|
RECOV ROOM COMX 2 1/2 TO 3 HR
|
Facility
|
OP
|
$7,996.59
|
|
| Hospital Charge Code |
1500011
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,039.56 |
| Max. Negotiated Rate |
$3,998.30 |
| Rate for Payer: Aetna Commercial |
$2,398.98
|
| Rate for Payer: Aetna Medicare Advantage |
$2,398.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,039.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,039.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,039.13
|
| Rate for Payer: Cigna Commercial |
$3,998.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,039.56
|
| Rate for Payer: Oxford Commercial |
$3,998.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,199.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,998.30
|
|
|
RECOV ROOM COMX 2 1/2 TO 3 HR
|
Facility
|
IP
|
$7,996.59
|
|
| Hospital Charge Code |
1500011
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,199.49 |
| Max. Negotiated Rate |
$1,199.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,199.49
|
|
|
RECOV ROOM COMX 2 TO 2 1/2 HR
|
Facility
|
OP
|
$6,996.99
|
|
| Hospital Charge Code |
1500009
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$909.61 |
| Max. Negotiated Rate |
$3,498.49 |
| Rate for Payer: Aetna Commercial |
$2,099.10
|
| Rate for Payer: Aetna Medicare Advantage |
$2,099.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,784.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,784.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,784.23
|
| Rate for Payer: Cigna Commercial |
$3,498.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$909.61
|
| Rate for Payer: Oxford Commercial |
$3,498.49
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,049.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,498.49
|
|
|
RECOV ROOM COMX 2 TO 2 1/2 HR
|
Facility
|
IP
|
$6,996.99
|
|
| Hospital Charge Code |
1500009
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,049.55 |
| Max. Negotiated Rate |
$1,049.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,049.55
|
|
|
RECOV ROOM COMX 3 1/2 TO 4 HR
|
Facility
|
IP
|
$9,996.04
|
|
| Hospital Charge Code |
1500015
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,499.41 |
| Max. Negotiated Rate |
$1,499.41 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,499.41
|
|
|
RECOV ROOM COMX 3 1/2 TO 4 HR
|
Facility
|
OP
|
$9,996.04
|
|
| Hospital Charge Code |
1500015
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,299.49 |
| Max. Negotiated Rate |
$4,998.02 |
| Rate for Payer: Aetna Commercial |
$2,998.81
|
| Rate for Payer: Aetna Medicare Advantage |
$2,998.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,548.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,548.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,548.99
|
| Rate for Payer: Cigna Commercial |
$4,998.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,299.49
|
| Rate for Payer: Oxford Commercial |
$4,998.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,499.41
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,998.02
|
|
|
RECOV ROOM COMX 3 TO 3 1/2 HR
|
Facility
|
OP
|
$8,996.19
|
|
| Hospital Charge Code |
1500013
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,169.50 |
| Max. Negotiated Rate |
$4,498.10 |
| Rate for Payer: Aetna Commercial |
$2,698.86
|
| Rate for Payer: Aetna Medicare Advantage |
$2,698.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,294.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,294.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,294.03
|
| Rate for Payer: Cigna Commercial |
$4,498.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,169.50
|
| Rate for Payer: Oxford Commercial |
$4,498.10
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,349.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,498.10
|
|
|
RECOV ROOM COMX 3 TO 3 1/2 HR
|
Facility
|
IP
|
$8,996.19
|
|
| Hospital Charge Code |
1500013
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$1,349.43 |
| Max. Negotiated Rate |
$1,349.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,349.43
|
|
|
RECOV ROOM COMX ADD 1/2 HR
|
Facility
|
OP
|
$999.60
|
|
| Hospital Charge Code |
1500017
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$129.95 |
| Max. Negotiated Rate |
$499.80 |
| Rate for Payer: Aetna Commercial |
$299.88
|
| Rate for Payer: Aetna Medicare Advantage |
$299.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$254.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$254.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$254.90
|
| Rate for Payer: Cigna Commercial |
$499.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$129.95
|
| Rate for Payer: Oxford Commercial |
