|
RECOV ROOM < 1 HR
|
Facility
|
IP
|
$2,398.87
|
|
| Hospital Charge Code |
1500020
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$359.83 |
| Max. Negotiated Rate |
$359.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$359.83
|
|
|
RECOV ROOM 1 TO 1 1/2 HR
|
Facility
|
OP
|
$3,998.23
|
|
| Hospital Charge Code |
1500032
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$519.77 |
| Max. Negotiated Rate |
$1,999.12 |
| Rate for Payer: Aetna Commercial |
$1,199.47
|
| Rate for Payer: Aetna Medicare Advantage |
$1,199.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,019.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,019.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,019.55
|
| Rate for Payer: Cigna Commercial |
$1,999.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$519.77
|
| Rate for Payer: Oxford Commercial |
$1,999.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$599.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,999.12
|
|
|
RECOV ROOM 1 TO 1 1/2 HR
|
Facility
|
IP
|
$3,998.23
|
|
| Hospital Charge Code |
1500032
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$599.73 |
| Max. Negotiated Rate |
$599.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$599.73
|
|
|
RECOV ROOM 2 1/2 TO 3 HRS
|
Facility
|
IP
|
$6,397.27
|
|
| Hospital Charge Code |
1500065
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$959.59 |
| Max. Negotiated Rate |
$959.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$959.59
|
|
|
RECOV ROOM 2 1/2 TO 3 HRS
|
Facility
|
OP
|
$6,397.27
|
|
| Hospital Charge Code |
1500065
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$831.65 |
| Max. Negotiated Rate |
$3,198.64 |
| Rate for Payer: Aetna Commercial |
$1,919.18
|
| Rate for Payer: Aetna Medicare Advantage |
$1,919.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,631.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,631.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,631.30
|
| Rate for Payer: Cigna Commercial |
$3,198.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$831.65
|
| Rate for Payer: Oxford Commercial |
$3,198.64
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$959.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,198.64
|
|
|
RECOV ROOM 2 TO 2 1/2 HRS
|
Facility
|
IP
|
$5,597.59
|
|
| Hospital Charge Code |
1500057
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$839.64 |
| Max. Negotiated Rate |
$839.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$839.64
|
|
|
RECOV ROOM 2 TO 2 1/2 HRS
|
Facility
|
OP
|
$5,597.59
|
|
| Hospital Charge Code |
1500057
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$727.69 |
| Max. Negotiated Rate |
$2,798.80 |
| Rate for Payer: Aetna Commercial |
$1,679.28
|
| Rate for Payer: Aetna Medicare Advantage |
$1,679.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,427.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,427.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,427.39
|
| Rate for Payer: Cigna Commercial |
$2,798.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$727.69
|
| Rate for Payer: Oxford Commercial |
$2,798.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$839.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,798.80
|
|
|
RECOV ROOM 3 1/2 TO 4 HRS
|
Facility
|
IP
|
$7,996.83
|
|
| Hospital Charge Code |
1500081
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,199.52 |
| Max. Negotiated Rate |
$1,199.52 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,199.52
|
|
|
RECOV ROOM 3 1/2 TO 4 HRS
|
Facility
|
OP
|
$7,996.83
|
|
| Hospital Charge Code |
1500081
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,039.59 |
| Max. Negotiated Rate |
$3,998.41 |
| Rate for Payer: Aetna Commercial |
$2,399.05
|
| Rate for Payer: Aetna Medicare Advantage |
$2,399.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,039.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,039.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,039.19
|
| Rate for Payer: Cigna Commercial |
$3,998.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,039.59
|
| Rate for Payer: Oxford Commercial |
$3,998.41
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,199.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,998.41
|
|
|
RECOV ROOM 3 TO 3 1/2 HRS
|
Facility
|
OP
|
$7,196.95
|
|
| Hospital Charge Code |
1500073
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$935.60 |
| Max. Negotiated Rate |
$3,598.47 |
| Rate for Payer: Aetna Commercial |
$2,159.09
|
| Rate for Payer: Aetna Medicare Advantage |
$2,159.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,835.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,835.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,835.22
|
| Rate for Payer: Cigna Commercial |
$3,598.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$935.60
|
| Rate for Payer: Oxford Commercial |
$3,598.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,079.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,598.47
|
|
|
RECOV ROOM 3 TO 3 1/2 HRS
|
Facility
|
IP
|
$7,196.95
|
|
| Hospital Charge Code |
1500073
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,079.54 |
| Max. Negotiated Rate |
$1,079.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,079.54
|
|
|
RECOV ROOM ADD 1/2 HR
|
Facility
|
IP
|
$799.68
|
|
| Hospital Charge Code |
1500099
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$119.95 |
| Max. Negotiated Rate |
$119.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.95
|
|
|
RECOV ROOM ADD 1/2 HR
|
Facility
|
OP
|
$799.68
|
|
| Hospital Charge Code |
1500099
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$103.96 |
| Max. Negotiated Rate |
$399.84 |
| Rate for Payer: Aetna Commercial |
$239.90
|
| Rate for Payer: Aetna Medicare Advantage |
$239.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$203.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$203.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$203.92
