|
NAIL BMT HUMERAL 9 28CM 340728
|
Facility
|
OP
|
$5,317.20
|
|
| Hospital Charge Code |
270624981
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$797.58 |
| Max. Negotiated Rate |
$2,658.60 |
| Rate for Payer: Aetna Commercial |
$1,595.16
|
| Rate for Payer: Aetna Medicare Advantage |
$1,595.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,355.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,355.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,063.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,355.89
|
| Rate for Payer: Cigna Commercial |
$2,658.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,286.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$797.58
|
|
|
NAIL BMT TIB 10 26 33344226
|
Facility
|
OP
|
$2,940.85
|
|
| Hospital Charge Code |
270626570
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$441.13 |
| Max. Negotiated Rate |
$1,470.42 |
| Rate for Payer: Aetna Commercial |
$882.25
|
| Rate for Payer: Aetna Medicare Advantage |
$882.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$749.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$749.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$588.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$749.92
|
| Rate for Payer: Cigna Commercial |
$1,470.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$711.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$441.13
|
|
|
NAIL BMT TIB 10 26 33344226
|
Facility
|
IP
|
$2,940.85
|
|
| Hospital Charge Code |
270626570
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$441.13 |
| Max. Negotiated Rate |
$711.69 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$588.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$711.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$441.13
|
|
|
NAIL BMT TIB 10 28 33344228
|
Facility
|
OP
|
$2,940.85
|
|
| Hospital Charge Code |
270626571
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$441.13 |
| Max. Negotiated Rate |
$1,470.42 |
| Rate for Payer: Aetna Commercial |
$882.25
|
| Rate for Payer: Aetna Medicare Advantage |
$882.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$749.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$749.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$588.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$749.92
|
| Rate for Payer: Cigna Commercial |
$1,470.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$711.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$441.13
|
|
|
NAIL BMT TIB 10 28 33344228
|
Facility
|
IP
|
$2,940.85
|
|
| Hospital Charge Code |
270626571
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$441.13 |
| Max. Negotiated Rate |
$711.69 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$588.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$711.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$441.13
|
|
|
NAIL BMT TIB 11 34 34344334
|
Facility
|
OP
|
$3,113.65
|
|
| Hospital Charge Code |
270623759
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$467.05 |
| Max. Negotiated Rate |
$1,556.83 |
| Rate for Payer: Aetna Commercial |
$934.10
|
| Rate for Payer: Aetna Medicare Advantage |
$934.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$793.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$793.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$622.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$793.98
|
| Rate for Payer: Cigna Commercial |
$1,556.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$753.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$467.05
|
|
|
NAIL BMT TIB 11 34 34344334
|
Facility
|
IP
|
$3,113.65
|
|
| Hospital Charge Code |
270623759
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$467.05 |
| Max. Negotiated Rate |
$753.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$622.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$753.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$467.05
|
|
|
NAIL BMT TIB 11 36 34344336
|
Facility
|
IP
|
$3,113.65
|
|
| Hospital Charge Code |
270623758
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$467.05 |
| Max. Negotiated Rate |
$753.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$622.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$753.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$467.05
|
|
|
NAIL BMT TIB 11 36 34344336
|
Facility
|
OP
|
$3,113.65
|
|
| Hospital Charge Code |
270623758
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$467.05 |
| Max. Negotiated Rate |
$1,556.83 |
| Rate for Payer: Aetna Commercial |
$934.10
|
| Rate for Payer: Aetna Medicare Advantage |
$934.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$793.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$793.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$622.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$793.98
|
| Rate for Payer: Cigna Commercial |
$1,556.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$753.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$467.05
|
|
|
NAIL BMT TIBIAL 100 28 156728
|
Facility
|
IP
|
$3,662.45
|
|
| Hospital Charge Code |
270617540
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$549.37 |
| Max. Negotiated Rate |
$886.31 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$732.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$886.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$549.37
|
|
|
NAIL BMT TIBIAL 100 28 156728
|
Facility
|
OP
|
$3,662.45
|
|
| Hospital Charge Code |
270617540
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$549.37 |
| Max. Negotiated Rate |
$1,831.22 |
| Rate for Payer: Aetna Commercial |
$1,098.73
|
| Rate for Payer: Aetna Medicare Advantage |
$1,098.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$933.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$933.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$732.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$933.92
|
| Rate for Payer: Cigna Commercial |
$1,831.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$886.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$549.37
|
|
|
NAIL BMT UX FEM 12 36 341436
|
Facility
|
OP
|
$3,263.25
|
|
| Hospital Charge Code |
270614894
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$489.49 |
| Max. Negotiated Rate |
$1,631.62 |
| Rate for Payer: Aetna Commercial |
$978.98
|
| Rate for Payer: Aetna Medicare Advantage |
$978.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$832.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$832.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$652.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$832.13
|
| Rate for Payer: Cigna Commercial |
$1,631.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$789.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$489.49
|
|
|
NAIL BMT UX FEM 12 36 341436
|
Facility
