|
NERVO PROTECTOR
|
Facility
|
OP
|
$9,400.00
|
|
| Hospital Charge Code |
270661463
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,410.00 |
| Max. Negotiated Rate |
$4,700.00 |
| Rate for Payer: Aetna Commercial |
$2,820.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,820.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,397.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,397.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,880.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,397.00
|
| Rate for Payer: Cigna Commercial |
$4,700.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,274.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,410.00
|
|
|
NERVO PROTECTOR
|
Facility
|
IP
|
$9,400.00
|
|
| Hospital Charge Code |
270661463
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,410.00 |
| Max. Negotiated Rate |
$2,274.80 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,880.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,274.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,410.00
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$14,368.19
|
|
|
Service Code
|
APR-DRG 0413
|
| Min. Negotiated Rate |
$11,219.27 |
| Max. Negotiated Rate |
$14,368.19 |
| Rate for Payer: Aetna Better Health Medicaid |
$14,086.46
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$14,368.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11,219.27
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$10,861.46
|
|
|
Service Code
|
APR-DRG 0412
|
| Min. Negotiated Rate |
$8,213.90 |
| Max. Negotiated Rate |
$10,861.46 |
| Rate for Payer: Aetna Better Health Medicaid |
$10,648.49
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$10,861.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8,213.90
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$20,987.10
|
|
|
Service Code
|
APR-DRG 0414
|
| Min. Negotiated Rate |
$19,936.88 |
| Max. Negotiated Rate |
$20,987.10 |
| Rate for Payer: Aetna Better Health Medicaid |
$20,575.59
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$20,987.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19,936.88
|
|
|
NERVOUS SYSTEM MALIGNANCY
|
Facility
|
IP
|
$10,433.13
|
|
|
Service Code
|
APR-DRG 0411
|
| Min. Negotiated Rate |
$7,392.52 |
| Max. Negotiated Rate |
$10,433.13 |
| Rate for Payer: Aetna Better Health Medicaid |
$10,228.56
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$10,433.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7,392.52
|
|
|
NERVOUS SYSTEM NEOPLASMS WITH MCC
|
Facility
|
IP
|
$56,141.61
|
|
|
Service Code
|
MSDRG 054
|
| Min. Negotiated Rate |
$16,662.42 |
| Max. Negotiated Rate |
$56,141.61 |
| Rate for Payer: Aetna Commercial |
$51,486.88
|
| Rate for Payer: Aetna Medicare Advantage |
$16,662.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$40,523.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$40,523.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18,713.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$40,523.49
|
| Rate for Payer: Cigna Medicare Advantage |
$18,713.87
|
| Rate for Payer: Clover Medicare Advantage |
$17,778.18
|
| Rate for Payer: EmblemHealth Commercial |
$56,141.61
|
| Rate for Payer: Humana Medicare Advantage |
$19,275.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18,713.87
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$19,836.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$18,713.87
|
|
|
NERVOUS SYSTEM NEOPLASMS WITHOUT MCC
|
Facility
|
IP
|
$41,416.86
|
|
|
Service Code
|
MSDRG 055
|
| Min. Negotiated Rate |
$11,126.47 |
| Max. Negotiated Rate |
$41,416.86 |
| Rate for Payer: Aetna Commercial |
$34,380.79
|
| Rate for Payer: Aetna Medicare Advantage |
$11,126.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29,496.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29,496.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,805.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29,496.69
|
| Rate for Payer: Cigna Medicare Advantage |
$13,805.62
|
| Rate for Payer: Clover Medicare Advantage |
$13,115.34
|
| Rate for Payer: EmblemHealth Commercial |
$41,416.86
|
| Rate for Payer: Humana Medicare Advantage |
$14,219.79
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,805.62
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$14,633.96
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,805.62
|
|
|
NET RETRIEVAL***
|
Facility
|
IP
|
$57.00
|
|
| Hospital Charge Code |
2300846
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$8.55 |
| Max. Negotiated Rate |
$8.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.55
|
|
|
NET RETRIEVAL***
|
Facility
|
OP
|
$57.00
|
|
| Hospital Charge Code |
2300846
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$7.41 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Aetna Commercial |
$17.10
|
| Rate for Payer: Aetna Medicare Advantage |
$17.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.54
|
| Rate for Payer: Cigna Commercial |
$28.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.41
|
| Rate for Payer: Oxford Commercial |
$28.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$28.50
|
|
|
NET RETRIEVAL ROTH DISP 2.5mm
|
Facility
|
IP
|
$392.65
|
|
| Hospital Charge Code |
270650906
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$58.90 |
| Max. Negotiated Rate |
$58.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.90
|
|
|
NET RETRIEVAL ROTH DISP 2.5mm
|
Facility
|
OP
|
$392.65
|
|
| Hospital Charge Code |
270650906
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$51.04 |
| Max. Negotiated Rate |
$196.32 |
| Rate for Payer: Aetna Commercial |
$117.80
|
| Rate for Payer: Aetna Medicare Advantage |
$117.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100.13
|
| Rate for Payer: Cigna Commercial |
$196.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$51.04
|
| Rate for Payer: Oxford Commercial |
$196.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$196.32
|
|
|
NET ROTH RETRIEVAL 2.5MM
|
Facility
|
IP
|
$525.00
|
|
| Hospital Charge Code |
