|
REVISE FINGER/TOE NERVE-F6
|
Facility
|
OP
|
$16,437.00
|
|
|
Service Code
|
HCPCS 64702
|
| Hospital Charge Code |
16000526
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$396.13 |
| 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 |
$862.00
|
| 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 |
$4,931.10
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,465.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$396.13
|
| 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 |
$435.58
|
|
|
REVISE FINGER/TOE NERVE-F6
|
Facility
|
IP
|
$16,437.00
|
|
|
Service Code
|
HCPCS 64702
|
| Hospital Charge Code |
16000526
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,465.55 |
| Max. Negotiated Rate |
$2,465.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,465.55
|
|
|
REVISE LAGB
|
Facility
|
IP
|
$112,126.91
|
|
|
Service Code
|
HCPCS 43771
|
| Hospital Charge Code |
1600164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16,819.04 |
| Max. Negotiated Rate |
$16,819.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16,819.04
|
|
|
REVISE LAGB
|
Facility
|
OP
|
$112,126.91
|
|
|
Service Code
|
HCPCS 43771
|
| Hospital Charge Code |
1600164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,702.26 |
| Max. Negotiated Rate |
$56,063.46 |
| Rate for Payer: Aetna Commercial |
$42,608.23
|
| Rate for Payer: Aetna Medicare Advantage |
$33,638.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,120.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,120.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12,971.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12,120.00
|
| Rate for Payer: Cigna Commercial |
$56,063.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33,638.07
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16,819.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,702.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,971.36
|
|
|
REVISE LOW BACK NERVE(S)
|
Facility
|
IP
|
$9,663.00
|
|
|
Service Code
|
HCPCS 64714
|
| Hospital Charge Code |
16001044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,449.45 |
| Max. Negotiated Rate |
$1,449.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,449.45
|
|
|
REVISE LOW BACK NERVE(S)
|
Facility
|
OP
|
$9,663.00
|
|
|
Service Code
|
HCPCS 64714
|
| Hospital Charge Code |
16001044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$232.88 |
| 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 |
$1,016.00
|
| 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 |
$2,898.90
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,449.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$232.88
|
| 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 |
$256.07
|
|
|
REVISE LOWER LEG TENDON
|
Facility
|
IP
|
$22,425.68
|
|
|
Service Code
|
HCPCS 27691
|
| Hospital Charge Code |
16000565
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,363.85 |
| Max. Negotiated Rate |
$3,363.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,363.85
|
|
|
REVISE LOWER LEG TENDON
|
Facility
|
OP
|
$22,425.68
|
|
|
Service Code
|
HCPCS 27691
|
| Hospital Charge Code |
16000565
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$540.46 |
| 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 |
$6,727.70
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,363.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$540.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$580.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$569.19
|
|
|
REVISE RECONSTR BREAST
|
Facility
|
IP
|
$42,601.70
|
|
|
Service Code
|
HCPCS 19380
|
| Hospital Charge Code |
16000790
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,390.26 |
| Max. Negotiated Rate |
$6,390.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,390.26
|
|
|
REVISE RECONSTR BREAST
|
Facility
|
OP
|
$42,601.70
|
|
|
Service Code
|
HCPCS 19380
|
| Hospital Charge Code |
16000790
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,026.70 |
| Max. Negotiated Rate |
$28,475.80 |
| Rate for Payer: Aetna Commercial |
$21,457.24
|
| Rate for Payer: Aetna Medicare Advantage |
$25,559.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28,475.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28,475.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,888.69
|
| 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 |
$28,475.80
|
| Rate for Payer: Cigna Commercial |
$15,812.86
|
| Rate for Payer: Cigna Medicare Advantage |
$7,888.69
|
| Rate for Payer: Clover Medicare Advantage |
$7,494.26
|
| Rate for Payer: EmblemHealth Commercial |
$23,666.07
|
| Rate for Payer: Humana Medicare Advantage |
$8,125.35
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,888.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12,780.51
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,390.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,870.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,026.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,888.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,888.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,128.95
|
|
|
REVISE/REMOVE NEUROELECTRODE
|
Facility
|
OP
|
$16,134.72
|
|
|
Service Code
|
HCPCS 64585
|
| Hospital Charge Code |
1600000694
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$388.85 |
| Max. Negotiated Rate |
$14,992.78 |
| Rate for Payer: Aetna Commercial |
$11,297.44
|
| Rate for Payer: Aetna Medicare Advantage |
$13,457.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,992.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,992.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,153.47
|
| 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 |
$14,992.78
|
| Rate for Payer: Cigna Commercial |
$8,325.61
|
| Rate for Payer: Cigna Medicare Advantage |
$4,153.47
|
| Rate for Payer: Clover Medicare Advantage |
$3,945.80
|
| Rate for Payer: EmblemHealth Commercial |
$12,460.41
|
| Rate for Payer: Humana Medicare Advantage |
$4,278.07
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,153.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,840.42
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,420.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$388.85
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,153.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,153.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$427.57
|
|
|
REVISE/REMOVE NEUROELECTRODE
|
Facility
|
IP
|
$16,134.72
|
|
|
Service Code
|
HCPCS 64585
|
| Hospital Charge Code |
1600000694
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,420.21 |
| Max. Negotiated Rate |
$2,420.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,420.21
|
|
|
REVISE/REPLACE KNEE JOINT 1 CO
|
Facility
|
IP
|
$12,899.50
|
|
|
Service Code
|
HCPCS 27486
|
| Hospital Charge Code |
16000448
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,934.92 |
| Max. Negotiated Rate |
$1,934.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,934.92
