|
DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$39,840.78
|
|
|
Service Code
|
MSDRG 442
|
| Min. Negotiated Rate |
$10,533.92 |
| Max. Negotiated Rate |
$39,840.78 |
| Rate for Payer: Aetna Commercial |
$32,549.81
|
| Rate for Payer: Aetna Medicare Advantage |
$10,533.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26,188.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26,188.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,280.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26,188.65
|
| Rate for Payer: Cigna Commercial |
$20,774.22
|
| Rate for Payer: Cigna Medicare Advantage |
$13,280.26
|
| Rate for Payer: Clover Medicare Advantage |
$12,616.25
|
| Rate for Payer: EmblemHealth Commercial |
$39,840.78
|
| Rate for Payer: Humana Medicare Advantage |
$13,678.67
|
| Rate for Payer: Oxford Commercial |
$12,983.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,737.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,280.26
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$14,077.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,280.26
|
|
|
DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$63,914.73
|
|
|
Service Code
|
MSDRG 441
|
| Min. Negotiated Rate |
$19,584.81 |
| Max. Negotiated Rate |
$63,914.73 |
| Rate for Payer: Aetna Commercial |
$60,517.06
|
| Rate for Payer: Aetna Medicare Advantage |
$19,584.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50,447.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50,447.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,304.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50,447.61
|
| Rate for Payer: Cigna Commercial |
$38,623.74
|
| Rate for Payer: Cigna Medicare Advantage |
$21,304.91
|
| Rate for Payer: Clover Medicare Advantage |
$20,239.66
|
| Rate for Payer: EmblemHealth Commercial |
$63,914.73
|
| Rate for Payer: Humana Medicare Advantage |
$21,944.06
|
| Rate for Payer: Oxford Commercial |
$24,138.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$27,399.68
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,304.91
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$22,583.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,304.91
|
|
|
DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$32,131.53
|
|
|
Service Code
|
MSDRG 443
|
| Min. Negotiated Rate |
$7,635.53 |
| Max. Negotiated Rate |
$32,131.53 |
| Rate for Payer: Aetna Commercial |
$23,593.79
|
| Rate for Payer: Aetna Medicare Advantage |
$7,635.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19,572.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19,572.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10,710.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19,572.57
|
| Rate for Payer: Cigna Commercial |
$15,058.24
|
| Rate for Payer: Cigna Medicare Advantage |
$10,710.51
|
| Rate for Payer: Clover Medicare Advantage |
$10,174.98
|
| Rate for Payer: EmblemHealth Commercial |
$32,131.53
|
| Rate for Payer: Humana Medicare Advantage |
$11,031.83
|
| Rate for Payer: Oxford Commercial |
$9,410.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,682.32
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10,710.51
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$11,353.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$10,710.51
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$9,353.20
|
|
|
Service Code
|
APR-DRG 2822
|
| Min. Negotiated Rate |
$6,552.56 |
| Max. Negotiated Rate |
$9,353.20 |
| Rate for Payer: Aetna Better Health Medicaid |
$9,169.80
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$9,353.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6,552.56
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$31,588.75
|
|
|
Service Code
|
APR-DRG 2824
|
| Min. Negotiated Rate |
$30,460.48 |
| Max. Negotiated Rate |
$31,588.75 |
| Rate for Payer: Aetna Better Health Medicaid |
$30,969.36
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$31,588.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30,460.48
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$7,231.20
|
|
|
Service Code
|
APR-DRG 2821
|
| Min. Negotiated Rate |
$5,070.54 |
| Max. Negotiated Rate |
$7,231.20 |
| Rate for Payer: Aetna Better Health Medicaid |
$7,089.41
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$7,231.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5,070.54
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$14,451.10
|
|
|
Service Code
|
APR-DRG 2823
|
| Min. Negotiated Rate |
$10,945.76 |
| Max. Negotiated Rate |
$14,451.10 |
| Rate for Payer: Aetna Better Health Medicaid |
$14,167.75
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$14,451.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10,945.76
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC
|
Facility
|
IP
|
$36,238.68
|
|
|
Service Code
|
MSDRG 439
|
| Min. Negotiated Rate |
$9,179.66 |
| Max. Negotiated Rate |
$36,238.68 |
| Rate for Payer: Aetna Commercial |
$28,365.15
|
| Rate for Payer: Aetna Medicare Advantage |
$9,179.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,707.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,707.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12,079.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,707.62
|
| Rate for Payer: Cigna Commercial |
$18,103.47
|
| Rate for Payer: Cigna Medicare Advantage |
$12,079.56
|
| Rate for Payer: Clover Medicare Advantage |
$11,475.58
|
| Rate for Payer: EmblemHealth Commercial |
$36,238.68
|
| Rate for Payer: Humana Medicare Advantage |
$12,441.95
|
| Rate for Payer: Oxford Commercial |
$11,314.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,842.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12,079.56
