|
REMOVE WRIST/FOREARM LESION
|
Facility
|
IP
|
$10,580.92
|
|
|
Service Code
|
HCPCS 25116
|
| Hospital Charge Code |
16000616
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,587.14 |
| Max. Negotiated Rate |
$1,587.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,587.14
|
|
|
REMOVE WRIST/FOREARM LESION
|
Facility
|
OP
|
$10,580.92
|
|
|
Service Code
|
HCPCS 25116
|
| Hospital Charge Code |
16000616
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$255.00 |
| 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 |
$3,174.28
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,587.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$255.00
|
| 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 |
$280.39
|
|
|
REMOVE WRIST JOINT LINING
|
Facility
|
OP
|
$12,406.91
|
|
|
Service Code
|
HCPCS 25105
|
| Hospital Charge Code |
16000471
|
|
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 |
$1,626.00
|
| 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 |
$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
|
|
|
REMOVE WRIST JOINT LINING
|
Facility
|
IP
|
$12,406.91
|
|
|
Service Code
|
HCPCS 25105
|
| Hospital Charge Code |
16000471
|
|
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
|
|
|
REMOV PERM PACE W/REPLC SNG
|
Facility
|
OP
|
$38,922.60
|
|
|
Service Code
|
HCPCS 33227
|
| Hospital Charge Code |
74110072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$938.03 |
| 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 |
$1,626.00
|
| 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 |
$11,676.78
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,838.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$938.03
|
| 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 |
$1,031.45
|
|
|
REMOV PERM PACE W/REPLC SNG
|
Facility
|
OP
|
$38,922.60
|
|
|
Service Code
|
HCPCS 33227
|
| Hospital Charge Code |
5100771
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$938.03 |
| 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 |
$1,626.00
|
| 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 |
$11,676.78
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,838.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$938.03
|
| 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 |
$1,031.45
|
|
|
REMOV PERM PACE W/REPLC SNG
|
Facility
|
IP
|
$38,922.60
|
|
|
Service Code
|
HCPCS 33227
|
| Hospital Charge Code |
74110072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,838.39 |
| Max. Negotiated Rate |
$5,838.39 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,838.39
|
|
|
REMOV PERM PACE W/REPLC SNG
|
Facility
|
IP
|
$38,922.60
|
|
|
Service Code
|
HCPCS 33227
|
| Hospital Charge Code |
5100771
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,838.39 |
| Max. Negotiated Rate |
$5,838.39 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,838.39
|
|
|
REMOV PERM PM W/REPLC DUL LEAD
|
Facility
|
OP
|
$42,670.00
|
|
|
Service Code
|
HCPCS 33228
|
| Hospital Charge Code |
5100772
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,028.35 |
| Max. Negotiated Rate |
$44,822.55 |
| Rate for Payer: Aetna Commercial |
$33,774.92
|
| Rate for Payer: Aetna Medicare Advantage |
$40,231.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44,822.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44,822.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12,417.25
|
| 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 |
$44,822.55
|
| Rate for Payer: Cigna Commercial |
$24,890.32
|
| Rate for Payer: Cigna Medicare Advantage |
$12,417.25
|
| Rate for Payer: Clover Medicare Advantage |
$11,796.39
|
| Rate for Payer: EmblemHealth Commercial |
$37,251.75
|
| Rate for Payer: Humana Medicare Advantage |
$12,789.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12,417.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12,801.00
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,400.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,028.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12,417.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$12,417.25
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$17,126.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16,790.24
|
|
|
REMOV PERM PM W/REPLC DUL LEAD
|
Facility
|
IP
|
$42,670.00
|
|
|
Service Code
|
HCPCS 33228
|
| Hospital Charge Code |
5100772
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,400.50 |
| Max. Negotiated Rate |
$6,400.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,400.50
|
|
|
REMOV PERM PM W/REPLC DUL LEAD
|
Facility
|
OP
|
$42,670.00
|
|
|
Service Code
|
HCPCS 33228
|
| Hospital Charge Code |
74110073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,028.35 |
| Max. Negotiated Rate |
$44,822.55 |
| Rate for Payer: Aetna Commercial |
$33,774.92
|
| Rate for Payer: Aetna Medicare Advantage |
$40,231.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44,822.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44,822.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12,417.25
|
| 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 |
$44,822.55
|
| Rate for Payer: Cigna Commercial |
$24,890.32
|
| Rate for Payer: Cigna Medicare Advantage |
$12,417.25
|
| Rate for Payer: Clover Medicare Advantage |
$11,796.39
|
| Rate for Payer: EmblemHealth Commercial |
$37,251.75
|
| Rate for Payer: Humana Medicare Advantage |
$12,789.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12,417.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12,801.00
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,400.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,028.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12,417.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$12,417.25