$499.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$499.80
|
|
|
RECOV ROOM COMX ADD 1/2 HR
|
Facility
|
IP
|
$999.60
|
|
| Hospital Charge Code |
1500017
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$149.94 |
| Max. Negotiated Rate |
$149.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$149.94
|
|
|
RECOV ROOM/DELIVERY
|
Facility
|
OP
|
$750.00
|
|
| Hospital Charge Code |
1800051
|
|
Hospital Revenue Code
|
722
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$2,979.00 |
| Rate for Payer: Aetna Commercial |
$225.00
|
| Rate for Payer: Aetna Medicare Advantage |
$225.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$191.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$191.25
|
| Rate for Payer: Cigna Commercial |
$375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.50
|
| Rate for Payer: Oxford Commercial |
$2,624.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,979.00
|
|
|
RECOV ROOM/DELIVERY
|
Facility
|
IP
|
$750.00
|
|
| Hospital Charge Code |
1800051
|
|
Hospital Revenue Code
|
722
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$112.50
|
|
|
REC - PROC ONLY
|
Facility
|
OP
|
$664.00
|
|
| Hospital Charge Code |
73190155
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$86.32 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: Aetna Commercial |
$199.20
|
| Rate for Payer: Aetna Medicare Advantage |
$199.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$169.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$169.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$169.32
|
| Rate for Payer: Cigna Commercial |
$332.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.32
|
| Rate for Payer: Oxford Commercial |
$332.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$332.00
|
|
|
REC - PROC ONLY
|
Facility
|
IP
|
$664.00
|
|
| Hospital Charge Code |
73190155
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$99.60 |
| Max. Negotiated Rate |
$99.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$99.60
|
|
|
RECTAL RESECTION WITH CC
|
Facility
|
IP
|
$79,806.30
|
|
|
Service Code
|
MSDRG 333
|
| Min. Negotiated Rate |
$25,271.99 |
| Max. Negotiated Rate |
$79,806.30 |
| Rate for Payer: Aetna Commercial |
$78,978.70
|
| Rate for Payer: Aetna Medicare Advantage |
$25,559.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57,339.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57,339.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$26,602.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57,339.36
|
| Rate for Payer: Cigna Commercial |
$50,406.49
|
| Rate for Payer: Cigna Medicare Advantage |
$26,602.10
|
| Rate for Payer: Clover Medicare Advantage |
$25,271.99
|
| Rate for Payer: EmblemHealth Commercial |
$79,806.30
|
| Rate for Payer: Humana Medicare Advantage |
$27,400.16
|
| Rate for Payer: Oxford Commercial |
$31,502.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$35,758.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$26,602.10
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$28,198.23
|
| Rate for Payer: Wellcare Medicare Advantage |
$26,602.10
|
|
|
RECTAL RESECTION WITH MCC
|
Facility
|
IP
|
$122,089.58
|
|
|
Service Code
|
MSDRG 332
|
| Min. Negotiated Rate |
$37,023.31 |
| Max. Negotiated Rate |
$122,089.58 |
| Rate for Payer: Aetna Commercial |
$122,089.58
|
| Rate for Payer: Aetna Medicare Advantage |
$39,511.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100,619.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100,619.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$38,971.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$100,619.55
|
| Rate for Payer: Cigna Commercial |
$77,921.08
|
| Rate for Payer: Cigna Medicare Advantage |
$38,971.91
|
| Rate for Payer: Clover Medicare Advantage |
$37,023.31
|
| Rate for Payer: EmblemHealth Commercial |
$116,915.73
|
| Rate for Payer: Humana Medicare Advantage |
$40,141.07
|
| Rate for Payer: Oxford Commercial |
$48,698.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$55,277.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$38,971.91
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$41,310.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$38,971.91
|
|
|
RECTAL RESECTION WITHOUT CC/MCC
|
Facility
|
IP
|
$59,363.49
|
|
|
Service Code
|
MSDRG 334
|
| Min. Negotiated Rate |
$17,873.72 |
| Max. Negotiated Rate |
$59,363.49 |
| Rate for Payer: Aetna Commercial |
$55,229.79
|
| Rate for Payer: Aetna Medicare Advantage |
$17,873.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44,382.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44,382.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$19,787.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44,382.87
