|
DEL ANESTHESIA MONITORED CARE
|
Facility
|
OP
|
$1,937.60
|
|
| Hospital Charge Code |
73190125
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$251.89 |
| Max. Negotiated Rate |
$968.80 |
| Rate for Payer: Aetna Commercial |
$581.28
|
| Rate for Payer: Aetna Medicare Advantage |
$581.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$494.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$494.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$494.09
|
| Rate for Payer: Cigna Commercial |
$968.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$251.89
|
| Rate for Payer: Oxford Commercial |
$968.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$290.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$968.80
|
|
|
DEL ANESTHESIA MONITORED CARE
|
Facility
|
IP
|
$1,937.60
|
|
| Hospital Charge Code |
73190125
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$290.64 |
| Max. Negotiated Rate |
$290.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$290.64
|
|
|
DEL ANESTHESIA OTHER
|
Facility
|
IP
|
$272.00
|
|
| Hospital Charge Code |
73190133
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$40.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.80
|
|
|
DEL ANESTHESIA OTHER
|
Facility
|
OP
|
$272.00
|
|
| Hospital Charge Code |
73190133
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$136.00 |
| Rate for Payer: Aetna Commercial |
$81.60
|
| Rate for Payer: Aetna Medicare Advantage |
$81.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$69.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$69.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$69.36
|
| Rate for Payer: Cigna Commercial |
$136.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.36
|
| Rate for Payer: Oxford Commercial |
$136.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$136.00
|
|
|
DEL ANESTHESIA SPINAL
|
Facility
|
OP
|
$3,106.60
|
|
| Hospital Charge Code |
73190129
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$403.86 |
| Max. Negotiated Rate |
$1,553.30 |
| Rate for Payer: Aetna Commercial |
$931.98
|
| Rate for Payer: Aetna Medicare Advantage |
$931.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$792.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$792.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$792.18
|
| Rate for Payer: Cigna Commercial |
$1,553.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$403.86
|
| Rate for Payer: Oxford Commercial |
$1,553.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$465.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,553.30
|
|
|
DEL ANESTHESIA SPINAL
|
Facility
|
IP
|
$3,106.60
|
|
| Hospital Charge Code |
73190129
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$465.99 |
| Max. Negotiated Rate |
$465.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$465.99
|
|
|
DEL CARE AFTER DELIVERY
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
HCPCS 59430
|
| Hospital Charge Code |
73190039
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$67.50 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.50
|
|
|
DEL CARE AFTER DELIVERY
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
HCPCS 59430
|
| Hospital Charge Code |
73190039
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$2,979.00 |
| Rate for Payer: Aetna Commercial |
$135.00
|
| Rate for Payer: Aetna Medicare Advantage |
$135.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$114.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$114.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$110.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$114.75
|
| Rate for Payer: Cigna Commercial |
$174.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$58.50
|
| Rate for Payer: Oxford Commercial |
$2,624.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$67.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,979.00
|
|
|
DEL CATHETER FOR HYSTEROGRPHY
|
Facility
|
OP
|
$166.00
|
|
|
Service Code
|
HCPCS 58340
|
| Hospital Charge Code |
73190011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$21.58 |
| Max. Negotiated Rate |
$1,864.00 |
| Rate for Payer: Aetna Commercial |
$49.80
|
| Rate for Payer: Aetna Medicare Advantage |
$49.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.33
|
| 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 |
$42.33
|
| Rate for Payer: Cigna Commercial |
$57.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.58
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,686.00
|
|
|
DEL CATHETER FOR HYSTEROGRPHY
|
Facility
|
IP
|
$166.00
|
|
|
Service Code
|
HCPCS 58340
|
| Hospital Charge Code |
73190011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$24.90 |
| Max. Negotiated Rate |
$24.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.90
|
|
|
DEL CERCLAGE OF CERVIX
|
Facility
|
OP
|
$8,582.36
|
|
|
Service Code
|
HCPCS 59320
|
| Hospital Charge Code |
73190029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,115.71 |
| Max. Negotiated Rate |
$7,708.87 |
| Rate for Payer: Aetna Commercial |
$2,574.71
|
| Rate for Payer: Aetna Medicare Advantage |
$2,574.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,188.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,188.50
|
| 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 |
$2,188.50
|
| Rate for Payer: Cigna Commercial |
$7,708.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,115.71
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,287.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,529.00
|
|
|
DEL CERCLAGE OF CERVIX
|
Facility
|
IP
|
$8,582.36
|
|
|
Service Code
|
HCPCS 59320
|
| Hospital Charge Code |
73190029
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,287.35 |
| Max. Negotiated Rate |
$1,287.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,287.35
|
|
|
DEL CESAREA DEL/ATTEM VAG DEL
|
Facility
|
OP
|
$11,810.75
|
|
|
Service Code
|
HCPCS 59620
|
| Hospital Charge Code |
73190051
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$918.42 |
| Max. Negotiated Rate |
$3,543.22 |
| Rate for Payer: Aetna Commercial |
$3,543.22
|
