|
ACROMIBLASTER 5.5 MM ELITE
|
Facility
|
OP
|
$250.00
|
|
| Hospital Charge Code |
270698576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$125.00 |
| Rate for Payer: Aetna Commercial |
$75.00
|
| Rate for Payer: Aetna Medicare Advantage |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.75
|
| Rate for Payer: Cigna Commercial |
$125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$125.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$125.00
|
|
|
ACROMIBLASTER 5.5 MM ELITE
|
Facility
|
IP
|
$250.00
|
|
| Hospital Charge Code |
270698576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.50
|
|
|
ACROMIOCLA JOINTS-BIL
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 73050
|
| Hospital Charge Code |
94061103
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.66 |
| Max. Negotiated Rate |
$1,530.00 |
| Rate for Payer: Aetna Better Health Medicaid |
$212.34
|
| Rate for Payer: Aetna Commercial |
$1,530.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,300.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$33.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,300.50
|
| Rate for Payer: Cigna Commercial |
$207.24
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$663.00
|
| Rate for Payer: Oxford Commercial |
$1,311.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,489.00
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$216.59
|
|
|
ACROMIOCLA JOINTS-BIL
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 73050
|
| Hospital Charge Code |
94061103
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
ACROMIONIZER CV 3452
|
Facility
|
OP
|
$616.00
|
|
| Hospital Charge Code |
270601293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.08 |
| Max. Negotiated Rate |
$308.00 |
| Rate for Payer: Aetna Commercial |
$184.80
|
| 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 |
$80.08
|
| Rate for Payer: Oxford Commercial |
$308.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$308.00
|
|
|
ACROMIONIZER CV 3452
|
Facility
|
IP
|
$616.00
|
|
| Hospital Charge Code |
270601293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$92.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.40
|
|
|
ACROMIOPL/ACROMIONECT,PRTL LT
|
Facility
|
IP
|
$44,916.00
|
|
|
Service Code
|
HCPCS 23130
|
| Hospital Charge Code |
16000675
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,737.40 |
| Max. Negotiated Rate |
$6,737.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,737.40
|
|
|
ACROMIOPL/ACROMIONECT,PRTL LT
|
Facility
|
OP
|
$44,916.00
|
|
|
Service Code
|
HCPCS 23130
|
| Hospital Charge Code |
16000675
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$13,474.80 |
| Rate for Payer: Aetna Commercial |
$13,474.80
|
| Rate for Payer: Aetna Medicare Advantage |
$13,474.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11,453.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11,453.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,864.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11,453.58
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,839.08
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,737.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,580.00
|
|
|
ACROMIOPLASTY ELECTRODE
|
Facility
|
OP
|
$604.00
|
|
| Hospital Charge Code |
270330635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.52 |
| Max. Negotiated Rate |
$302.00 |
| Rate for Payer: Aetna Commercial |
$181.20
|
| Rate for Payer: Aetna Medicare Advantage |
$181.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$154.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$154.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$154.02
|
| Rate for Payer: Cigna Commercial |
$302.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$78.52
|
| Rate for Payer: Oxford Commercial |
$302.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$302.00
|
|
|
ACROMIOPLASTY ELECTRODE
|
Facility
|
IP
|
$604.00
|
|
| Hospital Charge Code |
270330635
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.60 |
| Max. Negotiated Rate |
$90.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.60
|
|
|
ACROSOFT LENS 18.5
|
Facility
|
IP
|
$745.00
|
|
| Hospital Charge Code |
270666996
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$180.29 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACROSOFT LENS 18.5
|
Facility
|
OP
|
$745.00
|
|
| Hospital Charge Code |
270666996
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$372.50 |
| Rate for Payer: Aetna Commercial |
$223.50
|
| Rate for Payer: Aetna Medicare Advantage |
$223.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$189.97
|
| Rate for Payer: Cigna Commercial |
$372.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACROSOFT LENS 24.0D
|
Facility
|
IP
|
$745.00
|
|
| Hospital Charge Code |
270675781
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$180.29 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACROSOFT LENS 24.0D
|
Facility
|
OP
|
$745.00
|
|
| Hospital Charge Code |
270675781
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$372.50 |
| Rate for Payer: Aetna Commercial |
$223.50
|
| Rate for Payer: Aetna Medicare Advantage |
$223.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$189.97
|
| Rate for Payer: Cigna Commercial |
$372.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACROSOFT LENS 24.5D
|
Facility
|
OP
|
$745.00
|
|
| Hospital Charge Code |
270666695
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$372.50 |
| Rate for Payer: Aetna Commercial |
$223.50
|
| Rate for Payer: Aetna Medicare Advantage |
$223.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$189.97
|
| Rate for Payer: Cigna Commercial |
$372.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACROSOFT LENS 24.5D
|
Facility
|
IP
|
$745.00
|
|
| Hospital Charge Code |
270666695
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$180.29 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACROSOFT LENS 25.00
|
Facility
|
IP
|
$745.00
|
|
|
Service Code
|
HCPCS V2632
|
| Hospital Charge Code |
270666997
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$180.29 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACROSOFT LENS 25.00
|
Facility
|
OP
|
$745.00
|
|
|
Service Code
|
HCPCS V2632
|
| Hospital Charge Code |
270666997
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$87.44 |
| Max. Negotiated Rate |
$223.50 |
| Rate for Payer: Aetna Commercial |
$223.50
|
| Rate for Payer: Aetna Medicare Advantage |
$223.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$189.97
|
| Rate for Payer: Cigna Commercial |
$145.73
|
| Rate for Payer: Cigna Medicare Advantage |
$87.44
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACRYSOF IOL W/BLUE LIGHT
|
Facility
|
OP
|
$745.00
|
|
| Hospital Charge Code |
270656053
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$372.50 |
| Rate for Payer: Aetna Commercial |
$223.50
|
| Rate for Payer: Aetna Medicare Advantage |
$223.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$189.97
|
| Rate for Payer: Cigna Commercial |
$372.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACRYSOF IOL W/BLUE LIGHT
|
Facility
|
IP
|
$745.00
|
|
| Hospital Charge Code |
270656053
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$180.29 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACRYSOF LENS 20.5
|
Facility
|
IP
|
$745.00
|
|
| Hospital Charge Code |
270667810
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$180.29 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACRYSOF LENS 20.5
|
Facility
|
OP
|
$745.00
|
|
| Hospital Charge Code |
270667810
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$372.50 |
| Rate for Payer: Aetna Commercial |
$223.50
|
| Rate for Payer: Aetna Medicare Advantage |
$223.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$189.97
|
| Rate for Payer: Cigna Commercial |
$372.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACRYSOF LENS 27.5
|
Facility
|
OP
|
$745.00
|
|
| Hospital Charge Code |
270667809
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$372.50 |
| Rate for Payer: Aetna Commercial |
$223.50
|
| Rate for Payer: Aetna Medicare Advantage |
$223.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$189.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$189.97
|
| Rate for Payer: Cigna Commercial |
$372.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACRYSOF LENS 27.5
|
Facility
|
IP
|
$745.00
|
|
| Hospital Charge Code |
270667809
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$111.75 |
| Max. Negotiated Rate |
$180.29 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$180.29
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.75
|
|
|
ACRYSOF LENS 29.00
|
Facility
|
OP
|
$750.00
|
|
| Hospital Charge Code |
270668381
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$225.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$181.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|