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$12,804.33
|
| Rate for Payer: Wellcare Medicare Advantage |
$12,079.56
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC
|
Facility
|
IP
|
$59,139.99
|
|
|
Service Code
|
MSDRG 438
|
| Min. Negotiated Rate |
$17,789.69 |
| Max. Negotiated Rate |
$59,139.99 |
| Rate for Payer: Aetna Commercial |
$54,970.14
|
| Rate for Payer: Aetna Medicare Advantage |
$17,789.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46,036.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46,036.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$19,713.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46,036.89
|
| Rate for Payer: Cigna Commercial |
$35,083.53
|
| Rate for Payer: Cigna Medicare Advantage |
$19,713.33
|
| Rate for Payer: Clover Medicare Advantage |
$18,727.66
|
| Rate for Payer: EmblemHealth Commercial |
$59,139.99
|
| Rate for Payer: Humana Medicare Advantage |
$20,304.73
|
| Rate for Payer: Oxford Commercial |
$21,926.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$24,888.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$19,713.33
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$20,896.13
|
| Rate for Payer: Wellcare Medicare Advantage |
$19,713.33
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$29,858.82
|
|
|
Service Code
|
MSDRG 440
|
| Min. Negotiated Rate |
$6,781.08 |
| Max. Negotiated Rate |
$29,858.82 |
| Rate for Payer: Aetna Commercial |
$20,953.54
|
| Rate for Payer: Aetna Medicare Advantage |
$6,781.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17,091.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17,091.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9,952.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17,091.54
|
| Rate for Payer: Cigna Commercial |
$13,373.15
|
| Rate for Payer: Cigna Medicare Advantage |
$9,952.94
|
| Rate for Payer: Clover Medicare Advantage |
$9,455.29
|
| Rate for Payer: EmblemHealth Commercial |
$29,858.82
|
| Rate for Payer: Humana Medicare Advantage |
$10,251.53
|
| Rate for Payer: Oxford Commercial |
$8,357.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$9,486.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9,952.94
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$10,550.12
|
| Rate for Payer: Wellcare Medicare Advantage |
$9,952.94
|
|
|
DISORDERS OF PERSONALITY AND IMPULSE CONTROL
|
Facility
|
IP
|
$68,895.54
|
|
|
Service Code
|
MSDRG 883
|
| Min. Negotiated Rate |
$21,457.41 |
| Max. Negotiated Rate |
$68,895.54 |
| Rate for Payer: Aetna Commercial |
$66,303.40
|
| Rate for Payer: Aetna Medicare Advantage |
$21,457.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51,825.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51,825.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$22,965.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51,825.96
|
| Rate for Payer: Cigna Commercial |
$42,316.74
|
| Rate for Payer: Cigna Medicare Advantage |
$22,965.18
|
| Rate for Payer: Clover Medicare Advantage |
$21,816.92
|
| Rate for Payer: EmblemHealth Commercial |
$68,895.54
|
| Rate for Payer: Humana Medicare Advantage |
$23,654.14
|
| Rate for Payer: Oxford Commercial |
$26,446.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$30,019.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$22,965.18
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$24,343.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$22,965.18
|
|
|
DISORDERS OF THE BILIARY TRACT WITH CC
|
Facility
|
IP
|
$43,587.99
|
|
|
Service Code
|
MSDRG 445
|
| Min. Negotiated Rate |
$11,942.73 |
| Max. Negotiated Rate |
$43,587.99 |
| Rate for Payer: Aetna Commercial |
$36,903.04
|
| Rate for Payer: Aetna Medicare Advantage |
$11,942.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30,048.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30,048.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14,529.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30,048.03
|
| Rate for Payer: Cigna Commercial |
$23,552.58
|
| Rate for Payer: Cigna Medicare Advantage |
$14,529.33
|
| Rate for Payer: Clover Medicare Advantage |
$13,802.86
|
| Rate for Payer: EmblemHealth Commercial |
$43,587.99
|
| Rate for Payer: Humana Medicare Advantage |
$14,965.21
|
| Rate for Payer: Oxford Commercial |
$14,719.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,708.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14,529.33
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$15,401.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$14,529.33
|
|
|
DISORDERS OF THE BILIARY TRACT WITH MCC
|
Facility
|
IP
|
$60,321.33
|
|
|
Service Code
|
MSDRG 444
|
| Min. Negotiated Rate |
$18,233.83 |
| Max. Negotiated Rate |
$60,321.33 |
| Rate for Payer: Aetna Commercial |
$56,342.53
|
| Rate for Payer: Aetna Medicare Advantage |
$18,233.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44,934.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44,934.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20,107.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44,934.21
|
| Rate for Payer: Cigna Commercial |
$35,959.44
|
| Rate for Payer: Cigna Medicare Advantage |
$20,107.11
|
| Rate for Payer: Clover Medicare Advantage |
$19,101.75
|
| Rate for Payer: EmblemHealth Commercial |
$60,321.33
|
| Rate for Payer: Humana Medicare Advantage |
$20,710.32
|
| Rate for Payer: Oxford Commercial |
$22,473.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$25,509.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20,107.11
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$21,313.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$20,107.11
