|
CRANIOTOME ADULT 3CR MEDNEXT
|
Facility
|
OP
|
$186.00
|
|
| Hospital Charge Code |
270335590
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.18 |
| Max. Negotiated Rate |
$93.00 |
| Rate for Payer: Aetna Commercial |
$55.80
|
| Rate for Payer: Aetna Medicare Advantage |
$55.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$47.43
|
| Rate for Payer: Cigna Commercial |
$93.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.18
|
| Rate for Payer: Oxford Commercial |
$93.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$93.00
|
|
|
CRANIOTOME ADULT 3CR MEDNEXT
|
Facility
|
IP
|
$186.00
|
|
| Hospital Charge Code |
270335590
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.90
|
|
|
CRANIOTOME BUR PED 2CR MEDNEXT
|
Facility
|
OP
|
$180.00
|
|
| Hospital Charge Code |
270335589
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$54.00
|
| Rate for Payer: Aetna Medicare Advantage |
$54.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$45.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$45.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$45.90
|
| Rate for Payer: Cigna Commercial |
$90.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.40
|
| Rate for Payer: Oxford Commercial |
$90.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$90.00
|
|
|
CRANIOTOME BUR PED 2CR MEDNEXT
|
Facility
|
IP
|
$180.00
|
|
| Hospital Charge Code |
270335589
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.00
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$104,841.85
|
|
|
Service Code
|
MSDRG 026
|
| Min. Negotiated Rate |
$32,321.87 |
| Max. Negotiated Rate |
$104,841.85 |
| Rate for Payer: Aetna Commercial |
$104,841.85
|
| Rate for Payer: Aetna Medicare Advantage |
$33,929.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81,322.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81,322.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$34,023.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81,322.65
|
| Rate for Payer: Cigna Medicare Advantage |
$34,023.02
|
| Rate for Payer: Clover Medicare Advantage |
$32,321.87
|
| Rate for Payer: EmblemHealth Commercial |
$102,069.06
|
| Rate for Payer: Humana Medicare Advantage |
$35,043.71
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$34,023.02
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$36,064.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$34,023.02
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$153,314.18
|
|
|
Service Code
|
MSDRG 025
|
| Min. Negotiated Rate |
$45,534.62 |
| Max. Negotiated Rate |
$153,314.18 |
| Rate for Payer: Aetna Commercial |
$153,314.18
|
| Rate for Payer: Aetna Medicare Advantage |
$49,616.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$121,846.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$121,846.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$47,931.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$121,846.14
|
| Rate for Payer: Cigna Medicare Advantage |
$47,931.18
|
| Rate for Payer: Clover Medicare Advantage |
$45,534.62
|
| Rate for Payer: EmblemHealth Commercial |
$143,793.54
|
| Rate for Payer: Humana Medicare Advantage |
$49,369.12
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$47,931.18
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$50,807.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$47,931.18
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$85,071.90
|
|
|
Service Code
|
MSDRG 027
|
| Min. Negotiated Rate |
$26,932.90 |
| Max. Negotiated Rate |
$85,071.90 |
| Rate for Payer: Aetna Commercial |
$85,071.90
|
| Rate for Payer: Aetna Medicare Advantage |
$27,531.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$66,987.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$66,987.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$28,350.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$66,987.81
|
| Rate for Payer: Cigna Medicare Advantage |
$28,350.42
|
| Rate for Payer: Clover Medicare Advantage |
$26,932.90
|
| Rate for Payer: EmblemHealth Commercial |
$85,051.26
|
| Rate for Payer: Humana Medicare Advantage |
$29,200.93
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$28,350.42
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$30,051.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$28,350.42
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$56,703.31
|
|
|
Service Code
|
APR-DRG 9103
|
| Min. Negotiated Rate |
$46,053.59 |
| Max. Negotiated Rate |
$56,703.31 |
| Rate for Payer: Aetna Better Health Medicaid |
$55,591.48
