|
REVERSE BODY SCREW AND STD
|
Facility
|
OP
|
$7,711.30
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270691400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$185.84 |
| Max. Negotiated Rate |
$3,855.65 |
| Rate for Payer: Aetna Commercial |
$2,930.29
|
| Rate for Payer: Aetna Medicare Advantage |
$2,313.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,966.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,966.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,542.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,966.38
|
| Rate for Payer: Cigna Commercial |
$3,855.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,866.13
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,696.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,156.69
|
| Rate for Payer: UnitedHealthcare Community & State |
$185.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$204.35
|
|
|
REVERSE BODY SCREW TITAN
|
Facility
|
IP
|
$12,205.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,830.83 |
| Max. Negotiated Rate |
$2,953.74 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,441.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,953.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,685.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,830.83
|
|
|
REVERSE BODY SCREW TITAN
|
Facility
|
OP
|
$12,205.55
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270691467
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$294.15 |
| Max. Negotiated Rate |
$6,102.77 |
| Rate for Payer: Aetna Commercial |
$4,638.11
|
| Rate for Payer: Aetna Medicare Advantage |
$3,661.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,112.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,112.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,441.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,112.42
|
| Rate for Payer: Cigna Commercial |
$6,102.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,953.74
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$2,685.22
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,830.83
|
| Rate for Payer: UnitedHealthcare Community & State |
$294.15
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$323.45
|
|
|
REVERSE BODY SMALL & SCREW
|
Facility
|
OP
|
$14,852.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270688777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$357.95 |
| Max. Negotiated Rate |
$7,426.25 |
| Rate for Payer: Aetna Commercial |
$5,643.95
|
| Rate for Payer: Aetna Medicare Advantage |
$4,455.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,787.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,787.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,970.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,787.39
|
| Rate for Payer: Cigna Commercial |
$7,426.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,594.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,267.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,227.88
|
| Rate for Payer: UnitedHealthcare Community & State |
$357.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$393.59
|
|
|
REVERSE BODY SMALL & SCREW
|
Facility
|
IP
|
$14,852.50
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270688777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,227.88 |
| Max. Negotiated Rate |
$3,594.30 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,970.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,594.30
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$3,267.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,227.88
|
|
|
REVERSE SHOULDER SYSTEM
|
Facility
|
OP
|
$5,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270704899
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$120.50 |
| Max. Negotiated Rate |
$2,500.00 |
| Rate for Payer: Aetna Commercial |
$1,900.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,500.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,275.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,275.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,000.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,275.00
|
| Rate for Payer: Cigna Commercial |
$2,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,210.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,100.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$750.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$120.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$132.50
|
|
|
REVERSE SHOULDER SYSTEM
|
Facility
|
IP
|
$5,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270704899
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$1,210.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,210.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$1,100.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$750.00
|
|
|
REV GJ ANASTOM WO VAGOT
|
Facility
|
IP
|
$8,727.00
|
|
|
Service Code
|
HCPCS 43860
|
| Hospital Charge Code |
16000968
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,309.05 |
| Max. Negotiated Rate |
$1,309.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,309.05
|
|
|
REV GJ ANASTOM WO VAGOT
|
Facility
|
OP
|
$8,727.00
|
|
|
Service Code
|
HCPCS 43860
|
| Hospital Charge Code |
16000968
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$210.32 |
| Max. Negotiated Rate |
$10,232.00 |
| Rate for Payer: Aetna Commercial |
$3,316.26
|
| Rate for Payer: Aetna Medicare Advantage |
$2,618.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,225.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,225.39
|
| 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 |
$2,225.39
|
| Rate for Payer: Cigna Commercial |
$4,363.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,618.10
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,309.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$210.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$231.27
|
|
|
REV HIP/ANCA TIBA W SCRW H70MM
|
Facility
|
IP
|
$26,250.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270678329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,937.50 |
| Max. Negotiated Rate |
$6,352.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,352.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$5,775.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,937.50
|
|
|
REV HIP/ANCA TIBA W SCRW H70MM
|
Facility
|
OP
|
$26,250.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270678329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$632.62 |
| Max. Negotiated Rate |
$13,125.00 |
| Rate for Payer: Aetna Commercial |
$9,975.00
|
| Rate for Payer: Aetna Medicare Advantage |
$7,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,693.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,693.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,693.75
|
| Rate for Payer: Cigna Commercial |
$13,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,352.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$5,775.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$632.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$695.62
|
|
|
REV HIP/TIBA DIA-18MM L-140MM
|
Facility
|
IP
|
$28,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270678330
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,200.00 |
| Max. Negotiated Rate |
$6,776.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,600.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,776.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,160.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,200.00
|
|
|
REV HIP/TIBA DIA-18MM L-140MM
|
Facility
|
OP
|
$28,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270678330
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$674.80 |
| Max. Negotiated Rate |
$14,000.00 |
| Rate for Payer: Aetna Commercial |
$10,640.00
|
| Rate for Payer: Aetna Medicare Advantage |
