|
EXPL LAPAROTOMY EXPL CELIOTOMY
|
Facility
|
OP
|
$8,578.30
|
|
|
Service Code
|
HCPCS 49000
|
| Hospital Charge Code |
16000985
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$796.54 |
| Max. Negotiated Rate |
$6,873.00 |
| Rate for Payer: Aetna Commercial |
$2,573.49
|
| Rate for Payer: Aetna Medicare Advantage |
$2,573.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,187.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,187.47
|
| 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 |
$2,187.47
|
| Rate for Payer: Cigna Commercial |
$796.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,115.18
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,286.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
EXPL LAPAROTOMY EXPL CELIOTOMY
|
Facility
|
IP
|
$8,578.30
|
|
|
Service Code
|
HCPCS 49000
|
| Hospital Charge Code |
16000985
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,286.74 |
| Max. Negotiated Rate |
$1,286.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,286.74
|
|
|
EXPL N/FLWD SURG NECK ART
|
Facility
|
OP
|
$23,767.00
|
|
|
Service Code
|
HCPCS 35701
|
| Hospital Charge Code |
1600000721
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$417.11 |
| Max. Negotiated Rate |
$7,130.10 |
| Rate for Payer: Aetna Commercial |
$7,130.10
|
| Rate for Payer: Aetna Medicare Advantage |
$7,130.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,060.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,060.59
|
| 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 |
$6,060.59
|
| Rate for Payer: Cigna Commercial |
$417.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,089.71
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,565.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
EXPL N/FLWD SURG NECK ART
|
Facility
|
IP
|
$23,767.00
|
|
|
Service Code
|
HCPCS 35701
|
| Hospital Charge Code |
1600000721
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,565.05 |
| Max. Negotiated Rate |
$3,565.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,565.05
|
|
|
EXPLORE ADRENAL GLAND
|
Facility
|
OP
|
$23,063.00
|
|
|
Service Code
|
HCPCS 60540
|
| Hospital Charge Code |
1600000750
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,103.66 |
| Max. Negotiated Rate |
$6,918.90 |
| Rate for Payer: Aetna Commercial |
$6,918.90
|
| Rate for Payer: Aetna Medicare Advantage |
$6,918.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,881.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,881.06
|
| 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 |
$5,881.06
|
| Rate for Payer: Cigna Commercial |
$1,103.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,998.19
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,459.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
EXPLORE ADRENAL GLAND
|
Facility
|
IP
|
$23,063.00
|
|
|
Service Code
|
HCPCS 60540
|
| Hospital Charge Code |
1600000750
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,459.45 |
| Max. Negotiated Rate |
$3,459.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,459.45
|
|
|
EXPLORE PARATHYROID GLANDS
|
Facility
|
IP
|
$20,350.20
|
|
|
Service Code
|
HCPCS 60500
|
| Hospital Charge Code |
1600000352
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,052.53 |
| Max. Negotiated Rate |
$3,052.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,052.53
|
|
|
EXPLORE PARATHYROID GLANDS
|
Facility
|
OP
|
$20,350.20
|
|
|
Service Code
|
HCPCS 60500
|
| Hospital Charge Code |
1600000352
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$14,097.46 |
| Rate for Payer: Aetna Commercial |
$6,105.06
|
| Rate for Payer: Aetna Medicare Advantage |
$6,105.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,189.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,189.30
|
| 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 |
$5,189.30
|
| Rate for Payer: Cigna Commercial |
$14,097.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,645.53
|
| Rate for Payer: Oxford Commercial |
$7,559.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,052.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,580.00
|
|
|
EXPLORE SCROTUM
|
Facility
|
IP
|
$20,303.55
|
|
|
Service Code
|
HCPCS 55110
|
| Hospital Charge Code |
1600000480
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,045.53 |
| Max. Negotiated Rate |
$3,045.53 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,045.53
|
|
|
EXPLORE SCROTUM
|
Facility
|
OP
|
$20,303.55
|
|
|
Service Code
|
HCPCS 55110
|
| Hospital Charge Code |
1600000480
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$8,394.37 |
| Rate for Payer: Aetna Commercial |
$6,091.06
|
| Rate for Payer: Aetna Medicare Advantage |
$6,091.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,177.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,177.41
|
| 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 |
$5,177.41
|
| Rate for Payer: Cigna Commercial |
$8,394.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,639.46
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,045.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,529.00
|
|
|
EXPLORE SMALL INTESTINE
|
Facility
|
OP
|
$20,827.80
|
|
|
Service Code
|
HCPCS 44020
|
| Hospital Charge Code |
1600000761
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$998.01 |
| Max. Negotiated Rate |
$6,873.00 |
| Rate for Payer: Aetna Commercial |
$6,248.34
|
| Rate for Payer: Aetna Medicare Advantage |
$6,248.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,311.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,311.09
|
| 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 |
$5,311.09
|
| Rate for Payer: Cigna Commercial |
$998.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,707.61
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,124.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
EXPLORE SMALL INTESTINE
|
Facility
|
IP
|
$20,827.80
|
|
|
Service Code
|
HCPCS 44020
|
| Hospital Charge Code |
1600000761
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,124.17 |
| Max. Negotiated Rate |
$3,124.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,124.17
|
|
|
EXPLORE SPINAL FUSION
|
Facility
|
IP
|
$12,938.72
|
|
|
Service Code
|
HCPCS 22830
|
| Hospital Charge Code |
160000230
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,940.81 |
| Max. Negotiated Rate |
$1,940.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,940.81
