|
REREPAIR ING HERNIA,REDUCE-RT
|
Facility
|
OP
|
$30,877.00
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
160000242
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$744.14 |
| 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 |
$1,936.00
|
| 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 |
$9,263.10
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,631.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$744.14
|
| 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 |
$818.24
|
|
|
RESCUE NET RETRIEVAL NET
|
Facility
|
IP
|
$425.00
|
|
| Hospital Charge Code |
270680399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
|
|
RESCUE NET RETRIEVAL NET
|
Facility
|
OP
|
$425.00
|
|
| Hospital Charge Code |
270680399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.24 |
| Max. Negotiated Rate |
$212.50 |
| Rate for Payer: Aetna Commercial |
$161.50
|
| Rate for Payer: Aetna Medicare Advantage |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$108.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$108.38
|
| Rate for Payer: Cigna Commercial |
$212.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$127.50
|
| Rate for Payer: Oxford Commercial |
$85.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$85.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.26
|
|
|
RESECT BACK TUM < 5 CM
|
Facility
|
IP
|
$13,615.50
|
|
|
Service Code
|
HCPCS 21935
|
| Hospital Charge Code |
16000799
|
|
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
|
|
|
RESECT BACK TUM < 5 CM
|
Facility
|
OP
|
$13,615.50
|
|
|
Service Code
|
HCPCS 21935
|
| Hospital Charge Code |
16000799
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$328.13 |
| 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 |
$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 |
$3,450.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$360.81
|
|
|
RESECT BONE SPUR FOOT
|
Facility
|
OP
|
$19,998.60
|
|
|
Service Code
|
HCPCS 28119
|
| Hospital Charge Code |
16000239
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$481.97 |
| 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 |
$5,999.58
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$481.97
|
| 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 |
$529.96
|
|
|
RESECT BONE SPUR FOOT
|
Facility
|
IP
|
$19,998.60
|
|
|
Service Code
|
HCPCS 28119
|
| Hospital Charge Code |
16000239
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,999.79 |
| Max. Negotiated Rate |
$2,999.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.79
|
|
|
RESECT DIAPHRAGM SIMPLE
|
Facility
|
IP
|
$17,181.00
|
|
|
Service Code
|
HCPCS 39560
|
| Hospital Charge Code |
1600000586
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,577.15 |
| Max. Negotiated Rate |
$2,577.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,577.15
|
|
|
RESECT DIAPHRAGM SIMPLE
|
Facility
|
OP
|
$17,181.00
|
|
|
Service Code
|
HCPCS 39560
|
| Hospital Charge Code |
1600000586
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$414.06 |
| Max. Negotiated Rate |
$10,232.00 |
| Rate for Payer: Aetna Commercial |
$6,528.78
|
| Rate for Payer: Aetna Medicare Advantage |
$5,154.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,381.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,381.15
|
| 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 |
$4,381.15
|
| Rate for Payer: Cigna Commercial |
$8,590.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,154.30
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,577.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$414.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.30
|
|
|
RESECT FOOT/TOE TUMOR 3+ CM
|
Facility
|
IP
|
$22,282.25
|
|
|
Service Code
|
HCPCS 28047
|
| Hospital Charge Code |
16000631
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,342.34 |
| Max. Negotiated Rate |
$3,342.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,342.34
|
|
|
RESECT FOOT/TOE TUMOR 3+ CM
|
Facility
|
OP
|
$22,282.25
|
|
|
Service Code
|
HCPCS 28047
|
| Hospital Charge Code |
16000631
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$537.00 |
| 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 |
$1,742.00
|
| 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 |
$6,684.68
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,342.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$537.00
|
| 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 |
$590.48
|
|
|
RESECT FOOT/TOE TUMOR< 3CM
|
Facility
|
OP
|
$16,852.60
|
|
|
Service Code
|
HCPCS 28046
|
| Hospital Charge Code |
1600000302
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$406.15 |
| 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 |
$5,055.78
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,527.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$406.15
|
| 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 |
$446.59
|
|
|
RESECT FOOT/TOE TUMOR< 3CM
|
Facility
|
IP
|
$16,852.60
|
|
|
Service Code
|
HCPCS 28046
|
| Hospital Charge Code |
1600000302
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,527.89 |
| Max. Negotiated Rate |
$2,527.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,527.89
|
|
|
RESECT INFEOR TURBINATE-BILTRL
|
Facility
|
OP
|
$22,083.40
|
|
|
Service Code
|
HCPCS 30140
|
| Hospital Charge Code |
1600000273
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$532.21 |
| Max. Negotiated Rate |
$14,218.07 |
| Rate for Payer: Aetna Commercial |
$10,713.67
|
| Rate for Payer: Aetna Medicare Advantage |
$12,761.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,218.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,218.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,938.85
