|
CERUMENEX
|
Facility
|
IP
|
$125.45
|
|
| Hospital Charge Code |
6008379
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$18.82 |
| Max. Negotiated Rate |
$18.82 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.82
|
|
|
CERUMENEX
|
Facility
|
OP
|
$125.45
|
|
| Hospital Charge Code |
6008379
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$16.31 |
| Max. Negotiated Rate |
$62.73 |
| Rate for Payer: Aetna Commercial |
$37.63
|
| Rate for Payer: Aetna Medicare Advantage |
$37.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.99
|
| Rate for Payer: Cigna Commercial |
$62.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.31
|
| Rate for Payer: Oxford Commercial |
$62.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.82
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.73
|
|
|
CERUMENEX 10% OTIC/12ML
|
Facility
|
IP
|
$118.00
|
|
| Hospital Charge Code |
60632670
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$17.70 |
| Max. Negotiated Rate |
$17.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.70
|
|
|
CERUMENEX 10% OTIC/12ML
|
Facility
|
OP
|
$118.00
|
|
| Hospital Charge Code |
60632670
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$59.00 |
| Rate for Payer: Aetna Commercial |
$35.40
|
| Rate for Payer: Aetna Medicare Advantage |
$35.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.09
|
| Rate for Payer: Cigna Commercial |
$59.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.34
|
| Rate for Payer: Oxford Commercial |
$59.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$59.00
|
|
|
CERUMEN REMOVAL
|
Facility
|
OP
|
$274.00
|
|
|
Service Code
|
HCPCS 69210
|
| Hospital Charge Code |
9808280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$33.17 |
| Max. Negotiated Rate |
$197.37 |
| Rate for Payer: Aetna Better Health Medicaid |
$193.50
|
| Rate for Payer: Aetna Commercial |
$82.20
|
| Rate for Payer: Aetna Medicare Advantage |
$82.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$69.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$69.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$33.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$69.87
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.62
|
| Rate for Payer: Oxford Commercial |
$137.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$137.00
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$197.37
|
|
|
CERUMEN REMOVAL
|
Facility
|
IP
|
$274.00
|
|
|
Service Code
|
HCPCS 69210
|
| Hospital Charge Code |
9808280
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$41.10 |
| Max. Negotiated Rate |
$41.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.10
|
|
|
CERV 3D TITANIUM IBFD 14X12MM
|
Facility
|
OP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704642
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$3,000.00 |
| Rate for Payer: Aetna Commercial |
$1,800.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,530.00
|
| Rate for Payer: Cigna Commercial |
$3,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
|
|
CERV 3D TITANIUM IBFD 14X12MM
|
Facility
|
IP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704642
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$1,452.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
|
|
CERV 3D TITANIUM IBFD 15X13MM
|
Facility
|
IP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704678
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$1,452.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
|
|
CERV 3D TITANIUM IBFD 15X13MM
|
Facility
|
OP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704678
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$3,000.00 |
| Rate for Payer: Aetna Commercial |
$1,800.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,530.00
|
| Rate for Payer: Cigna Commercial |
$3,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
|
|
CERV 3D TITANIUM IBFD 17X14MM
|
Facility
|
OP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$3,000.00 |
| Rate for Payer: Aetna Commercial |
$1,800.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,530.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,530.00
|
| Rate for Payer: Cigna Commercial |
$3,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
|
|
CERV 3D TITANIUM IBFD 17X14MM
|
Facility
|
IP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704640
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$900.00 |
| Max. Negotiated Rate |
$1,452.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,200.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,452.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$900.00
|
|
|
CERV ARTIFIC DISKECTOMY
|
Facility
|
IP
|
$47,548.90
|
|
|
Service Code
|
HCPCS 22856
|
| Hospital Charge Code |
1600000278
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,132.34 |
| Max. Negotiated Rate |
$7,132.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,132.34
|
|
|
CERV ARTIFIC DISKECTOMY
|
Facility
|
OP
|
$47,548.90
|
|
|
Service Code
|
HCPCS 22856
|
| Hospital Charge Code |
1600000305
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$41,754.94 |
| Rate for Payer: Aetna Commercial |
$14,264.67
|
| Rate for Payer: Aetna Medicare Advantage |
