|
REMOVAL OF BLADDER
|
Facility
|
OP
|
$31,076.20
|
|
|
Service Code
|
HCPCS 51570
|
| Hospital Charge Code |
1600000523
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,415.66 |
| Max. Negotiated Rate |
$9,322.86 |
| Rate for Payer: Aetna Commercial |
$9,322.86
|
| Rate for Payer: Aetna Medicare Advantage |
$9,322.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,924.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,924.43
|
| 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 |
$7,924.43
|
| Rate for Payer: Cigna Commercial |
$1,415.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,039.91
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,661.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REMOVAL OF BLADDER CYST
|
Facility
|
OP
|
$24,921.08
|
|
|
Service Code
|
HCPCS 51500
|
| Hospital Charge Code |
1600000311
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$14,396.79 |
| Rate for Payer: Aetna Commercial |
$7,476.32
|
| Rate for Payer: Aetna Medicare Advantage |
$7,476.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,354.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,354.88
|
| 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 |
$6,354.88
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,239.74
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,738.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REMOVAL OF BLADDER CYST
|
Facility
|
IP
|
$24,921.08
|
|
|
Service Code
|
HCPCS 51500
|
| Hospital Charge Code |
1600000311
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,738.16 |
| Max. Negotiated Rate |
$3,738.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,738.16
|
|
|
REMOVAL OF BONE LESION
|
Facility
|
OP
|
$19,105.25
|
|
|
Service Code
|
HCPCS 23140
|
| Hospital Charge Code |
1600000804
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$7,791.93 |
| Rate for Payer: Aetna Commercial |
$5,731.57
|
| Rate for Payer: Aetna Medicare Advantage |
$5,731.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,871.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,871.84
|
| 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 |
$4,871.84
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,483.68
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,865.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,529.00
|
|
|
REMOVAL OF BONE LESION
|
Facility
|
IP
|
$19,105.25
|
|
|
Service Code
|
HCPCS 23140
|
| Hospital Charge Code |
1600000804
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,865.79 |
| Max. Negotiated Rate |
$2,865.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,865.79
|
|
|
REMOVAL OF BRAIN LESION
|
Facility
|
IP
|
$27,732.00
|
|
|
Service Code
|
HCPCS 61510
|
| Hospital Charge Code |
1600000656
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,159.80 |
| Max. Negotiated Rate |
$4,159.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,159.80
|
|
|
REMOVAL OF BRAIN LESION
|
Facility
|
OP
|
$27,732.00
|
|
|
Service Code
|
HCPCS 61510
|
| Hospital Charge Code |
1600000656
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$8,319.60 |
| Rate for Payer: Aetna Commercial |
$8,319.60
|
| Rate for Payer: Aetna Medicare Advantage |
$8,319.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,071.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,071.66
|
| 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 |
$7,071.66
|
| Rate for Payer: Cigna Commercial |
$2,370.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,605.16
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,159.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REMOVAL OF BREAST LESION 1+
|
Facility
|
OP
|
$41,701.77
|
|
|
Service Code
|
HCPCS 19120
|
| Hospital Charge Code |
16000187
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$12,510.53 |
| Rate for Payer: Aetna Commercial |
$12,510.53
|
| Rate for Payer: Aetna Medicare Advantage |
$12,510.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10,633.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10,633.95
|
| 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 |
$10,633.95
|
| Rate for Payer: Cigna Commercial |
$9,324.19
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,421.23
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,255.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,529.00
|
|
|
REMOVAL OF BREAST LESION 1+
|
Facility
|
IP
|
$41,701.77
|
|
|
Service Code
|
HCPCS 19120
|
| Hospital Charge Code |
16000187
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,255.27 |
| Max. Negotiated Rate |
$6,255.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,255.27
|
|
|
REMOVAL OF BREAST TISSUE
|
Facility
|
IP
|
$15,552.48
|
|
|
Service Code
|
HCPCS 19300
|
| Hospital Charge Code |
16000407
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,332.87 |
| Max. Negotiated Rate |
$2,332.87 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,332.87
|
|
|
REMOVAL OF BREAST TISSUE
|
Facility
|
OP
|
$15,552.48
|
|
|
Service Code
|
HCPCS 19300
|
| Hospital Charge Code |
16000407
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$9,324.19 |
| Rate for Payer: Aetna Commercial |
$4,665.74
|
| Rate for Payer: Aetna Medicare Advantage |
$4,665.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,965.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,965.88
|
| 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 |
$3,965.88
|
| Rate for Payer: Cigna Commercial |
$9,324.19
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,021.82
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,332.87
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,529.00
|
|
|
REMOVAL OF COLON
|
Facility
|
OP
|
$17,954.72
|
|
|
Service Code
|
HCPCS 44160
|
| Hospital Charge Code |
1600000577
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,261.46 |
| Max. Negotiated Rate |
$6,873.00 |
| Rate for Payer: Aetna Commercial |
$5,386.42
|
| Rate for Payer: Aetna Medicare Advantage |
$5,386.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,578.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,578.45
|
| 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 |
$4,578.45
|
| Rate for Payer: Cigna Commercial |
$1,261.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,334.11