| Rate for Payer: Aetna Medicare Advantage |
$3,543.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,011.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,011.74
|
| 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 |
$3,011.74
|
| Rate for Payer: Cigna Commercial |
$918.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,535.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,771.61
|
|
|
DEL CESAREA DEL/ATTEM VAG DEL
|
Facility
|
IP
|
$11,810.75
|
|
|
Service Code
|
HCPCS 59620
|
| Hospital Charge Code |
73190051
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,771.61 |
| Max. Negotiated Rate |
$1,771.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,771.61
|
|
|
DEL CESAREAN DELIVERY
|
Facility
|
OP
|
$8,195.00
|
|
|
Service Code
|
HCPCS 59510
|
| Hospital Charge Code |
73190041
|
|
Hospital Revenue Code
|
722
|
| Min. Negotiated Rate |
$687.70 |
| Max. Negotiated Rate |
$2,979.00 |
| Rate for Payer: Aetna Commercial |
$2,458.50
|
| Rate for Payer: Aetna Medicare Advantage |
$2,458.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,089.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,089.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$687.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,089.72
|
| Rate for Payer: Cigna Commercial |
$2,696.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,065.35
|
| Rate for Payer: Oxford Commercial |
$2,624.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,229.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,979.00
|
|
|
DEL CESAREAN DELIVERY
|
Facility
|
IP
|
$8,195.00
|
|
|
Service Code
|
HCPCS 59510
|
| Hospital Charge Code |
73190041
|
|
Hospital Revenue Code
|
722
|
| Min. Negotiated Rate |
$1,229.25 |
| Max. Negotiated Rate |
$1,229.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,229.25
|
|
|
DEL C SECTION 1ST HR
|
Facility
|
OP
|
$10,100.00
|
|
| Hospital Charge Code |
73190043
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,313.00 |
| Max. Negotiated Rate |
$5,050.00 |
| Rate for Payer: Aetna Commercial |
$3,030.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,030.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,575.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,575.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,575.50
|
| Rate for Payer: Cigna Commercial |
$5,050.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,313.00
|
| Rate for Payer: Oxford Commercial |
$2,624.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,515.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,979.00
|
|
|
DEL C SECTION 1ST HR
|
Facility
|
IP
|
$10,100.00
|
|
| Hospital Charge Code |
73190043
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,515.00 |
| Max. Negotiated Rate |
$1,515.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,515.00
|
|
|
DEL C SECTION EA ADD HR
|
Facility
|
OP
|
$10,100.00
|
|
| Hospital Charge Code |
73190044
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,313.00 |
| Max. Negotiated Rate |
$5,050.00 |
| Rate for Payer: Aetna Commercial |
$3,030.00
|
| Rate for Payer: Aetna Medicare Advantage |
$3,030.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,575.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,575.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,575.50
|
| Rate for Payer: Cigna Commercial |
$5,050.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,313.00
|
| Rate for Payer: Oxford Commercial |
$2,624.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,515.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,979.00
|
|
|
DEL C SECTION EA ADD HR
|
Facility
|
IP
|
$10,100.00
|
|
| Hospital Charge Code |
73190044
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,515.00 |
| Max. Negotiated Rate |
$1,515.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,515.00
|
|
|
DEL C SEC W/ TUBAL 1ST HR
|
Facility
|
OP
|
$11,272.60
|
|
| Hospital Charge Code |
73190142
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,465.44 |
| Max. Negotiated Rate |
$5,636.30 |
| Rate for Payer: Aetna Commercial |
$3,381.78
|
| Rate for Payer: Aetna Medicare Advantage |
$3,381.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,874.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,874.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,874.51
|
| Rate for Payer: Cigna Commercial |
$5,636.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,465.44
|
| Rate for Payer: Oxford Commercial |
$2,624.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,690.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,979.00
|
|
|
DEL C SEC W/ TUBAL 1ST HR
|
Facility
|
IP
|
$11,272.60
|
|
| Hospital Charge Code |
73190142
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,690.89 |
| Max. Negotiated Rate |
$1,690.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,690.89
|
|
|
DEL C SEC W/TUBAL 1ST HR
|
Facility
|
IP
|
$9,448.60
|
|
| Hospital Charge Code |
73190150
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,417.29 |
| Max. Negotiated Rate |
$1,417.29 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,417.29
|
|
|
DEL C SEC W/TUBAL 1ST HR
|
Facility
|
OP
|
$9,448.60
|
|
| Hospital Charge Code |
73190150
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,228.32 |
| Max. Negotiated Rate |
$4,724.30 |
| Rate for Payer: Aetna Commercial |
$2,834.58
|
| Rate for Payer: Aetna Medicare Advantage |
$2,834.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,409.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,409.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,409.39
|
| Rate for Payer: Cigna Commercial |
$4,724.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,228.32
|
| Rate for Payer: Oxford Commercial |
$2,624.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,417.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,979.00
|
|
|
DEL C SEC W/ TUBAL EA ADD HR
|
Facility
|
IP
|
$10,100.00
|
|
| Hospital Charge Code |
73190143
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,515.00 |
| Max. Negotiated Rate |
$1,515.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,515.00
|
|