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$56,703.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$46,053.59
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$37,954.84
|
|
|
Service Code
|
APR-DRG 9102
|
| Min. Negotiated Rate |
$35,308.44 |
| Max. Negotiated Rate |
$37,954.84 |
| Rate for Payer: Aetna Better Health Medicaid |
$37,210.63
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$37,954.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35,308.44
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$36,057.48
|
|
|
Service Code
|
APR-DRG 9101
|
| Min. Negotiated Rate |
$29,770.62 |
| Max. Negotiated Rate |
$36,057.48 |
| Rate for Payer: Aetna Better Health Medicaid |
$35,350.47
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$36,057.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29,770.62
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$226,971.90
|
|
|
Service Code
|
MSDRG 955
|
| Min. Negotiated Rate |
$65,612.50 |
| Max. Negotiated Rate |
$226,971.90 |
| Rate for Payer: Aetna Commercial |
$226,971.90
|
| Rate for Payer: Aetna Medicare Advantage |
$73,453.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$167,883.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$167,883.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$69,065.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$167,883.03
|
| Rate for Payer: Cigna Commercial |
$144,860.00
|
| Rate for Payer: Cigna Medicare Advantage |
$69,065.79
|
| Rate for Payer: Clover Medicare Advantage |
$65,612.50
|
| Rate for Payer: EmblemHealth Commercial |
$207,197.37
|
| Rate for Payer: Humana Medicare Advantage |
$71,137.76
|
| Rate for Payer: Oxford Commercial |
$90,533.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$102,763.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$69,065.79
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$73,209.74
|
| Rate for Payer: Wellcare Medicare Advantage |
$69,065.79
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$95,133.96
|
|
|
Service Code
|
APR-DRG 9104
|
| Min. Negotiated Rate |
$89,158.95 |
| Max. Negotiated Rate |
$95,133.96 |
| Rate for Payer: Aetna Better Health Medicaid |
$89,158.95
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$90,942.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$95,133.96
|
|
|
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR
|
Facility
|
IP
|
$193,225.02
|
|
|
Service Code
|
MSDRG 023
|
| Min. Negotiated Rate |
$56,413.67 |
| Max. Negotiated Rate |
$193,225.02 |
| Rate for Payer: Aetna Commercial |
$193,225.02
|
| Rate for Payer: Aetna Medicare Advantage |
$62,532.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$59,382.81
|
| Rate for Payer: Cigna Medicare Advantage |
$59,382.81
|
| Rate for Payer: Clover Medicare Advantage |
$56,413.67
|
| Rate for Payer: EmblemHealth Commercial |
$178,148.43
|
| Rate for Payer: Humana Medicare Advantage |
$61,164.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$59,382.81
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$62,945.78
|
| Rate for Payer: Wellcare Medicare Advantage |
$59,382.81
|
|
|
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR
|
Facility
|
IP
|
$193,225.02
|
|
|
Service Code
|
MSDRG 023
|
| Min. Negotiated Rate |
$56,413.67 |
| Max. Negotiated Rate |
$193,225.02 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$156,304.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$156,304.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$156,304.89
|
|
|
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC
|
Facility
|
IP
|
$131,908.79
|
|
|
Service Code
|
MSDRG 024
|
| Min. Negotiated Rate |
$39,699.87 |
| Max. Negotiated Rate |
$131,908.79 |
| Rate for Payer: Aetna Commercial |
$131,908.79
|
| Rate for Payer: Aetna Medicare Advantage |
$42,688.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$104,478.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$104,478.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$41,789.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$104,478.93
|
| Rate for Payer: Cigna Medicare Advantage |
$41,789.34
|
| Rate for Payer: Clover Medicare Advantage |
$39,699.87
|
| Rate for Payer: EmblemHealth Commercial |
$125,368.02
|
| Rate for Payer: Humana Medicare Advantage |
$43,043.02
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$41,789.34
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$44,296.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$41,789.34
|
|
|
CRANK HANDLE C TORQ
|
Facility
|
IP
|
$1,875.00
|
|
| Hospital Charge Code |
270657347
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$281.25 |
