|
MD SCREW 2.7MM X 22MM
|
Facility
|
OP
|
$742.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688187
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.38 |
| Max. Negotiated Rate |
$371.25 |
| Rate for Payer: Aetna Commercial |
$222.75
|
| Rate for Payer: Aetna Medicare Advantage |
$222.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$189.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$189.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$148.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$189.34
|
| Rate for Payer: Cigna Commercial |
$371.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$179.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.38
|
|
|
MD SCREW 2.7MM X 22MM
|
Facility
|
IP
|
$742.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270688187
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$111.38 |
| Max. Negotiated Rate |
$179.69 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$148.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$179.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$111.38
|
|
|
MEASLES AB (IGG)
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86765
|
| Hospital Charge Code |
39900386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.44 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$41.73
|
| Rate for Payer: Aetna Medicare Advantage |
$12.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$47.19
|
| Rate for Payer: Cigna Commercial |
$12.88
|
| Rate for Payer: Cigna Medicare Advantage |
$6.44
|
| Rate for Payer: Clover Medicare Advantage |
$12.24
|
| Rate for Payer: EmblemHealth Commercial |
$38.64
|
| Rate for Payer: Humana Medicare Advantage |
$13.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.88
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$13.65
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.88
|
|
|
MEASLES AB (IGG)
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86765
|
| Hospital Charge Code |
39900386
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
MEASLES/MUMPS PANEL I
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86765
|
| Hospital Charge Code |
39990103A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
MEASLES/MUMPS PANEL I
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86765
|
| Hospital Charge Code |
39990103A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.44 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$41.73
|
| Rate for Payer: Aetna Medicare Advantage |
$12.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$47.19
|
| Rate for Payer: Cigna Commercial |
$12.88
|
| Rate for Payer: Cigna Medicare Advantage |
$6.44
|
| Rate for Payer: Clover Medicare Advantage |
$12.24
|
| Rate for Payer: EmblemHealth Commercial |
$38.64
|
| Rate for Payer: Humana Medicare Advantage |
$13.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.88
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$13.65
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.88
|
|
|
MEASLES/MUMPS PANEL II
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86762
|
| Hospital Charge Code |
39990103B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$46.62
|
| Rate for Payer: Aetna Medicare Advantage |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.72
|
| Rate for Payer: Cigna Commercial |
$14.39
|
| Rate for Payer: Cigna Medicare Advantage |
$7.20
|
| Rate for Payer: Clover Medicare Advantage |
$13.67
|
| Rate for Payer: EmblemHealth Commercial |
$43.17
|
| Rate for Payer: Humana Medicare Advantage |
$14.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.39
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$15.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.39
|
|
|
MEASLES/MUMPS PANEL II
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86762
|
| Hospital Charge Code |
39990103B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
MEASLES/MUMPS/RUBELLA VACCINE
|
Facility
|
IP
|
$6.70
|
|
|
Service Code
|
HCPCS 90707
|
| Hospital Charge Code |
60628307
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$1.62 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.00
|
|
|
MEASLES/MUMPS/RUBELLA VACCINE
|
Facility
|
OP
|
$6.70
|
|
|
Service Code
|
HCPCS 90707
|
| Hospital Charge Code |
60628307
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$62.82 |
| Rate for Payer: Aetna Commercial |
$2.01
|
| Rate for Payer: Aetna Medicare Advantage |
$2.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$62.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.71
|
| Rate for Payer: Cigna Commercial |
$3.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.00
|
|
|
MEASLES MUMPS RUBL VACCINE INJ
|
Facility
|
IP
|
$224.00
|
|
|
Service Code
|
HCPCS 90707
|
| Hospital Charge Code |
6017834
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$54.21 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.60
|
|
|
MEASLES MUMPS RUBL VACCINE INJ
|
Facility
|
OP
|
$224.00
|
|
|
Service Code
|
HCPCS 90707
|
| Hospital Charge Code |
6017834
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$112.00 |
| Rate for Payer: Aetna Commercial |
$67.20
|
| Rate for Payer: Aetna Medicare Advantage |
$67.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$62.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.12
|
| Rate for Payer: Cigna Commercial |
