|
REMOVAL OF PELVIS CONTENTS
|
Facility
|
OP
|
$15,702.60
|
|
|
Service Code
|
HCPCS 58240
|
| Hospital Charge Code |
1600000729
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$378.43 |
| Max. Negotiated Rate |
$10,232.00 |
| Rate for Payer: Aetna Commercial |
$5,966.99
|
| Rate for Payer: Aetna Medicare Advantage |
$4,710.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,004.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,004.16
|
| 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 |
$4,004.16
|
| Rate for Payer: Cigna Commercial |
$7,851.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,710.78
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,355.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$378.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$416.12
|
|
|
REMOVAL OF PENIS
|
Facility
|
IP
|
$23,731.00
|
|
|
Service Code
|
HCPCS 54125
|
| Hospital Charge Code |
1600000767
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,559.65 |
| Max. Negotiated Rate |
$3,559.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,559.65
|
|
|
REMOVAL OF PENIS
|
Facility
|
OP
|
$23,731.00
|
|
|
Service Code
|
HCPCS 54125
|
| Hospital Charge Code |
1600000767
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$571.92 |
| Max. Negotiated Rate |
$11,865.50 |
| Rate for Payer: Aetna Commercial |
$9,017.78
|
| Rate for Payer: Aetna Medicare Advantage |
$7,119.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,051.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,051.40
|
| 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 |
$6,051.40
|
| Rate for Payer: Cigna Commercial |
$11,865.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,119.30
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,559.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$571.92
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$628.87
|
|
|
REMOVAL OF PM GENERATOR
|
Facility
|
IP
|
$48,966.00
|
|
|
Service Code
|
HCPCS 33233
|
| Hospital Charge Code |
411033233
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,344.90 |
| Max. Negotiated Rate |
$7,344.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,344.90
|
|
|
REMOVAL OF PM GENERATOR
|
Facility
|
OP
|
$48,966.00
|
|
|
Service Code
|
HCPCS 33233
|
| Hospital Charge Code |
411033233
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,180.08 |
| Max. Negotiated Rate |
$35,488.33 |
| Rate for Payer: Aetna Commercial |
$26,741.35
|
| Rate for Payer: Aetna Medicare Advantage |
$31,853.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35,488.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35,488.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9,831.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,194.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35,488.33
|
| Rate for Payer: Cigna Commercial |
$19,706.96
|
| Rate for Payer: Cigna Medicare Advantage |
$9,831.38
|
| Rate for Payer: Clover Medicare Advantage |
$9,339.81
|
| Rate for Payer: EmblemHealth Commercial |
$29,494.14
|
| Rate for Payer: Humana Medicare Advantage |
$10,126.32
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9,831.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14,689.80
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,344.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,180.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9,831.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$9,831.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,297.60
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Facility
|
OP
|
$11,677.88
|
|
|
Service Code
|
HCPCS 20680
|
| Hospital Charge Code |
16000180
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$281.44 |
| Max. Negotiated Rate |
$12,456.64 |
| Rate for Payer: Aetna Commercial |
$9,386.39
|
| Rate for Payer: Aetna Medicare Advantage |
$11,180.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,456.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,456.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,450.88
|
| 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 |
$12,456.64
|
| Rate for Payer: Cigna Commercial |
$6,917.28
|
| Rate for Payer: Cigna Medicare Advantage |
$3,450.88
|
| Rate for Payer: Clover Medicare Advantage |
$3,278.34
|
| Rate for Payer: EmblemHealth Commercial |
$10,352.64
|
| Rate for Payer: Humana Medicare Advantage |
$3,554.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,450.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,503.36
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,751.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$281.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$309.46
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Facility
|
IP
|
$13,615.50
|
|
|
Service Code
|
HCPCS 20670
|
| Hospital Charge Code |
16000668
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,042.33 |
| Max. Negotiated Rate |
$2,042.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,042.33
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Facility
|
OP
|
$13,615.50
|
|
|
Service Code
|
HCPCS 20670
|
| Hospital Charge Code |
16000668
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$328.13 |
| Max. Negotiated Rate |
$7,082.74 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,082.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$862.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,082.74
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,084.65
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,042.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$328.13
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$360.81
|
|
|
REMOVAL OF SUPPORT IMPLANT
|
Facility
|
IP
|
$11,677.88
|
|
|
Service Code
|
HCPCS 20680
|
| Hospital Charge Code |
16000180
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,751.68 |
| Max. Negotiated Rate |
$1,751.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,751.68
|
|
|
REMOVAL OF TESTIS
|
Facility
|
OP
|
$16,624.12
|
|
|
Service Code
|
HCPCS 54530
|
| Hospital Charge Code |
160000212
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$400.64 |
| Max. Negotiated Rate |
$15,354.26 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,354.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,354.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,354.26
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,987.24
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,493.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$400.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$440.54
|
|
|
REMOVAL OF TESTIS
|
Facility
|
IP
|
$16,624.12
|
|
|
Service Code
|
HCPCS 54530
|
| Hospital Charge Code |
160000212
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,493.62 |
| Max. Negotiated Rate |
$2,493.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,493.62
|
|
|
REMOVAL OF THYROID
|
Facility
|
OP
|
$27,866.56
|
|
|