|
|
|
REVISE/REPLACE KNEE JOINT 1 CO
|
Facility
|
OP
|
$12,899.50
|
|
|
Service Code
|
HCPCS 27486
|
| Hospital Charge Code |
16000448
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$310.88 |
| 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 |
$3,869.85
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,934.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$310.88
|
| 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 |
$341.84
|
|
|
REVISE/RMV PN/GASTR STIMUL
|
Facility
|
OP
|
$15,827.28
|
|
|
Service Code
|
HCPCS 64595
|
| Hospital Charge Code |
1600000693
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$381.44 |
| Max. Negotiated Rate |
$14,992.78 |
| Rate for Payer: Aetna Commercial |
$11,297.44
|
| Rate for Payer: Aetna Medicare Advantage |
$13,457.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,992.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,992.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,153.47
|
| 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 |
$14,992.78
|
| Rate for Payer: Cigna Commercial |
$8,325.61
|
| Rate for Payer: Cigna Medicare Advantage |
$4,153.47
|
| Rate for Payer: Clover Medicare Advantage |
$3,945.80
|
| Rate for Payer: EmblemHealth Commercial |
$12,460.41
|
| Rate for Payer: Humana Medicare Advantage |
$4,278.07
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,153.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,748.18
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,374.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$381.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,153.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,153.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$419.42
|
|
|
REVISE/RMV PN/GASTR STIMUL
|
Facility
|
IP
|
$15,827.28
|
|
|
Service Code
|
HCPCS 64595
|
| Hospital Charge Code |
1600000693
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,374.09 |
| Max. Negotiated Rate |
$2,374.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,374.09
|
|
|
REVISION ARTHROPLASTY,SHOULDER
|
Facility
|
OP
|
$16,453.00
|
|
|
Service Code
|
HCPCS 23472
|
| Hospital Charge Code |
16000421
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$396.52 |
| 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 |
$4,935.90
|
| Rate for Payer: Oxford Commercial |
$9,689.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,467.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,605.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$396.52
|
| 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 |
$436.00
|
|
|
REVISION ARTHROPLASTY,SHOULDER
|
Facility
|
IP
|
$16,453.00
|
|
|
Service Code
|
HCPCS 23472
|
| Hospital Charge Code |
16000421
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,467.95 |
| Max. Negotiated Rate |
$2,467.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,467.95
|
|
|
REVISION OF AORTIC VALVE
|
Facility
|
IP
|
$26,857.80
|
|
|
Service Code
|
HCPCS 92986
|
| Hospital Charge Code |
69008134
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,028.67 |
| Max. Negotiated Rate |
$4,028.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,028.67
|
|
|
REVISION OF AORTIC VALVE
|
Facility
|
OP
|
$26,857.80
|
|
|
Service Code
|
HCPCS 92986
|
| Hospital Charge Code |
69008134
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$647.27 |
| Max. Negotiated Rate |
$24,407.82 |
| Rate for Payer: Aetna Commercial |
$18,391.91
|
| Rate for Payer: Aetna Medicare Advantage |
$21,908.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24,407.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24,407.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,761.73
|
| 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 |
$24,407.82
|
| Rate for Payer: Cigna Commercial |
$13,553.85
|
| Rate for Payer: Cigna Medicare Advantage |
$6,761.73
|
| Rate for Payer: Clover Medicare Advantage |
$6,423.64
|
| Rate for Payer: EmblemHealth Commercial |
$20,285.19
|
| Rate for Payer: Humana Medicare Advantage |
$6,964.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,761.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,057.34
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$6,600.00
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,028.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$647.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,761.73
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,761.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$711.73
|
|
|
REVISION OF ARM NERVE(S)
|
Facility
|
OP
|
$9,198.80
|
|
|
Service Code
|
HCPCS 64713
|
| Hospital Charge Code |
16000158
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$221.69 |
| 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 |
$1,016.00
|
| 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 |
$2,759.64
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,379.82
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$221.69
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,319.89
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,319.89
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$5,656.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5,545.76
|
|
|
REVISION OF ARM NERVE(S)
|
Facility
|
IP
|
$9,198.80
|
|
|
Service Code
|
HCPCS 64713
|
| Hospital Charge Code |
16000158
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,379.82 |
| Max. Negotiated Rate |
$1,379.82 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,379.82
|
|
|
REVISION OF BLADDER/URETHRA
|
Facility
|
OP
|
$14,429.00
|
|
|
Service Code
|
HCPCS 51800
|
| Hospital Charge Code |
1600000621
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$347.74 |
| Max. Negotiated Rate |
$10,232.00 |
| Rate for Payer: Aetna Commercial |
$5,483.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4,328.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,679.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,679.39
|
| 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 |
$3,679.39
|
| Rate for Payer: Cigna Commercial |
$7,214.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,328.70
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,164.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,232.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$347.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$382.37
|
|
|
REVISION OF BLADDER/URETHRA
|
Facility
|
IP
|
$14,429.00
|
|
|
Service Code
|
HCPCS 51800
|
| Hospital Charge Code |
1600000621
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,164.35 |
| Max. Negotiated Rate |
$2,164.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,164.35
|
|
|
REVISION OF CALF TENDON
|
Facility
|
OP
|
$10,580.92
|
|
|
Service Code
|
HCPCS 27687
|
| Hospital Charge Code |
16000304
|
|
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 |
$1,355.00
|
| 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 |
$3,174.28
|
| 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
|
|
