|
PEG THREADED LOCKING 2.3x18MM
|
Facility
|
IP
|
$442.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664187
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$66.30 |
| Max. Negotiated Rate |
$106.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$88.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$97.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.30
|
|
|
PEG THREADED LOCKING 2.3x19MM
|
Facility
|
IP
|
$442.00
|
|
| Hospital Charge Code |
270664188
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$66.30 |
| Max. Negotiated Rate |
$106.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$88.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$97.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.30
|
|
|
PEG THREADED LOCKING 2.3x19MM
|
Facility
|
OP
|
$442.00
|
|
| Hospital Charge Code |
270664188
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$221.00 |
| Rate for Payer: Aetna Commercial |
$167.96
|
| Rate for Payer: Aetna Medicare Advantage |
$132.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$112.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$112.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$88.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$112.71
|
| Rate for Payer: Cigna Commercial |
$221.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$97.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.71
|
|
|
PEG THREADED LOCKING 2.3x22MM
|
Facility
|
IP
|
$442.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$66.30 |
| Max. Negotiated Rate |
$106.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$88.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$97.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.30
|
|
|
PEG THREADED LOCKING 2.3x22MM
|
Facility
|
OP
|
$442.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664189
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$221.00 |
| Rate for Payer: Aetna Commercial |
$167.96
|
| Rate for Payer: Aetna Medicare Advantage |
$132.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$112.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$112.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$88.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$112.71
|
| Rate for Payer: Cigna Commercial |
$221.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$97.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.71
|
|
|
PEG THREADED MULTDIR 2.5*22MM
|
Facility
|
OP
|
$955.00
|
|
| Hospital Charge Code |
270648291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.02 |
| Max. Negotiated Rate |
$477.50 |
| Rate for Payer: Aetna Commercial |
$362.90
|
| Rate for Payer: Aetna Medicare Advantage |
$286.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$243.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$243.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$243.53
|
| Rate for Payer: Cigna Commercial |
$477.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$286.50
|
| Rate for Payer: Oxford Commercial |
$191.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$191.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.31
|
|
|
PEG THREADED MULTDIR 2.5*22MM
|
Facility
|
IP
|
$955.00
|
|
| Hospital Charge Code |
270648291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$143.25 |
| Max. Negotiated Rate |
$143.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$143.25
|
|
|
PEG THREADED NL TI 2.7X24MM
|
Facility
|
IP
|
$495.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664418
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$74.25 |
| Max. Negotiated Rate |
$119.79 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$99.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$119.79
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$108.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.25
|
|
|
PEG THREADED NL TI 2.7X24MM
|
Facility
|
OP
|
$495.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664418
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$188.10
|
| Rate for Payer: Aetna Medicare Advantage |
$148.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$126.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$126.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$99.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.22
|
| Rate for Payer: Cigna Commercial |
$247.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$119.79
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$108.90
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.12
|
|
|
PEG THREADED NON LOCK 2.7x18MM
|
Facility
|
IP
|
$442.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664416
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$66.30 |
| Max. Negotiated Rate |
$106.96 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$88.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$97.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.30
|
|
|
PEG THREADED NON LOCK 2.7x18MM
|
Facility
|
OP
|
$442.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270664416
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$221.00 |
| Rate for Payer: Aetna Commercial |
$167.96
|
| Rate for Payer: Aetna Medicare Advantage |
$132.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$112.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$112.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$88.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$112.71
|
| Rate for Payer: Cigna Commercial |
$221.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.96
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$97.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.30
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.71
|
|
|
PEG THRED FLUTD LCKNG 2.3X22MM
|
Facility
|
OP
|
$570.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686659
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13.74 |
| Max. Negotiated Rate |
$285.00 |
| Rate for Payer: Aetna Commercial |
$216.60
|
| Rate for Payer: Aetna Medicare Advantage |
$171.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$145.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$145.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$114.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$145.35
|
| Rate for Payer: Cigna Commercial |
$285.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$125.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.11
|
|
|
PEG THRED FLUTD LCKNG 2.3X22MM
|
Facility
|
IP
|
$570.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270686659
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.50 |
| Max. Negotiated Rate |
$137.94 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$114.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$137.94
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$125.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.50
|
|
|
PEG VARIAX LOCKING T8 2X20MM
|
Facility
|
IP
|
$1,242.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700619
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$186.34 |
| Max. Negotiated Rate |
$300.64 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$248.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$300.64
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$273.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$186.34
|
|
|
PEG VARIAX LOCKING T8 2X20MM