|
|
|
EXPLORE SPINAL FUSION
|
Facility
|
OP
|
$12,938.72
|
|
|
Service Code
|
HCPCS 22830
|
| Hospital Charge Code |
160000230
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,682.03 |
| Max. Negotiated Rate |
$17,279.91 |
| Rate for Payer: Aetna Commercial |
$3,881.62
|
| Rate for Payer: Aetna Medicare Advantage |
$3,881.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,299.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,299.37
|
| 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 |
$3,299.37
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,682.03
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,940.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$9,851.00
|
|
|
EXPLORE/TREAT ANKLE JOINT-LT
|
Facility
|
IP
|
$32,127.31
|
|
|
Service Code
|
HCPCS 27610
|
| Hospital Charge Code |
16000890
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,819.10 |
| Max. Negotiated Rate |
$4,819.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,819.10
|
|
|
EXPLORE/TREAT ANKLE JOINT-LT
|
Facility
|
OP
|
$32,127.31
|
|
|
Service Code
|
HCPCS 27610
|
| Hospital Charge Code |
16000890
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$9,638.19 |
| Rate for Payer: Aetna Commercial |
$9,638.19
|
| Rate for Payer: Aetna Medicare Advantage |
$9,638.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,192.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,192.46
|
| 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 |
$8,192.46
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,176.55
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,819.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
EXPLORE/TREAT ELBOW JOINT
|
Facility
|
OP
|
$12,406.91
|
|
|
Service Code
|
HCPCS 24101
|
| Hospital Charge Code |
16000820
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,612.90 |
| Max. Negotiated Rate |
$7,791.93 |
| Rate for Payer: Aetna Commercial |
$3,722.07
|
| Rate for Payer: Aetna Medicare Advantage |
$3,722.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,163.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,163.76
|
| 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 |
$3,163.76
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,612.90
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,861.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
EXPLORE/TREAT ELBOW JOINT
|
Facility
|
IP
|
$12,406.91
|
|
|
Service Code
|
HCPCS 24101
|
| Hospital Charge Code |
16000820
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,861.04 |
| Max. Negotiated Rate |
$1,861.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,861.04
|
|
|
EXPLOR/TREAT ANKLE JOINT
|
Facility
|
IP
|
$12,832.72
|
|
|
Service Code
|
HCPCS 27620
|
| Hospital Charge Code |
1600000796
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,924.91 |
| Max. Negotiated Rate |
$1,924.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.91
|
|
|
EXPLOR/TREAT ANKLE JOINT
|
Facility
|
OP
|
$12,832.72
|
|
|
Service Code
|
HCPCS 27620
|
| Hospital Charge Code |
1600000796
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,668.25 |
| Max. Negotiated Rate |
$7,791.93 |
| Rate for Payer: Aetna Commercial |
$3,849.82
|
| Rate for Payer: Aetna Medicare Advantage |
$3,849.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,272.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,272.34
|
| 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 |
$3,272.34
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,668.25
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
EXPL P WND,ABD/FLANK
|
Facility
|
IP
|
$20,772.85
|
|
|
Service Code
|
HCPCS 20102
|
| Hospital Charge Code |
16000791
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,115.93 |
| Max. Negotiated Rate |
$3,115.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,115.93
|
|
|
EXPL P WND,ABD/FLANK
|
Facility
|
OP
|
$20,772.85
|
|
|
Service Code
|
HCPCS 20102
|
| Hospital Charge Code |
16000791
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$6,231.85 |
| Rate for Payer: Aetna Commercial |
$6,231.85
|
| Rate for Payer: Aetna Medicare Advantage |
$6,231.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,297.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,297.08
|
| 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 |
$5,297.08
|
| Rate for Payer: Cigna Commercial |
$4,913.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,700.47
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,115.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,687.00
|
|
|
EXPL P WOUND EXTREM
|
Facility
|
IP
|
$10,109.05
|
|
|
Service Code
|
HCPCS 20103
|
| Hospital Charge Code |
1600000334
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,516.36 |
| Max. Negotiated Rate |
$1,516.36 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,516.36
|
|
|
EXPL P WOUND EXTREM
|
Facility
|
OP
|
$10,109.05
|
|
|
Service Code
|
HCPCS 20103
|
| Hospital Charge Code |
1600000334
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,314.18 |
| Max. Negotiated Rate |
$3,933.12 |
| Rate for Payer: Aetna Better Health Medicaid |
$1,912.33
|
| Rate for Payer: Aetna Commercial |
$3,032.72
|
| Rate for Payer: Aetna Medicare Advantage |
$3,032.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,577.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,577.81
|
| 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 |
$2,577.81
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,314.18
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,516.36
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,575.00
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$1,950.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,912.33
|
|
|
EXPL/REM FB IPH JOINT EA
|
Facility
|
OP
|
$14,318.80
|
|
|
Service Code
|
HCPCS 26080
|
| Hospital Charge Code |
16000841
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,861.44 |
| Max. Negotiated Rate |
$4,295.64 |
| Rate for Payer: Aetna Commercial |
$4,295.64
|
| Rate for Payer: Aetna Medicare Advantage |
$4,295.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,651.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,651.29
|
| 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 |
$3,651.29
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,861.44
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,147.82
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,687.00
|
|