$14,264.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,124.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,124.97
|
| 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 |
$12,124.97
|
| Rate for Payer: Cigna Commercial |
$41,754.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,181.36
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,132.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$9,851.00
|
|
|
CERV ARTIFIC DISKECTOMY
|
Facility
|
OP
|
$47,548.90
|
|
|
Service Code
|
HCPCS 22856
|
| Hospital Charge Code |
1600000278
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$41,754.94 |
| Rate for Payer: Aetna Commercial |
$14,264.67
|
| Rate for Payer: Aetna Medicare Advantage |
$14,264.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,124.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,124.97
|
| 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 |
$12,124.97
|
| Rate for Payer: Cigna Commercial |
$41,754.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,181.36
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,132.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$9,851.00
|
|
|
CERV ARTIFIC DISKECTOMY
|
Facility
|
IP
|
$47,548.90
|
|
|
Service Code
|
HCPCS 22856
|
| Hospital Charge Code |
1600000305
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,132.34 |
| Max. Negotiated Rate |
$7,132.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,132.34
|
|
|
CERV CAGE 17.5X14X8MM 7DEG
|
Facility
|
OP
|
$15,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,325.00 |
| Max. Negotiated Rate |
$7,750.00 |
| Rate for Payer: Aetna Commercial |
$4,650.00
|
| Rate for Payer: Aetna Medicare Advantage |
$4,650.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,952.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,952.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,952.50
|
| Rate for Payer: Cigna Commercial |
$7,750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,751.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,325.00
|
|
|
CERV CAGE 17.5X14X8MM 7DEG
|
Facility
|
IP
|
$15,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,325.00 |
| Max. Negotiated Rate |
$3,751.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,751.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,325.00
|
|
|
CERVICAL 3DR RIGEL 16X14X7MM
|
Facility
|
IP
|
$5,000.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
270698897
|
|
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: Qualcare PPO/HMO/WC |
$750.00
|
|
|
CERVICAL 3DR RIGEL 16X14X7MM
|
Facility
|
OP
|
$5,000.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
270698897
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$2,500.00 |
| Rate for Payer: Aetna Commercial |
$1,500.00
|
| 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: Qualcare PPO/HMO/WC |
$750.00
|
|
|
CERVICAL CAGE 7MM MEDIUM
|
Facility
|
OP
|
$15,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705435
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,250.00 |
| Max. Negotiated Rate |
$7,500.00 |
| Rate for Payer: Aetna Commercial |
$4,500.00
|
| Rate for Payer: Aetna Medicare Advantage |
$4,500.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,825.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,825.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,000.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,825.00
|
| Rate for Payer: Cigna Commercial |
$7,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,630.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,250.00
|
|
|
CERVICAL CAGE 7MM MEDIUM
|
Facility
|
IP
|
$15,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705435
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,250.00 |
| Max. Negotiated Rate |
$3,630.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,630.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,250.00
|
|
|
CERVICAL CAGE LORDOTIC 7MM
|
Facility
|
OP
|
$10,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705761
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,575.00 |
| Max. Negotiated Rate |
$5,250.00 |
| Rate for Payer: Aetna Commercial |
$3,150.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,677.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,677.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,100.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,677.50
|
| Rate for Payer: Cigna Commercial |
$5,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,541.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,575.00
|
|
|
CERVICAL CAGE LORDOTIC 7MM
|
Facility
|
IP
|
$10,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705761
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,575.00 |
| Max. Negotiated Rate |
$2,541.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,541.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,575.00
|
|
|
CERVICAL CAGE LORDOTIC 8MM
|
Facility
|
IP
|
$10,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270705760
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,575.00 |
| Max. Negotiated Rate |
$2,541.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,100.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,541.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,575.00
|
|