|
RECOV ROOM 1 HOUR
|
Facility
|
OP
|
$3,198.55
|
|
| Hospital Charge Code |
1500024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$77.09 |
| Max. Negotiated Rate |
$1,599.28 |
| Rate for Payer: Aetna Commercial |
$1,215.45
|
| Rate for Payer: Aetna Medicare Advantage |
$959.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$815.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$815.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$815.63
|
| Rate for Payer: Cigna Commercial |
$1,599.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$959.57
|
| Rate for Payer: Oxford Commercial |
$639.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$479.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$639.71
|
| Rate for Payer: UnitedHealthcare Community & State |
$77.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$84.76
|
|
|
RECOV ROOM 1 HOUR
|
Facility
|
IP
|
$3,198.55
|
|
| Hospital Charge Code |
1500024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$479.78 |
| Max. Negotiated Rate |
$479.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$479.78
|
|
|
RECOV ROOM 1 HOUR
|
Facility
|
OP
|
$2,423.40
|
|
| Hospital Charge Code |
41101010
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$58.40 |
| Max. Negotiated Rate |
$1,211.70 |
| Rate for Payer: Aetna Commercial |
$920.89
|
| Rate for Payer: Aetna Medicare Advantage |
$727.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$617.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$617.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$617.97
|
| Rate for Payer: Cigna Commercial |
$1,211.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$727.02
|
| Rate for Payer: Oxford Commercial |
$484.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$484.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$58.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$64.22
|
|
|
RECOV ROOM 1 HOUR
|
Facility
|
IP
|
$2,423.40
|
|
| Hospital Charge Code |
41101010
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$363.51 |
| Max. Negotiated Rate |
$363.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.51
|
|
|
RECOV ROOM < 1 HR
|
Facility
|
OP
|
$2,398.87
|
|
| Hospital Charge Code |
1500020
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$57.81 |
| Max. Negotiated Rate |
$1,199.43 |
| Rate for Payer: Aetna Commercial |
$911.57
|
| Rate for Payer: Aetna Medicare Advantage |
$719.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$611.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$611.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$611.71
|
| Rate for Payer: Cigna Commercial |
$1,199.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$719.66
|
| Rate for Payer: Oxford Commercial |
$479.77
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$359.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$479.77
|
| Rate for Payer: UnitedHealthcare Community & State |
$57.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$63.57
|
|
|
RECOV ROOM < 1 HR
|
Facility
|
IP
|
$2,398.87
|
|
| Hospital Charge Code |
1500020
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$359.83 |
| Max. Negotiated Rate |
$359.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$359.83
|
|
|
RECOV ROOM 1 TO 1 1/2 HR
|
Facility
|
IP
|
$3,998.23
|
|
| Hospital Charge Code |
1500032
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$599.73 |
| Max. Negotiated Rate |
$599.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$599.73
|
|
|
RECOV ROOM 1 TO 1 1/2 HR
|
Facility
|
OP
|
$3,998.23
|
|
| Hospital Charge Code |
1500032
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$96.36 |
| Max. Negotiated Rate |
$1,999.12 |
| Rate for Payer: Aetna Commercial |
$1,519.33
|
| Rate for Payer: Aetna Medicare Advantage |
$1,199.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,019.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,019.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,019.55
|
| Rate for Payer: Cigna Commercial |
$1,999.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,199.47
|
| Rate for Payer: Oxford Commercial |
$799.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$599.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$799.65
|
| Rate for Payer: UnitedHealthcare Community & State |
$96.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$105.95
|
|
|
RECOV ROOM 2 1/2 TO 3 HRS
|
Facility
|
IP
|
$6,397.27
|
|
| Hospital Charge Code |
1500065
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$959.59 |
| Max. Negotiated Rate |
$959.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$959.59
|
|
|
RECOV ROOM 2 1/2 TO 3 HRS
|
Facility
|
OP
|
$6,397.27
|
|
| Hospital Charge Code |
1500065
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$154.17 |
| Max. Negotiated Rate |
$3,198.64 |
| Rate for Payer: Aetna Commercial |
$2,430.96
|
| Rate for Payer: Aetna Medicare Advantage |
$1,919.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,631.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,631.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,631.30
|
| Rate for Payer: Cigna Commercial |
$3,198.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,919.18
|
| Rate for Payer: Oxford Commercial |
$1,279.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$959.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,279.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$154.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$169.53
|
|
|
RECOV ROOM 2 TO 2 1/2 HRS
|
Facility
|
IP
|
$5,597.59
|
|
| Hospital Charge Code |
1500057
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$839.64 |
| Max. Negotiated Rate |
$839.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$839.64
|
|
|
RECOV ROOM 2 TO 2 1/2 HRS
|
Facility
|
OP
|
$5,597.59
|
|
| Hospital Charge Code |
1500057
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$134.90 |
| Max. Negotiated Rate |
$2,798.80 |
| Rate for Payer: Aetna Commercial |
$2,127.08
|
| Rate for Payer: Aetna Medicare Advantage |
$1,679.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,427.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,427.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,427.39
|
| Rate for Payer: Cigna Commercial |
$2,798.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,679.28
|
| Rate for Payer: Oxford Commercial |
$1,119.52
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$839.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,119.52
|