Service Code
|
HCPCS 60271
|
| Hospital Charge Code |
1600000457
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$671.58 |
| 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 |
$8,359.97
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,179.98
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$671.58
|
| 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 |
$738.46
|
|
|
REMOVAL OF THYROID
|
Facility
|
IP
|
$27,866.56
|
|
|
Service Code
|
HCPCS 60271
|
| Hospital Charge Code |
1600000457
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,179.98 |
| Max. Negotiated Rate |
$4,179.98 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,179.98
|
|
|
REMOVAL OF TOE LESIONS-T5
|
Facility
|
IP
|
$20,900.00
|
|
|
Service Code
|
HCPCS 28092
|
| Hospital Charge Code |
16000719
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,135.00 |
| Max. Negotiated Rate |
$3,135.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,135.00
|
|
|
REMOVAL OF TOE LESIONS-T5
|
Facility
|
OP
|
$20,900.00
|
|
|
Service Code
|
HCPCS 28092
|
| Hospital Charge Code |
16000719
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$503.69 |
| Max. Negotiated Rate |
$8,157.00 |
| Rate for Payer: Aetna Commercial |
$5,196.12
|
| Rate for Payer: Aetna Medicare Advantage |
$6,189.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,895.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,895.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,910.34
|
| 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 |
$6,895.75
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: Cigna Medicare Advantage |
$1,910.34
|
| Rate for Payer: Clover Medicare Advantage |
$1,814.82
|
| Rate for Payer: EmblemHealth Commercial |
$5,731.02
|
| Rate for Payer: Humana Medicare Advantage |
$1,967.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,910.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,270.00
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,135.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$503.69
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$553.85
|
|
|
REMOVAL OF TOE LESIONS-T9
|
Facility
|
IP
|
$20,900.00
|
|
|
Service Code
|
HCPCS 28108
|
| Hospital Charge Code |
16000401
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,135.00 |
| Max. Negotiated Rate |
$3,135.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,135.00
|
|
|
REMOVAL OF TOE LESIONS-T9
|
Facility
|
OP
|
$20,900.00
|
|
|
Service Code
|
HCPCS 28108
|
| Hospital Charge Code |
16000401
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$503.69 |
| Max. Negotiated Rate |
$8,157.00 |
| Rate for Payer: Aetna Commercial |
$5,196.12
|
| Rate for Payer: Aetna Medicare Advantage |
$6,189.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,895.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,895.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,910.34
|
| 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 |
$6,895.75
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: Cigna Medicare Advantage |
$1,910.34
|
| Rate for Payer: Clover Medicare Advantage |
$1,814.82
|
| Rate for Payer: EmblemHealth Commercial |
$5,731.02
|
| Rate for Payer: Humana Medicare Advantage |
$1,967.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,910.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,270.00
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,135.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$503.69
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$553.85
|
|
|
REMOVAL OF UPPER JAW
|
Facility
|
IP
|
$15,638.00
|
|
|
Service Code
|
HCPCS 31225
|
| Hospital Charge Code |
1600000663
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,345.70 |
| Max. Negotiated Rate |
$2,345.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,345.70
|
|
|
REMOVAL OF UPPER JAW
|
Facility
|
OP
|
$15,638.00
|
|
|
Service Code
|
HCPCS 31225
|
| Hospital Charge Code |
1600000663
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$376.88 |
| Max. Negotiated Rate |
$10,232.00 |
| Rate for Payer: Aetna Commercial |
$5,942.44
|
| Rate for Payer: Aetna Medicare Advantage |
$4,691.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,987.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,987.69
|
| 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 |
$3,987.69
|
| Rate for Payer: Cigna Commercial |
$7,819.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,691.40
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,345.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$376.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$414.41
|
|
|
REMOVAL OF URETER
|
Facility
|
OP
|
$11,332.50
|
|
|
Service Code
|
HCPCS 50660
|
| Hospital Charge Code |
1600000387
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$273.11 |
| Max. Negotiated Rate |
$10,232.00 |
| Rate for Payer: Aetna Commercial |
$4,306.35
|
| Rate for Payer: Aetna Medicare Advantage |
$3,399.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,889.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,889.79
|
| 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 |
$2,889.79
|
| Rate for Payer: Cigna Commercial |
$5,666.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,399.75
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,699.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$273.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$300.31
|
|
|
REMOVAL OF URETER
|
Facility
|
IP
|
$11,332.50
|
|
|
Service Code
|
HCPCS 50660
|
| Hospital Charge Code |
1600000387
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,699.88 |
| Max. Negotiated Rate |
$1,699.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,699.88
|
|
|
REMOVAL OF WRIST BONE
|
Facility
|
IP
|
$12,289.64
|
|
|
Service Code
|
HCPCS 25210
|
| Hospital Charge Code |
16000472
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,843.45 |
| Max. Negotiated Rate |
$1,843.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,843.45
|
|
|
REMOVAL OF WRIST BONE
|
Facility
|
OP
|
$12,289.64
|
|
|
Service Code
|
HCPCS 25210
|
| Hospital Charge Code |
16000472
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$296.18 |
| 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 |
$3,686.89
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,843.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$296.18
|
| 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 |
$325.68
|
|
|
REMOVAL OF WRIST LESION
|
Facility
|
IP
|
$12,406.91
|
|
|
Service Code
|
HCPCS 25130
|
| Hospital Charge Code |
16000830
|
|
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
|
|
|
REMOVAL OF WRIST LESION
|
Facility
|
OP
|
$12,406.91
|
|
|
Service Code
|
HCPCS 25130
|
| Hospital Charge Code |
16000830
|
|
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 |
$1,355.00
|
| 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 |
$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
|
|