|
IP
|
$3,263.25
|
|
| Hospital Charge Code |
270614894
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$489.49 |
| Max. Negotiated Rate |
$789.71 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$652.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$789.71
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$489.49
|
|
|
NAIL BMT UX FEM 13 34 343034
|
Facility
|
IP
|
$3,311.25
|
|
| Hospital Charge Code |
270621867
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$496.69 |
| Max. Negotiated Rate |
$801.32 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$662.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$801.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$496.69
|
|
|
NAIL BMT UX FEM 13 34 343034
|
Facility
|
OP
|
$3,311.25
|
|
| Hospital Charge Code |
270621867
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$496.69 |
| Max. Negotiated Rate |
$1,655.62 |
| Rate for Payer: Aetna Commercial |
$993.38
|
| Rate for Payer: Aetna Medicare Advantage |
$993.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$844.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$844.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$662.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$844.37
|
| Rate for Payer: Cigna Commercial |
$1,655.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$801.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$496.69
|
|
|
NAIL BMT UX TIB 10 30 33344230
|
Facility
|
IP
|
$2,020.85
|
|
| Hospital Charge Code |
270612855
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$303.13 |
| Max. Negotiated Rate |
$489.05 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$404.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$489.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.13
|
|
|
NAIL BMT UX TIB 10 30 33344230
|
Facility
|
OP
|
$2,020.85
|
|
| Hospital Charge Code |
270612855
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$303.13 |
| Max. Negotiated Rate |
$1,010.42 |
| Rate for Payer: Aetna Commercial |
$606.25
|
| Rate for Payer: Aetna Medicare Advantage |
$606.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$515.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$515.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$404.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$515.32
|
| Rate for Payer: Cigna Commercial |
$1,010.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$489.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$303.13
|
|
|
NAIL BMT UX TIB 10 32 33344232
|
Facility
|
OP
|
$3,555.25
|
|
| Hospital Charge Code |
270612854
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$533.29 |
| Max. Negotiated Rate |
$1,777.62 |
| Rate for Payer: Aetna Commercial |
$1,066.58
|
| Rate for Payer: Aetna Medicare Advantage |
$1,066.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$906.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$906.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$711.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$906.59
|
| Rate for Payer: Cigna Commercial |
$1,777.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$860.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$533.29
|
|
|
NAIL BMT UX TIB 10 32 33344232
|
Facility
|
IP
|
$3,555.25
|
|
| Hospital Charge Code |
270612854
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$533.29 |
| Max. Negotiated Rate |
$860.37 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$711.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$860.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$533.29
|
|
|
NAIL BMT UX TIB 10 34 33344334
|
Facility
|
OP
|
$3,113.65
|
|
| Hospital Charge Code |
270623820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$467.05 |
| Max. Negotiated Rate |
$1,556.83 |
| Rate for Payer: Aetna Commercial |
$934.10
|
| Rate for Payer: Aetna Medicare Advantage |
$934.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$793.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$793.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$622.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$793.98
|
| Rate for Payer: Cigna Commercial |
$1,556.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$753.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$467.05
|
|
|
NAIL BMT UX TIB 10 34 33344334
|
Facility
|
IP
|
$3,113.65
|
|
| Hospital Charge Code |
270623820
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$467.05 |
| Max. Negotiated Rate |
$753.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$622.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$753.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$467.05
|
|
|
NAIL BMT UX TIB 11 32 33344332
|
Facility
|
OP
|
$3,112.85
|
|
| Hospital Charge Code |
270623819
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$466.93 |
| Max. Negotiated Rate |
$1,556.42 |
| Rate for Payer: Aetna Commercial |
$933.86
|
| Rate for Payer: Aetna Medicare Advantage |
$933.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$793.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$793.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$622.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$793.78
|
| Rate for Payer: Cigna Commercial |
$1,556.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$753.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$466.93
|
|
|
NAIL BMT UX TIB 11 32 33344332
|
Facility
|
IP
|
$3,112.85
|
|
| Hospital Charge Code |
270623819
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$466.93 |
| Max. Negotiated Rate |
$753.31 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$622.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$753.31
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$466.93
|
|
|
NAIL BMT UX TIB 13 40 33344540
|
Facility
|
OP
|
$3,555.25
|
|
| Hospital Charge Code |
270613716
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$533.29 |
| Max. Negotiated Rate |
$1,777.62 |
| Rate for Payer: Aetna Commercial |
$1,066.58
|
| Rate for Payer: Aetna Medicare Advantage |
$1,066.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$906.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$906.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$711.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$906.59
|
| Rate for Payer: Cigna Commercial |
$1,777.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$860.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$533.29
|
|
|
NAIL BMT UX TIB 13 40 33344540
|
Facility
|
IP
|
$3,555.25
|
|
| Hospital Charge Code |
270613716
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$533.29 |
| Max. Negotiated Rate |
$860.37 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$711.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$860.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$533.29
|
|