|
| Rate for Payer: Cigna Commercial |
$399.84
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.96
|
| Rate for Payer: Oxford Commercial |
$399.84
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$399.84
|
|
|
RECOV ROOM ADD 1/2 HR
|
Facility
|
IP
|
$551.00
|
|
| Hospital Charge Code |
41101015
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$82.65 |
| Max. Negotiated Rate |
$82.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.65
|
|
|
RECOV ROOM ADD 1/2 HR
|
Facility
|
OP
|
$551.00
|
|
| Hospital Charge Code |
41101015
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$71.63 |
| Max. Negotiated Rate |
$275.50 |
| Rate for Payer: Aetna Commercial |
$165.30
|
| Rate for Payer: Aetna Medicare Advantage |
$165.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$140.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$140.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.50
|
| Rate for Payer: Cigna Commercial |
$275.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.63
|
| Rate for Payer: Oxford Commercial |
$275.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$275.50
|
|
|
RECOV ROOM ADD 15 MINUTES
|
Facility
|
OP
|
$276.00
|
|
| Hospital Charge Code |
1500025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$35.88 |
| Max. Negotiated Rate |
$138.00 |
| Rate for Payer: Aetna Commercial |
$82.80
|
| Rate for Payer: Aetna Medicare Advantage |
$82.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.38
|
| Rate for Payer: Cigna Commercial |
$138.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.88
|
| Rate for Payer: Oxford Commercial |
$138.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$138.00
|
|
|
RECOV ROOM ADD 15 MINUTES
|
Facility
|
IP
|
$276.00
|
|
| Hospital Charge Code |
1500025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$41.40 |
| Max. Negotiated Rate |
$41.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$41.40
|
|
|
RECOV ROOM COMX 1 1/2 TO 2 HR
|
Facility
|
IP
|
$5,997.39
|
|
| Hospital Charge Code |
1500007
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$899.61 |
| Max. Negotiated Rate |
$899.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$899.61
|
|
|
RECOV ROOM COMX 1 1/2 TO 2 HR
|
Facility
|
OP
|
$5,997.39
|
|
| Hospital Charge Code |
1500007
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$779.66 |
| Max. Negotiated Rate |
$2,998.70 |
| Rate for Payer: Aetna Commercial |
$1,799.22
|
| Rate for Payer: Aetna Medicare Advantage |
$1,799.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,529.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,529.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,529.33
|
| Rate for Payer: Cigna Commercial |
$2,998.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$779.66
|
| Rate for Payer: Oxford Commercial |
$2,998.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$899.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,998.70
|
|
|
RECOV ROOM COMX 1 HOUR
|
Facility
|
OP
|
$3,998.19
|
|
| Hospital Charge Code |
1500003
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$519.76 |
| Max. Negotiated Rate |
$1,999.10 |
| Rate for Payer: Aetna Commercial |
$1,199.46
|
| Rate for Payer: Aetna Medicare Advantage |
$1,199.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,019.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,019.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,019.54
|
| Rate for Payer: Cigna Commercial |
$1,999.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$519.76
|
| Rate for Payer: Oxford Commercial |
$1,999.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$599.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,999.10
|
|
|
RECOV ROOM COMX 1 HOUR
|
Facility
|
IP
|
$3,998.19
|
|
| Hospital Charge Code |
1500003
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$599.73 |
| Max. Negotiated Rate |
$599.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$599.73
|
|
|
RECOV ROOM COMX < 1 HR
|
Facility
|
IP
|
$2,998.59
|
|
| Hospital Charge Code |
1500001
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$449.79 |
| Max. Negotiated Rate |
$449.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$449.79
|
|
|
RECOV ROOM COMX < 1 HR
|
Facility
|
OP
|
$2,998.59
|
|
| Hospital Charge Code |
1500001
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$389.82 |
| Max. Negotiated Rate |
$1,499.30 |
| Rate for Payer: Aetna Commercial |
$899.58
|
| Rate for Payer: Aetna Medicare Advantage |
$899.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.64
|
| Rate for Payer: Cigna Commercial |
$1,499.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$389.82
|
| Rate for Payer: Oxford Commercial |
$1,499.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$449.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,499.30
|
|
|
RECOV ROOM COMX 1 TO 1 1/2 HR
|
Facility
|
OP
|
$4,997.79
|
|
| Hospital Charge Code |
1500005
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$649.71 |
| Max. Negotiated Rate |
$2,498.89 |
| Rate for Payer: Aetna Commercial |
$1,499.34
|
| Rate for Payer: Aetna Medicare Advantage |
$1,499.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,274.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,274.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,274.44
|
| Rate for Payer: Cigna Commercial |
$2,498.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$649.71
|
| Rate for Payer: Oxford Commercial |
$2,498.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$749.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,498.89
|
|
|
RECOV ROOM COMX 1 TO 1 1/2 HR
|
Facility
|
IP
|
$4,997.79
|
|
| Hospital Charge Code |
1500005
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$749.67 |
| Max. Negotiated Rate |
$749.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$749.67
|
|