270658147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
|
|
NET ROTH RETRIEVAL 2.5MM
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
270658147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.25 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial |
$157.50
|
| Rate for Payer: Aetna Medicare Advantage |
$157.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$133.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$133.88
|
| Rate for Payer: Cigna Commercial |
$262.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$68.25
|
| Rate for Payer: Oxford Commercial |
$262.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$78.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$262.50
|
|
|
NET ROTH RETRIEVAL 2.5mm 230cm
|
Facility
|
OP
|
$470.00
|
|
| Hospital Charge Code |
270600968
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.10 |
| Max. Negotiated Rate |
$235.00 |
| Rate for Payer: Aetna Commercial |
$141.00
|
| Rate for Payer: Aetna Medicare Advantage |
$141.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.85
|
| Rate for Payer: Cigna Commercial |
$235.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.10
|
| Rate for Payer: Oxford Commercial |
$235.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$235.00
|
|
|
NET ROTH RETRIEVAL 2.5mm 230cm
|
Facility
|
IP
|
$470.00
|
|
| Hospital Charge Code |
270600968
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$70.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.50
|
|
|
NEURO DRILL AGGRESSIVE 3X3.8MM
|
Facility
|
IP
|
$866.15
|
|
| Hospital Charge Code |
270673698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$129.92 |
| Max. Negotiated Rate |
$129.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.92
|
|
|
NEURO DRILL AGGRESSIVE 3X3.8MM
|
Facility
|
OP
|
$866.15
|
|
| Hospital Charge Code |
270673698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.60 |
| Max. Negotiated Rate |
$433.07 |
| Rate for Payer: Aetna Commercial |
$259.85
|
| Rate for Payer: Aetna Medicare Advantage |
$259.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$220.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$220.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$220.87
|
| Rate for Payer: Cigna Commercial |
$433.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$112.60
|
| Rate for Payer: Oxford Commercial |
$433.07
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$129.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$433.07
|
|
|
NEURO FLUID MANAGEMENT KIT
|
Facility
|
OP
|
$205.00
|
|
| Hospital Charge Code |
270682762
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.65 |
| Max. Negotiated Rate |
$102.50 |
| Rate for Payer: Aetna Commercial |
$61.50
|
| Rate for Payer: Aetna Medicare Advantage |
$61.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.27
|
| Rate for Payer: Cigna Commercial |
$102.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.65
|
| Rate for Payer: Oxford Commercial |
$102.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$102.50
|
|
|
NEURO FLUID MANAGEMENT KIT
|
Facility
|
IP
|
$205.00
|
|
| Hospital Charge Code |
270682762S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.75 |
| Max. Negotiated Rate |
$30.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.75
|
|
|
NEURO FLUID MANAGEMENT KIT
|
Facility
|
IP
|
$205.00
|
|
| Hospital Charge Code |
270682762
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.75 |
| Max. Negotiated Rate |
$30.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.75
|
|
|
NEURO FLUID MANAGEMENT KIT
|
Facility
|
OP
|
$205.00
|
|
| Hospital Charge Code |
270682762S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.65 |
| Max. Negotiated Rate |
$102.50 |
| Rate for Payer: Aetna Commercial |
$61.50
|
| Rate for Payer: Aetna Medicare Advantage |
$61.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.27
|
| Rate for Payer: Cigna Commercial |
$102.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.65
|
| Rate for Payer: Oxford Commercial |
$102.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$102.50
|
|
|
NEURO FLUID MGT KIT
|
Facility
|
OP
|
$283.10
|
|
| Hospital Charge Code |
270700399S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$141.55 |
| Rate for Payer: Aetna Commercial |
$84.93
|
| Rate for Payer: Aetna Medicare Advantage |
$84.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$72.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$72.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$72.19
|
| Rate for Payer: Cigna Commercial |
$141.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.80
|
| Rate for Payer: Oxford Commercial |
$141.55
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$141.55
|
|
|
NEURO FLUID MGT KIT
|
Facility
|
IP
|
$283.10
|
|
| Hospital Charge Code |
270700399S
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.47 |
| Max. Negotiated Rate |
$42.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.47
|
|
|
NEUROLOGICAL EYE DISORDERS
|
Facility
|
IP
|
$35,002.17
|
|
|
Service Code
|
MSDRG 123
|
| Min. Negotiated Rate |
$8,714.79 |
| Max. Negotiated Rate |
$35,002.17 |
| Rate for Payer: Aetna Commercial |
$26,928.70
|
| Rate for Payer: Aetna Medicare Advantage |
$8,714.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22,053.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22,053.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11,667.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22,053.60
|
| Rate for Payer: Cigna Commercial |
$17,186.67
|
| Rate for Payer: Cigna Medicare Advantage |
$11,667.39
|
| Rate for Payer: Clover Medicare Advantage |
$11,084.02
|
| Rate for Payer: EmblemHealth Commercial |
$35,002.17
|
| Rate for Payer: Humana Medicare Advantage |
$12,017.41
|
| Rate for Payer: Oxford Commercial |
$10,741.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,192.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11,667.39
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$12,367.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$11,667.39
|
|