage |
$66,787.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$45,591.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$45,591.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,406.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$45,591.56
|
| Rate for Payer: Cigna Commercial |
$37,433.61
|
| Rate for Payer: Cigna Medicare Advantage |
$21,406.14
|
| Rate for Payer: Clover Medicare Advantage |
$20,335.83
|
| Rate for Payer: EmblemHealth Commercial |
$64,218.42
|
| Rate for Payer: Humana Medicare Advantage |
$22,048.32
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,406.14
|
| Rate for Payer: Oxford Commercial |
$26,904.03
|
| Rate for Payer: UnitedHealthcare Commercial |
$47,177.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,406.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,406.14
|
|
|
MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$51,721.92
|
|
|
Service Code
|
MSDRG 708
|
| Min. Negotiated Rate |
$15,748.66 |
| Max. Negotiated Rate |
$51,721.92 |
| Rate for Payer: Aetna Commercial |
$35,796.17
|
| Rate for Payer: Aetna Medicare Advantage |
$51,721.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33,961.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33,961.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16,577.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33,961.06
|
| Rate for Payer: Cigna Commercial |
$28,711.02
|
| Rate for Payer: Cigna Medicare Advantage |
$16,577.54
|
| Rate for Payer: Clover Medicare Advantage |
$15,748.66
|
| Rate for Payer: EmblemHealth Commercial |
$49,732.62
|
| Rate for Payer: Humana Medicare Advantage |
$17,074.87
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16,577.54
|
| Rate for Payer: Oxford Commercial |
$20,634.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$36,184.11
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16,577.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$16,577.54
|
|
|
MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS
|
Facility
|
IP
|
$25,559.73
|
|
|
Service Code
|
APR-DRG 6802
|
| Min. Negotiated Rate |
$25,058.56 |
| Max. Negotiated Rate |
$25,559.73 |
| Rate for Payer: UnitedHealthcare Community & State |
$25,058.56
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$25,559.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25,058.56
|
|