$112.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.60
|
|
|
MEASLES VACCINE 0.5 ML SQ
|
Facility
|
OP
|
$95.40
|
|
| Hospital Charge Code |
6017008
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.31 |
| Max. Negotiated Rate |
$47.70 |
| Rate for Payer: Aetna Commercial |
$28.62
|
| Rate for Payer: Aetna Medicare Advantage |
$28.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.33
|
| Rate for Payer: Cigna Commercial |
$47.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.31
|
|
|
MEASLES VACCINE 0.5 ML SQ
|
Facility
|
IP
|
$95.40
|
|
| Hospital Charge Code |
6017008
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.31 |
| Max. Negotiated Rate |
$23.09 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.09
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.31
|
|
|
MEASLES VACCINE INJ
|
Facility
|
OP
|
$122.90
|
|
| Hospital Charge Code |
60628306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$61.45 |
| Rate for Payer: Aetna Commercial |
$36.87
|
| Rate for Payer: Aetna Medicare Advantage |
$36.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.34
|
| Rate for Payer: Cigna Commercial |
$61.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.98
|
| Rate for Payer: Oxford Commercial |
$61.45
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$61.45
|
|
|
MEASLES VACCINE INJ
|
Facility
|
IP
|
$122.90
|
|
| Hospital Charge Code |
60628306
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$18.43 |
| Max. Negotiated Rate |
$18.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.43
|
|
|
MEAT FIBERS, STOOL
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
HCPCS 89160
|
| Hospital Charge Code |
3008463
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.42 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$15.71
|
| Rate for Payer: Aetna Medicare Advantage |
$4.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.77
|
| Rate for Payer: Cigna Commercial |
$4.85
|
| Rate for Payer: Cigna Medicare Advantage |
$2.42
|
| Rate for Payer: Clover Medicare Advantage |
$4.61
|
| Rate for Payer: EmblemHealth Commercial |
$14.55
|
| Rate for Payer: Humana Medicare Advantage |
$5.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.85
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.85
|
|
|
MEAT FIBERS, STOOL
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
HCPCS 89160
|
| Hospital Charge Code |
3008463
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
|
|
MEAT FIBER, STOOL
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 89160
|
| Hospital Charge Code |
38475099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.42 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$15.71
|
| Rate for Payer: Aetna Medicare Advantage |
$4.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.77
|
| Rate for Payer: Cigna Commercial |
$4.85
|
| Rate for Payer: Cigna Medicare Advantage |
$2.42
|
| Rate for Payer: Clover Medicare Advantage |
$4.61
|
| Rate for Payer: EmblemHealth Commercial |
$14.55
|
| Rate for Payer: Humana Medicare Advantage |
$5.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.85
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.85
|
|
|
MEAT FIBER, STOOL
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 89160
|
| Hospital Charge Code |
38475099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
MEATOTOMY EXCEPT IN NEWBORN
|
Facility
|
OP
|
$18,162.80
|
|
|
Service Code
|
HCPCS 53020
|
| Hospital Charge Code |
1600000546
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$5,529.00 |
| Rate for Payer: Aetna Commercial |
$5,448.84
|
| Rate for Payer: Aetna Medicare Advantage |
$5,448.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,631.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,631.51
|
| 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 |
$4,631.51
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,361.16
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,724.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,529.00
|
|
|
MEATOTOMY EXCEPT IN NEWBORN
|
Facility
|
IP
|
$18,162.80
|
|
|
Service Code
|
HCPCS 53020
|
| Hospital Charge Code |
1600000546
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,724.42 |
| Max. Negotiated Rate |
$2,724.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,724.42
|
|
|
MEBENDAZOLE TAB 100MG
|
Facility
|
IP
|
$31.40
|
|
| Hospital Charge Code |
6003412
|
|
Hospital Revenue Code
|
252
|
| Min. Negotiated Rate |
$4.71 |
| Max. Negotiated Rate |
$4.71 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.71
|
|
|
MEBENDAZOLE TAB 100MG
|
Facility
|
OP
|
$31.40
|
|
| Hospital Charge Code |
6003412
|
|
Hospital Revenue Code
|
252
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$15.70 |
| Rate for Payer: Aetna Commercial |
$9.42
|
| Rate for Payer: Aetna Medicare Advantage |
$9.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.01
|
| Rate for Payer: Cigna Commercial |
$15.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4.08
|
| Rate for Payer: Oxford Commercial |
$15.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$15.70
|
|
|
MECHANICAL CHEST WALL OSCILL
|
Facility
|
IP
|
$676.95
|
|
|
Service Code
|
HCPCS 94669
|
| Hospital Charge Code |
317094669
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$101.54 |
| Max. Negotiated Rate |
$101.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$101.54
|
|