|
ANESTHESIA EPIDURAL 1ST HR
|
Facility
|
IP
|
$420.00
|
|
| Hospital Charge Code |
1650112
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.00
|
|
|
ANESTHESIA EPIDURAL 1ST HR
|
Facility
|
OP
|
$420.00
|
|
| Hospital Charge Code |
1650112
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$210.00 |
| Rate for Payer: Aetna Commercial |
$126.00
|
| Rate for Payer: Aetna Medicare Advantage |
$126.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$107.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$107.10
|
| Rate for Payer: Cigna Commercial |
$210.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.60
|
| Rate for Payer: Oxford Commercial |
$210.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$210.00
|
|
|
ANESTHESIA EPIDURAL EA ADD HR
|
Facility
|
OP
|
$140.00
|
|
| Hospital Charge Code |
1650113
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$18.20 |
| Max. Negotiated Rate |
$70.00 |
| Rate for Payer: Aetna Commercial |
$42.00
|
| Rate for Payer: Aetna Medicare Advantage |
$42.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.70
|
| Rate for Payer: Cigna Commercial |
$70.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.20
|
| Rate for Payer: Oxford Commercial |
$70.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$70.00
|
|
|
ANESTHESIA EPIDURAL EA ADD HR
|
Facility
|
IP
|
$140.00
|
|
| Hospital Charge Code |
1650113
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.00
|
|
|
ANESTHESIA FEM NERVE BLOCK
|
Facility
|
IP
|
$600.00
|
|
| Hospital Charge Code |
1650060
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.00
|
|
|
ANESTHESIA FEM NERVE BLOCK
|
Facility
|
OP
|
$600.00
|
|
| Hospital Charge Code |
1650060
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$300.00 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: Aetna Medicare Advantage |
$180.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$153.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$153.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$153.00
|
| Rate for Payer: Cigna Commercial |
$300.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$78.00
|
| Rate for Payer: Oxford Commercial |
$300.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$300.00
|
|
|
ANESTHESIA FEM NERVE BLOCK PRO
|
Facility
|
IP
|
$600.00
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
1650095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.00
|
|
|
ANESTHESIA FEM NERVE BLOCK PRO
|
Facility
|
OP
|
$600.00
|
|
|
Service Code
|
HCPCS 64450
|
| Hospital Charge Code |
1650095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$78.00 |
| Max. Negotiated Rate |
$2,575.00 |
| Rate for Payer: Aetna Commercial |
$180.00
|
| Rate for Payer: Aetna Medicare Advantage |
$180.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$153.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$153.00
|
| 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 |
$153.00
|
| Rate for Payer: Cigna Commercial |
$1,680.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$78.00
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,575.00
|
|
|
ANESTHESIA FEM NERVE BLOCK US
|
Facility
|
IP
|
$700.00
|
|
| Hospital Charge Code |
1650065
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$105.00 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
|
|
ANESTHESIA FEM NERVE BLOCK US
|
Facility
|
OP
|
$700.00
|
|
| Hospital Charge Code |
1650065
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$350.00 |
| Rate for Payer: Aetna Commercial |
$210.00
|
| Rate for Payer: Aetna Medicare Advantage |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$178.50
|
| Rate for Payer: Cigna Commercial |
$350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$91.00
|
| Rate for Payer: Oxford Commercial |
$350.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$105.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$350.00
|
|
|
ANESTHESIA GENERAL
|
Facility
|
OP
|
$1,001.51
|
|
| Hospital Charge Code |
1650010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$500.75 |
| Rate for Payer: Aetna Commercial |
$300.45
|
| Rate for Payer: Aetna Medicare Advantage |
$300.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$255.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$255.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$255.39
|
| Rate for Payer: Cigna Commercial |
$500.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.20
|
| Rate for Payer: Oxford Commercial |
$500.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$500.75
|
|
|
ANESTHESIA GENERAL
|
Facility
|
IP
|
$1,001.51
|
|
| Hospital Charge Code |
1650010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$150.23 |
| Max. Negotiated Rate |
$150.23 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.23
|
|
|
ANESTHESIA GENERAL 1ST HR
|
Facility
|
OP
|
$751.13
|
|
| Hospital Charge Code |
1650102
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$97.65 |
| Max. Negotiated Rate |
$375.56 |
| Rate for Payer: Aetna Commercial |
$225.34
|
| Rate for Payer: Aetna Medicare Advantage |
$225.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.54
|
| Rate for Payer: Cigna Commercial |
$375.56
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.65