|
| Rate for Payer: Cigna Commercial |
$35,249.25
|
| Rate for Payer: Cigna Medicare Advantage |
$19,787.83
|
| Rate for Payer: Clover Medicare Advantage |
$18,798.44
|
| Rate for Payer: EmblemHealth Commercial |
$59,363.49
|
| Rate for Payer: Humana Medicare Advantage |
$20,381.46
|
| Rate for Payer: Oxford Commercial |
$22,029.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$25,005.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$19,787.83
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$20,975.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$19,787.83
|
|
|
RECTANGLE EXPANDER 100CC
|
Facility
|
OP
|
$6,750.00
|
|
| Hospital Charge Code |
270702233
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,012.50 |
| Max. Negotiated Rate |
$3,375.00 |
| Rate for Payer: Aetna Commercial |
$2,025.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,025.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,721.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,721.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,350.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,721.25
|
| Rate for Payer: Cigna Commercial |
$3,375.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,633.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,012.50
|
|
|
RECTANGLE EXPANDER 100CC
|
Facility
|
IP
|
$6,750.00
|
|
| Hospital Charge Code |
270702233
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,012.50 |
| Max. Negotiated Rate |
$1,633.50 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,350.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,633.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,012.50
|
|
|
REC - VAG DELIVERY
|
Facility
|
IP
|
$1,162.00
|
|
| Hospital Charge Code |
73190152
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$174.30 |
| Max. Negotiated Rate |
$174.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$174.30
|
|
|
REC - VAG DELIVERY
|
Facility
|
OP
|
$1,162.00
|
|
| Hospital Charge Code |
73190152
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$151.06 |
| Max. Negotiated Rate |
$581.00 |
| Rate for Payer: Aetna Commercial |
$348.60
|
| Rate for Payer: Aetna Medicare Advantage |
$348.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$296.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$296.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$296.31
|
| Rate for Payer: Cigna Commercial |
$581.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$151.06
|
| Rate for Payer: Oxford Commercial |
$581.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$174.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$581.00
|
|
|
RED BLOOD CELL CMV NEG LEUKO
|
Facility
|
OP
|
$1,119.34
|
|
| Hospital Charge Code |
38471208
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$145.51 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: Aetna Commercial |
$335.80
|
| Rate for Payer: Aetna Medicare Advantage |
$335.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$285.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$285.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$285.43
|
| Rate for Payer: Cigna Commercial |
$559.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$145.51
|
| Rate for Payer: Oxford Commercial |
$666.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$167.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$756.00
|
|
|
RED BLOOD CELL CMV NEG LEUKO
|
Facility
|
IP
|
$1,119.34
|
|
| Hospital Charge Code |
38471208
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$167.90 |
| Max. Negotiated Rate |
$167.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$167.90
|
|
|
RED BLOOD CELL DEGLY LEUKO IRR
|
Facility
|
IP
|
$2,664.30
|
|
| Hospital Charge Code |
38471214
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$399.64 |
| Max. Negotiated Rate |
$399.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$399.64
|
|
|
RED BLOOD CELL DEGLY LEUKO IRR
|
Facility
|
OP
|
$2,664.30
|
|
| Hospital Charge Code |
38471214
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$346.36 |
| Max. Negotiated Rate |
$1,332.15 |
| Rate for Payer: Aetna Commercial |
$799.29
|
| Rate for Payer: Aetna Medicare Advantage |
$799.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$679.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$679.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$679.40
|
| Rate for Payer: Cigna Commercial |
$1,332.15
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$346.36
|
| Rate for Payer: Oxford Commercial |
$666.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$399.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$756.00
|
|