|
Facility
|
OP
|
$1,242.30
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270700619
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$29.94 |
| Max. Negotiated Rate |
$621.15 |
| Rate for Payer: Aetna Commercial |
$472.07
|
| Rate for Payer: Aetna Medicare Advantage |
$372.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$316.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$316.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$248.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$316.79
|
| Rate for Payer: Cigna Commercial |
$621.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$300.64
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$273.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$186.34
|
| Rate for Payer: UnitedHealthcare Community & State |
$29.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.92
|
|
|
PELLET SALT-WATER SOFTENER
|
Facility
|
IP
|
$4.00
|
|
| Hospital Charge Code |
270605607
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
PELLET SALT-WATER SOFTENER
|
Facility
|
OP
|
$4.00
|
|
| Hospital Charge Code |
270605607
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$0.10 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.52
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.20
|
| Rate for Payer: Oxford Commercial |
$0.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.11
|
|
|
PELLETS CALC SULF 20C CSP2006S
|
Facility
|
OP
|
$3,348.00
|
|
| Hospital Charge Code |
270628180
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.69 |
| Max. Negotiated Rate |
$1,674.00 |
| Rate for Payer: Aetna Commercial |
$1,272.24
|
| Rate for Payer: Aetna Medicare Advantage |
$1,004.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$853.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$853.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$853.74
|
| Rate for Payer: Cigna Commercial |
$1,674.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,004.40
|
| Rate for Payer: Oxford Commercial |
$669.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$502.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$669.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$80.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$88.72
|
|
|
PELLETS CALC SULF 20C CSP2006S
|
Facility
|
IP
|
$3,348.00
|
|
| Hospital Charge Code |
270628180
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$502.20 |
| Max. Negotiated Rate |
$502.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$502.20
|
|
|
PELVIC
|
Facility
|
OP
|
$6,700.00
|
|
|
Service Code
|
HCPCS 76856
|
| Hospital Charge Code |
94061179
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$117.99 |
| Max. Negotiated Rate |
$2,517.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$448.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$127.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$448.32
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$124.20
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,010.00
|
| Rate for Payer: Oxford Commercial |
$1,746.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,517.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$407.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$177.55
|
|
|
PELVIC
|
Facility
|
IP
|
$6,700.00
|
|
|
Service Code
|
HCPCS 76856
|
| Hospital Charge Code |
94061179
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,005.00 |
| Max. Negotiated Rate |
$1,005.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,005.00
|
|
|
PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC
|
Facility
|
IP
|
$70,979.22
|
|
|
Service Code
|
MSDRG 734
|
| Min. Negotiated Rate |
$21,612.26 |
| Max. Negotiated Rate |
$70,979.22 |
| Rate for Payer: Aetna Commercial |
$49,028.16
|
| Rate for Payer: Aetna Medicare Advantage |
$70,979.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50,476.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50,476.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$22,749.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50,476.37
|
| Rate for Payer: Cigna Commercial |
$39,860.82
|
| Rate for Payer: Cigna Medicare Advantage |
$22,749.75
|
| Rate for Payer: Clover Medicare Advantage |
$21,612.26
|
| Rate for Payer: EmblemHealth Commercial |
$68,249.25
|
| Rate for Payer: Humana Medicare Advantage |
$23,432.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$22,749.75
|
| Rate for Payer: Oxford Commercial |
$28,648.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$50,236.05
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$22,749.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$22,749.75
|
|
|
PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC
|
Facility
|
IP
|
$45,622.89
|
|
|
Service Code
|
MSDRG 735
|
| Min. Negotiated Rate |
$13,891.58 |
| Max. Negotiated Rate |
$45,622.89 |
| Rate for Payer: Aetna Commercial |
$31,605.44
|
| Rate for Payer: Aetna Medicare Advantage |
$45,622.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29,308.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29,308.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14,622.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29,308.86
|
| Rate for Payer: Cigna Commercial |
$25,179.69
|
| Rate for Payer: Cigna Medicare Advantage |
$14,622.72
|
| Rate for Payer: Clover Medicare Advantage |
$13,891.58
|
| Rate for Payer: EmblemHealth Commercial |
$43,868.16
|
| Rate for Payer: Humana Medicare Advantage |
$15,061.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14,622.72
|
| Rate for Payer: Oxford Commercial |
$18,096.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$31,733.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14,622.72
|
| Rate for Payer: Wellcare Medicare Advantage |
$14,622.72
|
|
|
PELVIC EXAM,UNDER ANESTHESIA
|
Facility
|
OP
|
$16,333.80
|
|
|
Service Code
|
HCPCS 57410
|
| Hospital Charge Code |
160000183
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$393.64 |
| Max. Negotiated Rate |
$13,882.15 |
| Rate for Payer: Aetna Commercial |
$10,460.55
|
| Rate for Payer: Aetna Medicare Advantage |
$12,460.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,882.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,882.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,845.79
|
| 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 |
$13,882.15
|
| Rate for Payer: Cigna Commercial |
$7,708.87
|
| Rate for Payer: Cigna Medicare Advantage |
$3,845.79
|
| Rate for Payer: Clover Medicare Advantage |
$3,653.50
|
| Rate for Payer: EmblemHealth Commercial |
$11,537.37
|
| Rate for Payer: Humana Medicare Advantage |
$3,961.16
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,845.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,900.14
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,450.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$393.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,845.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,845.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$432.85
|
|
|
PELVIC EXAM,UNDER ANESTHESIA
|
Facility
|
IP
|
$16,333.80
|
|
|
Service Code
|
HCPCS 57410
|
| Hospital Charge Code |
160000183
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,450.07 |
| Max. Negotiated Rate |
$2,450.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,450.07
|
|