$8,400.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,140.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,140.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,600.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,140.00
|
| Rate for Payer: Cigna Commercial |
$14,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,776.00
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,160.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,200.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$674.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$742.00
|
|
|
REV HIP TIB NCK W SCRW H80MM
|
Facility
|
IP
|
$26,250.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270678331
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,937.50 |
| Max. Negotiated Rate |
$6,352.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,352.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$5,775.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,937.50
|
|
|
REV HIP TIB NCK W SCRW H80MM
|
Facility
|
OP
|
$26,250.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270678331
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$632.62 |
| Max. Negotiated Rate |
$13,125.00 |
| Rate for Payer: Aetna Commercial |
$9,975.00
|
| Rate for Payer: Aetna Medicare Advantage |
$7,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,693.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,693.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,693.75
|
| Rate for Payer: Cigna Commercial |
$13,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,352.50
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$5,775.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,937.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$632.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$695.62
|
|
|
REVISE AV FISTULA - GRAFT
|
Facility
|
OP
|
$38,857.60
|
|
|
Service Code
|
HCPCS 36832
|
| Hospital Charge Code |
16000948
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$936.47 |
| Max. Negotiated Rate |
$23,862.86 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| 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 |
$23,862.86
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$6,610.76
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,657.28
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,828.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$936.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,029.73
|
|
|
REVISE AV FISTULA - GRAFT
|
Facility
|
IP
|
$38,857.60
|
|
|
Service Code
|
HCPCS 36832
|
| Hospital Charge Code |
16000948
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,828.64 |
| Max. Negotiated Rate |
$5,828.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,828.64
|
|
|
REVISE CERV ARTIFIC DISC
|
Facility
|
IP
|
$44,286.00
|
|
|
Service Code
|
HCPCS 22861
|
| Hospital Charge Code |
160000229
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,642.90 |
| Max. Negotiated Rate |
$6,642.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,642.90
|
|
|
REVISE CERV ARTIFIC DISC
|
Facility
|
OP
|
$44,286.00
|
|
|
Service Code
|
HCPCS 22861
|
| Hospital Charge Code |
160000229
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,067.29 |
| Max. Negotiated Rate |
$75,192.36 |
| Rate for Payer: Aetna Commercial |
$56,659.34
|
| Rate for Payer: Aetna Medicare Advantage |
$67,491.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75,192.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75,192.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20,830.64
|
| 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 |
$75,192.36
|
| Rate for Payer: Cigna Commercial |
$41,754.94
|
| Rate for Payer: Cigna Medicare Advantage |
$20,830.64
|
| Rate for Payer: Clover Medicare Advantage |
$19,789.11
|
| Rate for Payer: EmblemHealth Commercial |
$62,491.92
|
| Rate for Payer: Humana Medicare Advantage |
$21,455.56
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20,830.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13,285.80
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,642.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,067.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$20,830.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,173.58
|
|
|
REVISED TOTAL HIP ARTHROPL
|
Facility
|
IP
|
$22,885.90
|
|
|
Service Code
|
HCPCS 27138
|
| Hospital Charge Code |
1600000597
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,432.89 |
| Max. Negotiated Rate |
$3,432.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,432.89
|
|
|
REVISED TOTAL HIP ARTHROPL
|
Facility
|
OP
|
$22,885.90
|
|
|
Service Code
|
HCPCS 27138
|
| Hospital Charge Code |
1600000597
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$551.55 |
| Max. Negotiated Rate |
$55,057.64 |
| Rate for Payer: Aetna Commercial |
$41,487.32
|
| Rate for Payer: Aetna Medicare Advantage |
$49,418.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55,057.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55,057.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15,252.69
|
| 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 |
$55,057.64
|
| Rate for Payer: Cigna Commercial |
$30,573.98
|
| Rate for Payer: Cigna Medicare Advantage |
$15,252.69
|
| Rate for Payer: Clover Medicare Advantage |
$14,490.06
|
| Rate for Payer: EmblemHealth Commercial |
$45,758.07
|
| Rate for Payer: Humana Medicare Advantage |
$15,710.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15,252.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,865.77
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,432.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$551.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$606.48
|
|
|
REVISE FINGER JOINT EACH
|
Facility
|
OP
|
$10,580.92
|
|
|
Service Code
|
HCPCS 26135
|
| Hospital Charge Code |
16000699
|
|
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 |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,587.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| 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
|
|
|
REVISE FINGER JOINT EACH
|
Facility
|
IP
|
$10,580.92
|
|
|
Service Code
|
HCPCS 26135
|
| Hospital Charge Code |
16000699
|
|
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
|
|
|
REVISE FINGER/TOE NERVE
|
Facility
|
IP
|
$9,553.80
|
|
|
Service Code
|
HCPCS 64702
|
| Hospital Charge Code |
323064702
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,433.07 |
| Max. Negotiated Rate |
$1,433.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,433.07
|
|
|
REVISE FINGER/TOE NERVE
|
Facility
|
OP
|
$9,553.80
|
|
|
Service Code
|
HCPCS 64702
|
| Hospital Charge Code |
323064702
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$8,374.11 |
| Rate for Payer: Aetna Commercial |
$6,310.10
|
| Rate for Payer: Aetna Medicare Advantage |
$7,516.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,374.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,374.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,319.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$280.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,374.11
|
| Rate for Payer: Cigna Commercial |
$4,650.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2,319.89
|
| Rate for Payer: Clover Medicare Advantage |
$2,203.90
|
| Rate for Payer: EmblemHealth Commercial |
$6,959.67
|
| Rate for Payer: Humana Medicare Advantage |
$2,389.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,319.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,866.14
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$850.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,433.07
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,319.89
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,319.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$253.18
|
|