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,693.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REMOVAL OF COLON
|
Facility
|
IP
|
$17,954.72
|
|
|
Service Code
|
HCPCS 44160
|
| Hospital Charge Code |
1600000577
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,693.21 |
| Max. Negotiated Rate |
$2,693.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,693.21
|
|
|
REMOVAL OF FINGER TENDON
|
Facility
|
IP
|
$7,510.76
|
|
|
Service Code
|
HCPCS 26180
|
| Hospital Charge Code |
16000843
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,126.61 |
| Max. Negotiated Rate |
$1,126.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,126.61
|
|
|
REMOVAL OF FINGER TENDON
|
Facility
|
OP
|
$7,510.76
|
|
|
Service Code
|
HCPCS 26180
|
| Hospital Charge Code |
16000843
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$976.40 |
| Max. Negotiated Rate |
$3,829.26 |
| Rate for Payer: Aetna Commercial |
$2,253.23
|
| Rate for Payer: Aetna Medicare Advantage |
$2,253.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,915.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,915.24
|
| 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 |
$1,915.24
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$976.40
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,126.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,687.00
|
|
|
REMOVAL OF FOOT FASCIA-RT
|
Facility
|
OP
|
$21,064.69
|
|
|
Service Code
|
HCPCS 28062
|
| Hospital Charge Code |
16000570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$7,791.93 |
| Rate for Payer: Aetna Commercial |
$6,319.41
|
| Rate for Payer: Aetna Medicare Advantage |
$6,319.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,371.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,371.50
|
| 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 |
$5,371.50
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,738.41
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,159.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,529.00
|
|
|
REMOVAL OF FOOT FASCIA-RT
|
Facility
|
IP
|
$21,064.69
|
|
|
Service Code
|
HCPCS 28062
|
| Hospital Charge Code |
16000570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,159.70 |
| Max. Negotiated Rate |
$3,159.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,159.70
|
|
|
REMOVAL OF FOOT FOREIGN BODY
|
Facility
|
IP
|
$2,392.12
|
|
|
Service Code
|
HCPCS 28192
|
| Hospital Charge Code |
1600000642
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$358.82 |
| Max. Negotiated Rate |
$358.82 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$358.82
|
|
|
REMOVAL OF FOOT FOREIGN BODY
|
Facility
|
OP
|
$2,392.12
|
|
|
Service Code
|
HCPCS 28192
|
| Hospital Charge Code |
1600000642
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$310.98 |
| Max. Negotiated Rate |
$3,933.12 |
| Rate for Payer: Aetna Commercial |
$717.64
|
| Rate for Payer: Aetna Medicare Advantage |
$717.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$609.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$609.99
|
| 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 |
$609.99
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$310.98
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$358.82
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,687.00
|
|
|
REMOVAL OF HEMORRHOID CLOT
|
Facility
|
IP
|
$21,472.19
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
1600000557
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,220.83 |
| Max. Negotiated Rate |
$3,220.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,220.83
|
|
|
REMOVAL OF HEMORRHOID CLOT
|
Facility
|
OP
|
$4,707.64
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
1600000288
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$611.99 |
| Max. Negotiated Rate |
$3,687.00 |
| Rate for Payer: Aetna Commercial |
$1,412.29
|
| Rate for Payer: Aetna Medicare Advantage |
$1,412.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,200.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,200.45
|
| 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 |
$1,200.45
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$611.99
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$706.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,687.00
|
|
|
REMOVAL OF HEMORRHOID CLOT
|
Facility
|
IP
|
$4,707.64
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
1600000288
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$706.15 |
| Max. Negotiated Rate |
$706.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$706.15
|
|
|
REMOVAL OF HEMORRHOID CLOT
|
Facility
|
OP
|
$21,472.19
|
|
|
Service Code
|
HCPCS 46320
|
| Hospital Charge Code |
1600000557
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$6,441.66 |
| Rate for Payer: Aetna Commercial |
$6,441.66
|
| Rate for Payer: Aetna Medicare Advantage |
$6,441.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,475.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,475.41
|
| 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 |
$5,475.41
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,791.38
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,220.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,687.00
|
|
|
REMOVAL OF HYDROCELES
|
Facility
|
OP
|
$16,624.12
|
|
|
Service Code
|
HCPCS 55041
|
| Hospital Charge Code |
1600000394
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$8,526.35 |
| Rate for Payer: Aetna Commercial |
$4,987.24
|
| Rate for Payer: Aetna Medicare Advantage |
$4,987.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,239.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,239.15
|
| 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 |
$4,239.15
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,161.14
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,493.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REMOVAL OF HYDROCELES
|
Facility
|
IP
|
$16,624.12
|
|
|
Service Code
|
HCPCS 55041
|
| Hospital Charge Code |
1600000394
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,493.62 |
| Max. Negotiated Rate |
$2,493.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,493.62
|
|