|
| 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 |
$14,218.07
|
| Rate for Payer: Cigna Commercial |
$7,895.42
|
| Rate for Payer: Cigna Medicare Advantage |
$3,938.85
|
| Rate for Payer: Clover Medicare Advantage |
$3,741.91
|
| Rate for Payer: EmblemHealth Commercial |
$11,816.55
|
| Rate for Payer: Humana Medicare Advantage |
$4,057.02
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,938.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,625.02
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,312.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$532.21
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,938.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,938.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$585.21
|
|
|
RESECT INFEOR TURBINATE-BILTRL
|
Facility
|
IP
|
$22,083.40
|
|
|
Service Code
|
HCPCS 30140
|
| Hospital Charge Code |
1600000273
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,312.51 |
| Max. Negotiated Rate |
$3,312.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,312.51
|
|
|
RESECTION OF SCROTUM
|
Facility
|
OP
|
$20,308.55
|
|
|
Service Code
|
HCPCS 55150
|
| Hospital Charge Code |
1600000559
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$489.44 |
| Max. Negotiated Rate |
$15,116.59 |
| Rate for Payer: Aetna Commercial |
$11,390.73
|
| Rate for Payer: Aetna Medicare Advantage |
$13,568.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,116.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,116.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,187.77
|
| 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 |
$15,116.59
|
| Rate for Payer: Cigna Commercial |
$8,394.37
|
| Rate for Payer: Cigna Medicare Advantage |
$4,187.77
|
| Rate for Payer: Clover Medicare Advantage |
$3,978.38
|
| Rate for Payer: EmblemHealth Commercial |
$12,563.31
|
| Rate for Payer: Humana Medicare Advantage |
$4,313.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,187.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,092.56
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,046.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$489.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$538.18
|
|
|
RESECTION OF SCROTUM
|
Facility
|
IP
|
$20,308.55
|
|
|
Service Code
|
HCPCS 55150
|
| Hospital Charge Code |
1600000559
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,046.28 |
| Max. Negotiated Rate |
$3,046.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,046.28
|
|
|
RESECT LEG/ANKLE TUM < 5 CM
|
Facility
|
IP
|
$17,408.40
|
|
|
Service Code
|
HCPCS 27615
|
| Hospital Charge Code |
1600000825
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,611.26 |
| Max. Negotiated Rate |
$2,611.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,611.26
|
|
|
RESECT LEG/ANKLE TUM < 5 CM
|
Facility
|
OP
|
$17,408.40
|
|
|
Service Code
|
HCPCS 27615
|
| Hospital Charge Code |
1600000825
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$419.54 |
| 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 |
$5,222.52
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,611.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$419.54
|
| 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 |
$461.32
|
|
|
RESECT METATARSAL TUMOR
|
Facility
|
IP
|
$17,164.20
|
|
|
Service Code
|
HCPCS 28173
|
| Hospital Charge Code |
16000632
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,574.63 |
| Max. Negotiated Rate |
$2,574.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,574.63
|
|
|
RESECT METATARSAL TUMOR
|
Facility
|
OP
|
$17,164.20
|
|
|
Service Code
|
HCPCS 28173
|
| Hospital Charge Code |
16000632
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$413.66 |
| 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 |
$5,149.26
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,574.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$413.66
|
| 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 |
$454.85
|
|
|
RESECT NECK TUMOR 5 CM/>
|
Facility
|
OP
|
$16,680.90
|
|
|
Service Code
|
HCPCS 21558
|
| Hospital Charge Code |
16000541
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$402.01 |
| 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 |
$1,742.00
|
| 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 |
$5,004.27
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,502.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$402.01
|
| 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 |
$442.04
|
|
|
RESECT NECK TUMOR 5 CM/>
|
Facility
|
IP
|
$16,680.90
|
|
|
Service Code
|
HCPCS 21558
|
| Hospital Charge Code |
16000541
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,502.14 |
| Max. Negotiated Rate |
$2,502.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,502.14
|
|
|
RESECTOR STRY 4 MM 275-542
|
Facility
|
IP
|
$332.65
|
|
| Hospital Charge Code |
270601417
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$49.90 |
| Max. Negotiated Rate |
$49.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.90
|
|
|
RESECTOR STRY 4 MM 275-542
|
Facility
|
OP
|
$332.65
|
|
| Hospital Charge Code |
270601417
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.02 |
| Max. Negotiated Rate |
$166.32 |
| Rate for Payer: Aetna Commercial |
$126.41
|
| Rate for Payer: Aetna Medicare Advantage |
$99.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.83
|
| Rate for Payer: Cigna Commercial |
$166.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$99.80
|
| Rate for Payer: Oxford Commercial |
$66.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.53
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.82
|
|