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$17,126.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16,790.24
|
|
|
REMOV PERM PM W/REPLC DUL LEAD
|
Facility
|
IP
|
$42,670.00
|
|
|
Service Code
|
HCPCS 33228
|
| Hospital Charge Code |
74110073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,400.50 |
| Max. Negotiated Rate |
$6,400.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,400.50
|
|
|
REMOV TUNNL INTRAPER CATH
|
Facility
|
IP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 49422
|
| Hospital Charge Code |
411049422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,869.43 |
| Max. Negotiated Rate |
$1,869.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
|
|
REMOV TUNNL INTRAPER CATH
|
Facility
|
OP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 49422
|
| Hospital Charge Code |
411049422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$300.35 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| 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 |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,738.86
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$330.27
|
|
|
REMOV TUNNL INTRAPER CATH
|
Facility
|
IP
|
$6,578.00
|
|
|
Service Code
|
HCPCS 49422
|
| Hospital Charge Code |
7411589
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$986.70 |
| Max. Negotiated Rate |
$986.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$986.70
|
|
|
REMOV TUNNL INTRAPER CATH
|
Facility
|
OP
|
$6,578.00
|
|
|
Service Code
|
HCPCS 49422
|
| Hospital Charge Code |
7411589
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$158.53 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| 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 |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,973.40
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$986.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$158.53
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$174.32
|
|
|
REMOV TUNNL INTRAPER CATH
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 49422
|
| Hospital Charge Code |
2690150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
REMOV TUNNL INTRAPER CATH
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 49422
|
| Hospital Charge Code |
321049422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$372.79 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| 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 |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,640.55
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$372.79
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$409.92
|
|
|
REMOV TUNNL INTRAPER CATH
|
Facility
|
OP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 49422
|
| Hospital Charge Code |
366849422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$300.35 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| 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 |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,738.86
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$300.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$330.27
|
|
|
REMOV TUNNL INTRAPER CATH
|
Facility
|
IP
|
$12,462.85
|
|
|
Service Code
|
HCPCS 49422
|
| Hospital Charge Code |
366849422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,869.43 |
| Max. Negotiated Rate |
$1,869.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,869.43
|
|
|
REMOV TUNNL INTRAPER CATH
|
Facility
|
OP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 49422
|
| Hospital Charge Code |
2690150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$372.79 |
| Max. Negotiated Rate |
$13,540.60 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,540.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| 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 |
$13,540.60
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,640.55
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$372.79
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$409.92
|
|
|
REMOV TUNNL INTRAPER CATH
|
Facility
|
IP
|
$15,468.50
|
|
|
Service Code
|
HCPCS 49422
|
| Hospital Charge Code |
321049422
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,320.28 |
| Max. Negotiated Rate |
$2,320.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,320.28
|
|
|
REM P SEGMENT INSTRUMENT
|
Facility
|
OP
|
$11,058.29
|
|
|
Service Code
|
HCPCS 22852
|
| Hospital Charge Code |
16000810
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$266.50 |
| 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 |
$3,317.49
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,658.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$266.50
|
| 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 |
$293.04
|
|
|
REM P SEGMENT INSTRUMENT
|
Facility
|
IP
|
$11,058.29
|
|
|
Service Code
|
HCPCS 22852
|
| Hospital Charge Code |
16000810
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,658.74 |
| Max. Negotiated Rate |
$1,658.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,658.74
|
|
|
REM&REPL NEPHROURET STENT
|
Facility
|
OP
|
$6,757.27
|
|
|
Service Code
|
HCPCS 50387
|
| Hospital Charge Code |
7412031
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$162.85 |
| Max. Negotiated Rate |
$8,964.44 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| 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 |
$8,964.44
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,027.18
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,013.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$162.85
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$179.07
|
|