|
| Rate for Payer: Oxford Commercial |
$375.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$375.56
|
|
|
ANESTHESIA GENERAL 1ST HR
|
Facility
|
IP
|
$751.13
|
|
| Hospital Charge Code |
1650102
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$112.67 |
| Max. Negotiated Rate |
$112.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.67
|
|
|
ANESTHESIA GENERAL EA ADD HR
|
Facility
|
OP
|
$250.38
|
|
| Hospital Charge Code |
1650103
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$32.55 |
| Max. Negotiated Rate |
$125.19 |
| Rate for Payer: Aetna Commercial |
$75.11
|
| Rate for Payer: Aetna Medicare Advantage |
$75.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.85
|
| Rate for Payer: Cigna Commercial |
$125.19
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.55
|
| Rate for Payer: Oxford Commercial |
$125.19
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$125.19
|
|
|
ANESTHESIA GENERAL EA ADD HR
|
Facility
|
IP
|
$250.38
|
|
| Hospital Charge Code |
1650103
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$37.56 |
| Max. Negotiated Rate |
$37.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.56
|
|
|
ANESTHESIA IV GENERAL
|
Facility
|
OP
|
$630.00
|
|
| Hospital Charge Code |
1650011
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$81.90 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna Commercial |
$189.00
|
| Rate for Payer: Aetna Medicare Advantage |
$189.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$160.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$160.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$160.65
|
| Rate for Payer: Cigna Commercial |
$315.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$81.90
|
| Rate for Payer: Oxford Commercial |
$315.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$315.00
|
|
|
ANESTHESIA IV GENERAL
|
Facility
|
IP
|
$630.00
|
|
| Hospital Charge Code |
1650011
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$94.50 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.50
|
|
|
ANESTHESIA IV GENERAL 1ST HR
|
Facility
|
OP
|
$472.50
|
|
| Hospital Charge Code |
1650104
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$61.42 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: Aetna Commercial |
$141.75
|
| Rate for Payer: Aetna Medicare Advantage |
$141.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$120.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$120.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$120.49
|
| Rate for Payer: Cigna Commercial |
$236.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.42
|
| Rate for Payer: Oxford Commercial |
$236.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$236.25
|
|
|
ANESTHESIA IV GENERAL 1ST HR
|
Facility
|
IP
|
$472.50
|
|
| Hospital Charge Code |
1650104
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$70.88 |
| Max. Negotiated Rate |
$70.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.88
|
|
|
ANESTHESIA IV GENERL EA ADD HR
|
Facility
|
IP
|
$157.50
|
|
| Hospital Charge Code |
1650105
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$23.62 |
| Max. Negotiated Rate |
$23.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.62
|
|
|
ANESTHESIA IV GENERL EA ADD HR
|
Facility
|
OP
|
$157.50
|
|
| Hospital Charge Code |
1650105
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$20.48 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Aetna Commercial |
$47.25
|
| Rate for Payer: Aetna Medicare Advantage |
$47.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$40.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$40.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$40.16
|
| Rate for Payer: Cigna Commercial |
$78.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.48
|
| Rate for Payer: Oxford Commercial |
$78.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$78.75
|
|
|
ANESTHESIA LOCAL
|
Facility
|
OP
|
$112.00
|
|
| Hospital Charge Code |
1650025
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$14.56 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna Commercial |
$33.60
|
| Rate for Payer: Aetna Medicare Advantage |
$33.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.56
|
| Rate for Payer: Cigna Commercial |
$56.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.56
|
| Rate for Payer: Oxford Commercial |
$56.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$56.00
|
|
|
ANESTHESIA LOCAL
|
Facility
|
IP
|
$112.00
|
|
| Hospital Charge Code |
1650025
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$16.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.80
|
|
|
ANESTHESIA LOCAL 1ST HR
|
Facility
|
OP
|
$84.00
|
|
| Hospital Charge Code |
1650108
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$10.92 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Aetna Commercial |
$25.20
|
| Rate for Payer: Aetna Medicare Advantage |
$25.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21.42
|
| Rate for Payer: Cigna Commercial |
$42.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.92
|
| Rate for Payer: Oxford Commercial |
$42.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$42.00
|
|