|
ABLATOR HOOK 90DEG
|
Facility
|
IP
|
$575.00
|
|
| Hospital Charge Code |
270671808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$86.25 |
| Max. Negotiated Rate |
$86.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.25
|
|
|
ABO BLOOD TYPE
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
HCPCS 86900
|
| Hospital Charge Code |
38471070
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$15.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.15
|
|
|
ABO BLOOD TYPE
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
HCPCS 86900
|
| Hospital Charge Code |
38471070
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$316.85 |
| Rate for Payer: Aetna Commercial |
$8.13
|
| Rate for Payer: Aetna Medicare Advantage |
$9.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.79
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$2.99
|
| Rate for Payer: Clover Medicare Advantage |
$2.84
|
| Rate for Payer: EmblemHealth Commercial |
$8.97
|
| Rate for Payer: Humana Medicare Advantage |
$3.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$2.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.68
|
|
|
ABORH ADON AUTO DONOR
|
Facility
|
IP
|
$626.42
|
|
|
Service Code
|
HCPCS 86900
|
| Hospital Charge Code |
3100486
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$93.96 |
| Max. Negotiated Rate |
$93.96 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.96
|
|
|
ABORH ADON AUTO DONOR
|
Facility
|
OP
|
$626.42
|
|
|
Service Code
|
HCPCS 86900
|
| Hospital Charge Code |
3100486
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$316.85 |
| Rate for Payer: Aetna Commercial |
$8.13
|
| Rate for Payer: Aetna Medicare Advantage |
$9.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.79
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$2.99
|
| Rate for Payer: Clover Medicare Advantage |
$2.84
|
| Rate for Payer: EmblemHealth Commercial |
$8.97
|
| Rate for Payer: Humana Medicare Advantage |
$3.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$187.93
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.96
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$2.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.60
|
|
|
ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY
|
Facility
|
IP
|
$34,543.02
|
|
|
Service Code
|
MSDRG 770
|
| Min. Negotiated Rate |
$10,517.91 |
| Max. Negotiated Rate |
$34,543.02 |
| Rate for Payer: Aetna Commercial |
$23,992.32
|
| Rate for Payer: Aetna Medicare Advantage |
$34,543.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18,608.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18,608.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11,071.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18,608.80
|
| Rate for Payer: Cigna Commercial |
$18,764.53
|
| Rate for Payer: Cigna Medicare Advantage |
$11,071.48
|
| Rate for Payer: Clover Medicare Advantage |
$10,517.91
|
| Rate for Payer: EmblemHealth Commercial |
$33,214.44
|
| Rate for Payer: Humana Medicare Advantage |
$11,403.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11,071.48
|
| Rate for Payer: Oxford Commercial |
$13,486.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$23,648.68
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11,071.48
|
| Rate for Payer: Wellcare Medicare Advantage |
$11,071.48
|
|
|
ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY
|
Facility
|
IP
|
$7,849.20
|
|
|
Service Code
|
APR-DRG 5432
|
| Min. Negotiated Rate |
$7,695.29 |
| Max. Negotiated Rate |
$7,849.20 |
| Rate for Payer: UnitedHealthcare Community & State |
$7,695.29
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$7,849.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7,695.29
|
|
|
ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY
|
Facility
|
IP
|
$5,995.41
|
|
|
Service Code
|
APR-DRG 5431
|
| Min. Negotiated Rate |
$5,877.85 |
| Max. Negotiated Rate |
$5,995.41 |
| Rate for Payer: UnitedHealthcare Community & State |
$5,877.85
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$5,995.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5,877.85
|
|
|
ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY
|
Facility
|
IP
|
$24,664.74
|
|
|
Service Code
|
APR-DRG 5434
|
| Min. Negotiated Rate |
$24,181.12 |
| Max. Negotiated Rate |
$24,664.74 |
| Rate for Payer: UnitedHealthcare Community & State |
$24,181.12
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$24,664.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24,181.12
|
|
|
ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY
|
Facility
|
IP
|
$11,342.28
|
|
|
Service Code
|
APR-DRG 5433
|
| Min. Negotiated Rate |
$11,119.88 |
| Max. Negotiated Rate |
$11,342.28 |
| Rate for Payer: UnitedHealthcare Community & State |
$11,119.88
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$11,342.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11,119.88
|
|
|
ABORTION WITHOUT D&C
|
Facility
|
IP
|
$29,326.28
|
|
|
Service Code
|
MSDRG 779
|
| Min. Negotiated Rate |
$8,929.48 |
| Max. Negotiated Rate |
$29,326.28 |
| Rate for Payer: Aetna Commercial |
$20,407.82
|
| Rate for Payer: Aetna Medicare Advantage |
$29,326.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,028.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,028.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9,399.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,028.39
|
| Rate for Payer: Cigna Commercial |
$13,344.95
|
| Rate for Payer: Cigna Medicare Advantage |
$9,399.45
|
| Rate for Payer: Clover Medicare Advantage |
$8,929.48
|
| Rate for Payer: EmblemHealth Commercial |
$28,198.35
|
| Rate for Payer: Humana Medicare Advantage |
$9,681.43
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9,399.45
|
| Rate for Payer: Oxford Commercial |
$9,591.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,818.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9,399.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$9,399.45
