|
HIGH PROTEIN PUDDING
|
Facility
|
OP
|
$18.00
|
|
| Hospital Charge Code |
60634849
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Aetna Commercial |
$5.40
|
| Rate for Payer: Aetna Medicare Advantage |
$5.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4.59
|
| Rate for Payer: Cigna Commercial |
$9.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.34
|
| Rate for Payer: Oxford Commercial |
$9.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.00
|
|
|
HIGH PROTEIN PUDDING
|
Facility
|
IP
|
$18.00
|
|
| Hospital Charge Code |
60634849
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$2.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2.70
|
|
|
HIGH TEMP CAUTERY*********
|
Facility
|
IP
|
$43.00
|
|
| Hospital Charge Code |
8004269
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$6.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.45
|
|
|
HIGH TEMP CAUTERY*********
|
Facility
|
OP
|
$43.00
|
|
| Hospital Charge Code |
8004269
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$5.59 |
| Max. Negotiated Rate |
$21.50 |
| Rate for Payer: Aetna Commercial |
$12.90
|
| Rate for Payer: Aetna Medicare Advantage |
$12.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.96
|
| Rate for Payer: Cigna Commercial |
$21.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.59
|
| Rate for Payer: Oxford Commercial |
$21.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.50
|
|
|
HIGHTOP WALKER SMALL
|
Facility
|
OP
|
$997.00
|
|
| Hospital Charge Code |
270332313
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$129.61 |
| Max. Negotiated Rate |
$498.50 |
| Rate for Payer: Aetna Commercial |
$299.10
|
| Rate for Payer: Aetna Medicare Advantage |
$299.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$254.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$254.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$254.24
|
| Rate for Payer: Cigna Commercial |
$498.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$129.61
|
| Rate for Payer: Oxford Commercial |
$498.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$498.50
|
|
|
HIGHTOP WALKER SMALL
|
Facility
|
IP
|
$997.00
|
|
| Hospital Charge Code |
270332313
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$149.55 |
| Max. Negotiated Rate |
$149.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.55
|
|
|
HIGH WALL G7 36MM E
|
Facility
|
IP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270691146
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.50 |
| Max. Negotiated Rate |
$907.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$907.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.50
|
|
|
HIGH WALL G7 36MM E
|
Facility
|
OP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270691146
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.50 |
| Max. Negotiated Rate |
$1,875.00 |
| Rate for Payer: Aetna Commercial |
$1,125.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,125.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$956.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$956.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$956.25
|
| Rate for Payer: Cigna Commercial |
$1,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$907.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.50
|
|
|
HIGHWALL G7 LONGVI 32 MM SZ C
|
Facility
|
OP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270691942
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.50 |
| Max. Negotiated Rate |
$1,875.00 |
| Rate for Payer: Aetna Commercial |
$1,125.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,125.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$956.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$956.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$956.25
|
| Rate for Payer: Cigna Commercial |
$1,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$907.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.50
|
|
|
HIGHWALL G7 LONGVI 32 MM SZ C
|
Facility
|
IP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270691942
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.50 |
| Max. Negotiated Rate |
$907.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$907.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.50
|
|
|
HIGHWALL G7 LONGVITY 32 MM
|
Facility
|
IP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270691567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.50 |
| Max. Negotiated Rate |
$907.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$750.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$907.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.50
|
|
|
HIGHWALL G7 LONGVITY 32 MM
|
Facility
|
OP
|
$3,750.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270691567
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$562.50 |
| Max. Negotiated Rate |
$1,875.00 |
| Rate for Payer: Aetna Commercial |
$1,125.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,125.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$956.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$956.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$750.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$956.25
|
| Rate for Payer: Cigna Commercial |
$1,875.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$907.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$562.50
|
|
|
HIGH WALL LNR 36MM
|
Facility
|
IP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270692412
|
|
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
|
|
|
HIGH WALL LNR 36MM
|
Facility
|
OP
|
$6,000.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270692412
|
|
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
|
|
|
HINGED RODS
|
Facility
|
OP
|
$2,925.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687812