| Max. Negotiated Rate |
$281.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$281.25
|
|
|
CRANK HANDLE C TORQ
|
Facility
|
OP
|
$1,875.00
|
|
| Hospital Charge Code |
270657347
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$243.75 |
| Max. Negotiated Rate |
$937.50 |
| Rate for Payer: Aetna Commercial |
$562.50
|
| Rate for Payer: Aetna Medicare Advantage |
$562.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$478.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$478.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$478.12
|
| Rate for Payer: Cigna Commercial |
$937.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$243.75
|
| Rate for Payer: Oxford Commercial |
$937.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$281.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$937.50
|
|
|
CRASH CART
|
Facility
|
OP
|
$1,890.00
|
|
| Hospital Charge Code |
2705900014
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$245.70 |
| Max. Negotiated Rate |
$945.00 |
| Rate for Payer: Aetna Commercial |
$567.00
|
| Rate for Payer: Aetna Medicare Advantage |
$567.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$481.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$481.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$481.95
|
| Rate for Payer: Cigna Commercial |
$945.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$245.70
|
| Rate for Payer: Oxford Commercial |
$945.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$283.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$945.00
|
|
|
CRASH CART
|
Facility
|
IP
|
$1,890.00
|
|
| Hospital Charge Code |
2705900014
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$283.50
|
|
|
CRASH CART
|
Facility
|
IP
|
$6,034.10
|
|
| Hospital Charge Code |
270590014
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$905.12 |
| Max. Negotiated Rate |
$905.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$905.12
|
|
|
CRASH CART
|
Facility
|
OP
|
$6,034.10
|
|
| Hospital Charge Code |
270590014
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$784.43 |
| Max. Negotiated Rate |
$3,017.05 |
| Rate for Payer: Aetna Commercial |
$1,810.23
|
| Rate for Payer: Aetna Medicare Advantage |
$1,810.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,538.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,538.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,538.70
|
| Rate for Payer: Cigna Commercial |
$3,017.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$784.43
|
| Rate for Payer: Oxford Commercial |
$3,017.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$905.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,017.05
|
|
|
CRASH CART******
|
Facility
|
OP
|
$1,890.00
|
|
|
Service Code
|
HCPCS 99999
|
| Hospital Charge Code |
5900014
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$245.70 |
| Max. Negotiated Rate |
$945.00 |
| Rate for Payer: Aetna Commercial |
$567.00
|
| Rate for Payer: Aetna Medicare Advantage |
$567.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$481.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$481.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$481.95
|
| Rate for Payer: Cigna Commercial |
$945.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$245.70
|
| Rate for Payer: Oxford Commercial |
$945.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$283.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$945.00
|
|
|
CRASH CART******
|
Facility
|
IP
|
$1,890.00
|
|
|
Service Code
|
HCPCS 99999
|
| Hospital Charge Code |
5900014
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$283.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$283.50
|
|
|
CRASH CART-MEDS
|
Facility
|
OP
|
$573.00
|
|
| Hospital Charge Code |
60635246
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$74.49 |
| Max. Negotiated Rate |
$286.50 |
| Rate for Payer: Aetna Commercial |
$171.90
|
| Rate for Payer: Aetna Medicare Advantage |
$171.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$146.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$146.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$146.12
|
| Rate for Payer: Cigna Commercial |
$286.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$74.49
|
| Rate for Payer: Oxford Commercial |
$286.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$286.50
|
|
|
CRASH CART-MEDS
|
Facility
|
IP
|
$573.00
|
|
| Hospital Charge Code |
60635246
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$85.95 |
| Max. Negotiated Rate |
$85.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$85.95
|
|