|
|
|
ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY
|
Facility
|
IP
|
$7,360.21
|
|
|
Service Code
|
APR-DRG 5643
|
| Min. Negotiated Rate |
$7,215.89 |
| Max. Negotiated Rate |
$7,360.21 |
| Rate for Payer: UnitedHealthcare Community & State |
$7,215.89
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$7,360.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7,215.89
|
|
|
ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY
|
Facility
|
IP
|
$3,707.57
|
|
|
Service Code
|
APR-DRG 5641
|
| Min. Negotiated Rate |
$3,634.87 |
| Max. Negotiated Rate |
$3,707.57 |
| Rate for Payer: UnitedHealthcare Community & State |
$3,634.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$3,707.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3,634.87
|
|
|
ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY
|
Facility
|
IP
|
$4,957.48
|
|
|
Service Code
|
APR-DRG 5642
|
| Min. Negotiated Rate |
$4,860.27 |
| Max. Negotiated Rate |
$4,957.48 |
| Rate for Payer: UnitedHealthcare Community & State |
$4,860.27
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$4,957.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4,860.27
|
|
|
ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY
|
Facility
|
IP
|
$22,798.18
|
|
|
Service Code
|
APR-DRG 5644
|
| Min. Negotiated Rate |
$22,351.16 |
| Max. Negotiated Rate |
$22,798.18 |
| Rate for Payer: UnitedHealthcare Community & State |
$22,351.16
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$22,798.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22,351.16
|
|
|
ABO TITER****
|
Facility
|
OP
|
$21.00
|
|
| Hospital Charge Code |
3010014
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$7.98
|
| Rate for Payer: Aetna Medicare Advantage |
$6.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.36
|
| Rate for Payer: Cigna Commercial |
$10.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.56
|
|
|
ABO TITER****
|
Facility
|
IP
|
$21.00
|
|
| Hospital Charge Code |
3010014
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$3.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
|
|
ABRADER CV 4.0MM 3450
|
Facility
|
IP
|
$616.00
|
|
| Hospital Charge Code |
270601292
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$92.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.40
|
|
|
ABRADER CV 4.0MM 3450
|
Facility
|
OP
|
$616.00
|
|
| Hospital Charge Code |
270601292
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.85 |
| Max. Negotiated Rate |
$308.00 |
| Rate for Payer: Aetna Commercial |
$234.08
|
| Rate for Payer: Aetna Medicare Advantage |
$184.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$157.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$157.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$157.08
|
| Rate for Payer: Cigna Commercial |
$308.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$184.80
|
| Rate for Payer: Oxford Commercial |
$123.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$123.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.32
|
|
|
ABRAXANE 100MG VIAL
|
Facility
|
IP
|
$8,317.85
|
|
|
Service Code
|
HCPCS J9264
|
| Hospital Charge Code |
60629905
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,247.68 |
| Max. Negotiated Rate |
$2,012.92 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,012.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,247.68
|
|
|
ABRAXANE 100MG VIAL
|
Facility
|
OP
|
$8,317.85
|
|
|
Service Code
|
HCPCS J9264
|
| Hospital Charge Code |
60629905
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.72 |
| Max. Negotiated Rate |
$2,012.92 |
| Rate for Payer: Aetna Commercial |
$16.37
|
| Rate for Payer: Aetna Medicare Advantage |
$19.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21.73
|
| Rate for Payer: Cigna Medicare Advantage |
$6.02
|
| Rate for Payer: Clover Medicare Advantage |
$5.72
|
| Rate for Payer: EmblemHealth Commercial |
$18.06
|
| Rate for Payer: Humana Medicare Advantage |
$6.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,012.92
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,247.68
|
| Rate for Payer: UnitedHealthcare Community & State |
$200.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$220.42
|
|
|
ABRIC HEMA MDV 019514
|
Facility
|
OP
|
$685.65
|
|
| Hospital Charge Code |
270632211
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.52 |
| Max. Negotiated Rate |
$342.82 |
| Rate for Payer: Aetna Commercial |
$260.55
|
| Rate for Payer: Aetna Medicare Advantage |
$205.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$174.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$174.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$174.84
|
| Rate for Payer: Cigna Commercial |
$342.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$205.69
|
| Rate for Payer: Oxford Commercial |
$137.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$102.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.17
|
|
|
ABRIC HEMA MDV 019514
|
Facility
|
IP
|
$685.65
|
|
| Hospital Charge Code |
270632211
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$102.85 |
| Max. Negotiated Rate |
$102.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$102.85
|
|
|
AB RUBELLA
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86762
|
| Hospital Charge Code |
401386762
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
AB RUBELLA
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86762
|
| Hospital Charge Code |
401386762
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$39.14
|
| Rate for Payer: Aetna Medicare Advantage |
$46.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.94
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.39
|
| Rate for Payer: Clover Medicare Advantage |
$13.67
|
| Rate for Payer: EmblemHealth Commercial |
$43.17
|
| Rate for Payer: Humana Medicare Advantage |
$14.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