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$438.75 |
| Max. Negotiated Rate |
$1,462.50 |
| Rate for Payer: Aetna Commercial |
$877.50
|
| Rate for Payer: Aetna Medicare Advantage |
$877.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$745.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$745.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$585.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$745.88
|
| Rate for Payer: Cigna Commercial |
$1,462.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$707.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$438.75
|
|
|
HINGED RODS
|
Facility
|
IP
|
$2,925.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270687812
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$438.75 |
| Max. Negotiated Rate |
$707.85 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$585.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$707.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$438.75
|
|
|
HINGE HALF HOFFMAN II EXT FIX
|
Facility
|
OP
|
$936.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699517
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.45 |
| Max. Negotiated Rate |
$468.18 |
| Rate for Payer: Aetna Commercial |
$280.90
|
| Rate for Payer: Aetna Medicare Advantage |
$280.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$238.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$238.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$187.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$238.77
|
| Rate for Payer: Cigna Commercial |
$468.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$226.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$140.45
|
|
|
HINGE HALF HOFFMAN II EXT FIX
|
Facility
|
IP
|
$936.35
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270699517
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.45 |
| Max. Negotiated Rate |
$226.60 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$187.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$226.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$140.45
|
|
|
HIP/ANCA TIBIA W/SCREW 100mm
|
Facility
|
OP
|
$26,250.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270683440
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,937.50 |
| Max. Negotiated Rate |
$13,125.00 |
| Rate for Payer: Aetna Commercial |
$7,875.00
|
| Rate for Payer: Aetna Medicare Advantage |
$7,875.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,693.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,693.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,250.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,693.75
|
| Rate for Payer: Cigna Commercial |
$13,125.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,352.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,937.50
|
|
|
HIP/ANCA TIBIA W/SCREW 100mm
|
Facility
|
IP
|
$26,250.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
270683440
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,937.50 |
| Max. Negotiated Rate |
$6,352.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,352.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,937.50
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$22,763.62
|
|
|
Service Code
|
APR-DRG 3082
|
| Min. Negotiated Rate |
$14,271.46 |
| Max. Negotiated Rate |
$22,763.62 |
| Rate for Payer: Aetna Better Health Medicaid |
$22,317.27
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$22,763.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14,271.46
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$29,230.81
|
|
|
Service Code
|
APR-DRG 3083
|
| Min. Negotiated Rate |
$19,050.88 |
| Max. Negotiated Rate |
$29,230.81 |
| Rate for Payer: Aetna Better Health Medicaid |
$28,657.66
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$29,230.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19,050.88
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$43,410.82
|
|
|
Service Code
|
APR-DRG 3084
|
| Min. Negotiated Rate |
$33,302.44 |
| Max. Negotiated Rate |
$43,410.82 |
| Rate for Payer: Aetna Better Health Medicaid |
$42,559.63
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$43,410.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33,302.44
|
|
|
HIP AND FEMUR FRACTURE REPAIR
|
Facility
|
IP
|
$19,301.80
|
|
|
Service Code
|
APR-DRG 3081
|
| Min. Negotiated Rate |
$12,113.25 |
| Max. Negotiated Rate |
$19,301.80 |
| Rate for Payer: Aetna Better Health Medicaid |
$18,923.33
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$19,301.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12,113.25
|
|
|
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
|
Facility
|
IP
|
$72,616.62
|
|
|
Service Code
|
MSDRG 481
|
| Min. Negotiated Rate |
$22,856.40 |
| Max. Negotiated Rate |
$72,616.62 |
| Rate for Payer: Aetna Commercial |
$70,626.28
|
| Rate for Payer: Aetna Medicare Advantage |
$22,856.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57,063.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57,063.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24,205.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57,063.69
|
| Rate for Payer: Cigna Commercial |
$45,075.73
|
| Rate for Payer: Cigna Medicare Advantage |
$24,205.54
|
| Rate for Payer: Clover Medicare Advantage |
$22,995.26
|
| Rate for Payer: EmblemHealth Commercial |
$72,616.62
|
| Rate for Payer: Humana Medicare Advantage |
$24,931.71
|
| Rate for Payer: Oxford Commercial |
$28,171.03
|
| Rate for Payer: UnitedHealthcare Commercial |
$31,976.73
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24,205.54
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$25,657.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$24,205.54
|
|