|
|
|
DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC
|
Facility
|
IP
|
$35,835.21
|
|
|
Service Code
|
MSDRG 446
|
| Min. Negotiated Rate |
$9,027.98 |
| Max. Negotiated Rate |
$35,835.21 |
| Rate for Payer: Aetna Commercial |
$27,896.46
|
| Rate for Payer: Aetna Medicare Advantage |
$9,027.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22,053.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22,053.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11,945.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22,053.60
|
| Rate for Payer: Cigna Commercial |
$17,804.32
|
| Rate for Payer: Cigna Medicare Advantage |
$11,945.07
|
| Rate for Payer: Clover Medicare Advantage |
$11,347.82
|
| Rate for Payer: EmblemHealth Commercial |
$35,835.21
|
| Rate for Payer: Humana Medicare Advantage |
$12,303.42
|
| Rate for Payer: Oxford Commercial |
$11,127.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,630.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11,945.07
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$12,661.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$11,945.07
|
|
|
DISOSABLE I&A HAND PIECE
|
Facility
|
OP
|
$311.00
|
|
| Hospital Charge Code |
270331531
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.43 |
| Max. Negotiated Rate |
$155.50 |
| Rate for Payer: Aetna Commercial |
$93.30
|
| Rate for Payer: Aetna Medicare Advantage |
$93.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.31
|
| Rate for Payer: Cigna Commercial |
$155.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.43
|
| Rate for Payer: Oxford Commercial |
$155.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$155.50
|
|
|
DISOSABLE I&A HAND PIECE
|
Facility
|
IP
|
$311.00
|
|
| Hospital Charge Code |
270331531
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.65 |
| Max. Negotiated Rate |
$46.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
OP
|
$1,519.25
|
|
| Hospital Charge Code |
270704864
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$197.50 |
| Max. Negotiated Rate |
$759.62 |
| Rate for Payer: Aetna Commercial |
$455.77
|
| Rate for Payer: Aetna Medicare Advantage |
$455.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$387.41
|
| Rate for Payer: Cigna Commercial |
$759.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$197.50
|
| Rate for Payer: Oxford Commercial |
$759.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$759.62
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
IP
|
$1,416.25
|
|
| Hospital Charge Code |
270704865
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$212.44 |
| Max. Negotiated Rate |
$212.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$212.44
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
OP
|
$1,416.25
|
|
| Hospital Charge Code |
270704865
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$184.11 |
| Max. Negotiated Rate |
$708.12 |
| Rate for Payer: Aetna Commercial |
$424.88
|
| Rate for Payer: Aetna Medicare Advantage |
$424.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$361.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$361.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$361.14
|
| Rate for Payer: Cigna Commercial |
$708.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$184.11
|
| Rate for Payer: Oxford Commercial |
$708.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$212.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$708.12
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
IP
|
$1,519.25
|
|
| Hospital Charge Code |
270704864
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$227.89 |
| Max. Negotiated Rate |
$227.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
|
|
DISP MASK 7429
|
Facility
|
IP
|
$1,102.75
|
|
| Hospital Charge Code |
270656311
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$165.41 |
| Max. Negotiated Rate |
$165.41 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.41
|
|
|
DISP MASK 7429
|
Facility
|
OP
|
$1,102.75
|
|
| Hospital Charge Code |
270656311
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$143.36 |
| Max. Negotiated Rate |
$551.38 |
| Rate for Payer: Aetna Commercial |
$330.82
|
| Rate for Payer: Aetna Medicare Advantage |
$330.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$281.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$281.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$281.20
|
| Rate for Payer: Cigna Commercial |
$551.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.36
|
| Rate for Payer: Oxford Commercial |
$551.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$165.41
|
| Rate for Payer: UnitedHealthcare Commercial |
$551.38
|
|
|
DISP.MIXING BOWL W/SPATULA
|
Facility
|
IP
|
$75.00
|
|
| Hospital Charge Code |
270331843
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$11.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.25
|
|
|
DISP.MIXING BOWL W/SPATULA
|
Facility
|
OP
|
$75.00
|
|
| Hospital Charge Code |
270331843
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Aetna Commercial |
$22.50
|
| Rate for Payer: Aetna Medicare Advantage |
$22.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.12
|
| Rate for Payer: Cigna Commercial |
$37.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.75
|
| Rate for Payer: Oxford Commercial |
$37.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$37.50
|
|
|
DISPOSABLE ACCESSORY KIT,3 ARM
|
Facility
|
IP
|
$5,000.00
|
|
| Hospital Charge Code |
270664012
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$750.00 |
| Max. Negotiated Rate |
$750.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$750.00
|
|