| Rate for Payer: UnitedHealthcare Community & State |
$134.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$148.34
|
|
|
RECOV ROOM 3 1/2 TO 4 HRS
|
Facility
|
IP
|
$7,996.83
|
|
| Hospital Charge Code |
1500081
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,199.52 |
| Max. Negotiated Rate |
$1,199.52 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,199.52
|
|
|
RECOV ROOM 3 1/2 TO 4 HRS
|
Facility
|
OP
|
$7,996.83
|
|
| Hospital Charge Code |
1500081
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$192.72 |
| Max. Negotiated Rate |
$3,998.41 |
| Rate for Payer: Aetna Commercial |
$3,038.80
|
| Rate for Payer: Aetna Medicare Advantage |
$2,399.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,039.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,039.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,039.19
|
| Rate for Payer: Cigna Commercial |
$3,998.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,399.05
|
| Rate for Payer: Oxford Commercial |
$1,599.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,199.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,599.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$192.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$211.92
|
|
|
RECOV ROOM 3 TO 3 1/2 HRS
|
Facility
|
OP
|
$7,196.95
|
|
| Hospital Charge Code |
1500073
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$173.45 |
| Max. Negotiated Rate |
$3,598.47 |
| Rate for Payer: Aetna Commercial |
$2,734.84
|
| Rate for Payer: Aetna Medicare Advantage |
$2,159.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,835.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,835.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,835.22
|
| Rate for Payer: Cigna Commercial |
$3,598.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,159.09
|
| Rate for Payer: Oxford Commercial |
$1,439.39
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,079.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,439.39
|
| Rate for Payer: UnitedHealthcare Community & State |
$173.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$190.72
|
|
|
RECOV ROOM 3 TO 3 1/2 HRS
|
Facility
|
IP
|
$7,196.95
|
|
| Hospital Charge Code |
1500073
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,079.54 |
| Max. Negotiated Rate |
$1,079.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,079.54
|
|
|
RECOV ROOM ADD 1/2 HR
|
Facility
|
IP
|
$551.00
|
|
| Hospital Charge Code |
41101015
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$82.65 |
| Max. Negotiated Rate |
$82.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.65
|
|
|
RECOV ROOM ADD 1/2 HR
|
Facility
|
OP
|
$799.68
|
|
| Hospital Charge Code |
1500099
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$19.27 |
| Max. Negotiated Rate |
$399.84 |
| Rate for Payer: Aetna Commercial |
$303.88
|
| Rate for Payer: Aetna Medicare Advantage |
$239.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$203.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$203.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$203.92
|
| Rate for Payer: Cigna Commercial |
$399.84
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$239.90
|
| Rate for Payer: Oxford Commercial |
$159.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.94
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.19
|
|
|
RECOV ROOM ADD 1/2 HR
|
Facility
|
IP
|
$799.68
|
|
| Hospital Charge Code |
1500099
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$119.95 |
| Max. Negotiated Rate |
$119.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.95
|
|
|
RECOV ROOM ADD 1/2 HR
|
Facility
|
OP
|
$551.00
|
|
| Hospital Charge Code |
41101015
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$275.50 |
| Rate for Payer: Aetna Commercial |
$209.38
|
| Rate for Payer: Aetna Medicare Advantage |
$165.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$140.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$140.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.50
|
| Rate for Payer: Cigna Commercial |
$275.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$165.30
|
| Rate for Payer: Oxford Commercial |
$110.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$110.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.60
|
|
|
RECOV ROOM ADD 15 MINUTES
|
Facility
|
IP
|
$276.00
|
|
| Hospital Charge Code |
1500025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$41.40 |
| Max. Negotiated Rate |
$41.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.40
|
|
|
RECOV ROOM ADD 15 MINUTES
|
Facility
|
OP
|
$276.00
|
|
| Hospital Charge Code |
1500025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$6.65 |
| Max. Negotiated Rate |
$138.00 |
| Rate for Payer: Aetna Commercial |
$104.88
|
| Rate for Payer: Aetna Medicare Advantage |
$82.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.38
|
| Rate for Payer: Cigna Commercial |
$138.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$82.80
|
| Rate for Payer: Oxford Commercial |
$55.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$55.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.31
|
|
|
RECOV ROOM COMX 1 1/2 TO 2 HR
|
Facility
|
OP
|
$5,997.39
|
|
| Hospital Charge Code |
1500007
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$144.54 |
| Max. Negotiated Rate |
$2,998.70 |
| Rate for Payer: Aetna Commercial |
$2,279.01
|
| Rate for Payer: Aetna Medicare Advantage |
$1,799.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,529.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,529.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,529.33
|
| Rate for Payer: Cigna Commercial |
$2,998.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,799.22
|
| Rate for Payer: Oxford Commercial |
$1,199.48
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$899.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,199.48
|
| Rate for Payer: UnitedHealthcare Community & State |
$144.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$158.93
|
|
|
RECOV ROOM COMX 1 1/2 TO 2 HR
|
Facility
|
IP
|
$5,997.39
|
|
| Hospital Charge Code |
1500007
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$899.61 |
| Max. Negotiated Rate |
$899.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$899.61
|
|
|
RECOV ROOM COMX 1 HOUR
|
Facility
|
IP
|
$3,998.19
|
|
| Hospital Charge Code |
1500003
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$599.73 |
| Max. Negotiated Rate |
$599.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$599.73
|
|