|
REPOSITION PULSE GEN
|
Facility
|
IP
|
$9,195.40
|
|
|
Service Code
|
HCPCS 33222
|
| Hospital Charge Code |
7411029
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,379.31 |
| Max. Negotiated Rate |
$1,379.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,379.31
|
|
|
REPOSITION PULSE GEN
|
Facility
|
OP
|
$9,195.40
|
|
|
Service Code
|
HCPCS 33222
|
| Hospital Charge Code |
7411029
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$253.00 |
| Max. Negotiated Rate |
$4,913.48 |
| Rate for Payer: Aetna Commercial |
$2,758.62
|
| Rate for Payer: Aetna Medicare Advantage |
$2,758.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,344.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,344.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$253.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,344.83
|
| Rate for Payer: Cigna Commercial |
$4,913.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,195.40
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,379.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,793.00
|
|
|
REPOSITION RT ATRIAL/VENT LEAD
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
74110076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
REPOSITION RT ATRIAL/VENT LEAD
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
74110076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,235.00 |
| Max. Negotiated Rate |
$7,519.21 |
| Rate for Payer: Aetna Commercial |
$2,850.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,850.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,422.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,422.50
|
| 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 |
$2,422.50
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,235.00
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REPOSITION RT ATRIAL/VENT LEAD
|
Facility
|
OP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
5100775
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,235.00 |
| Max. Negotiated Rate |
$7,519.21 |
| Rate for Payer: Aetna Commercial |
$2,850.00
|
| Rate for Payer: Aetna Medicare Advantage |
$2,850.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,422.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,422.50
|
| 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 |
$2,422.50
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,235.00
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REPOSITION RT ATRIAL/VENT LEAD
|
Facility
|
IP
|
$9,500.00
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
5100775
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,425.00 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,425.00
|
|
|
REPOSITION RT AT/VEN
|
Facility
|
OP
|
$6,578.00
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
7411023
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$288.65 |
| Max. Negotiated Rate |
$7,519.21 |
| Rate for Payer: Aetna Commercial |
$1,973.40
|
| Rate for Payer: Aetna Medicare Advantage |
$1,973.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,677.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,677.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$288.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,677.39
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$855.14
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$986.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,793.00
|
|
|
REPOSITION RT AT/VEN
|
Facility
|
OP
|
$6,578.00
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
366833215
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$288.65 |
| Max. Negotiated Rate |
$7,519.21 |
| Rate for Payer: Aetna Commercial |
$1,973.40
|
| Rate for Payer: Aetna Medicare Advantage |
$1,973.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,677.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,677.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$288.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,677.39
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$855.14
|
| Rate for Payer: Oxford Commercial |
$1,580.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$986.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,793.00
|
|
|
REPOSITION RT AT/VEN
|
Facility
|
IP
|
$6,578.00
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
7411023
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$986.70 |
| Max. Negotiated Rate |
$986.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$986.70
|
|
|
REPOSITION RT AT/VEN
|
Facility
|
IP
|
$6,578.00
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
366833215
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$986.70 |
| Max. Negotiated Rate |
$986.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$986.70
|
|
|
REPOSITION VAD DIFF SESSION
|
Facility
|
OP
|
$2,750.00
|
|
|
Service Code
|
HCPCS 33993
|
| Hospital Charge Code |
411033993
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$153.49 |
| Max. Negotiated Rate |
$6,873.00 |
| Rate for Payer: Aetna Commercial |
$825.00
|
| Rate for Payer: Aetna Medicare Advantage |
$825.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$701.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$701.25
|
| 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 |
$701.25
|
| Rate for Payer: Cigna Commercial |
$153.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$357.50
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REPOSITION VAD DIFF SESSION
|
Facility
|
IP
|
$2,750.00
|
|
|
Service Code
|
HCPCS 33993
|
| Hospital Charge Code |
411033993
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$412.50 |
| Max. Negotiated Rate |
$412.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$412.50
|
|
|
REP RCR ING HRNIA A AGE,INCRCE
|
Facility
|
IP
|
$40,785.21
|
|
|
Service Code
|
HCPCS 49521
|
| Hospital Charge Code |
160000195
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,117.78 |
| Max. Negotiated Rate |
$6,117.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,117.78
|
|
|
REP RCR ING HRNIA A AGE,INCRCE
|
Facility
|
OP
|
$40,785.21
|
|
|
Service Code
|
HCPCS 49521
|
| Hospital Charge Code |
160000195
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$15,416.72 |
| Rate for Payer: Aetna Commercial |
$12,235.56
|
| Rate for Payer: Aetna Medicare Advantage |
$12,235.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10,400.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10,400.23
|
| 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 |
$10,400.23
|
| Rate for Payer: Cigna Commercial |
$15,416.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,302.08
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,117.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REPR DISL PERONEAL TNDN W FIB
|
Facility
|
OP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27676
|
| Hospital Charge Code |
1600000585
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$17,279.91 |
| Rate for Payer: Aetna Commercial |
$9,178.50
|
| Rate for Payer: Aetna Medicare Advantage |
$9,178.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,801.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,801.73
|
| 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 |
$7,801.73
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,977.35
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REPR DISL PERONEAL TNDN W FIB
|
Facility
|
IP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27676
|
| Hospital Charge Code |
1600000585
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,589.25 |
| Max. Negotiated Rate |
$4,589.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
|
|
REP&RECON FINGER VP IP JNT FA
|
Facility
|
IP
|
$26,471.80
|
|
|
Service Code
|
HCPCS 26548
|
| Hospital Charge Code |
16000855
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,970.77 |
| Max. Negotiated Rate |
$3,970.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,970.77
|
|
|
REP&RECON FINGER VP IP JNT FA
|
Facility
|
OP
|
$26,471.80
|
|
|
Service Code
|
HCPCS 26548
|
| Hospital Charge Code |
16000855
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$7,941.54 |
| Rate for Payer: Aetna Commercial |
$7,941.54
|
| Rate for Payer: Aetna Medicare Advantage |
$7,941.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,750.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,750.31
|
| 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 |
$6,750.31
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,441.33
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,970.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REP RECURRENT INC HERNIA REDC
|
Facility
|
IP
|
$30,877.00
|
|
|
Service Code
|
HCPCS 49565
|
| Hospital Charge Code |
16000990
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,631.55 |
| Max. Negotiated Rate |
$4,631.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,631.55
|
|
|
REP RECURRENT INC HERNIA REDC
|
Facility
|
OP
|
$30,877.00
|
|
|
Service Code
|
HCPCS 49565
|
| Hospital Charge Code |
16000990
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$15,438.50 |
| Rate for Payer: Aetna Commercial |
$9,263.10
|
| Rate for Payer: Aetna Medicare Advantage |
$9,263.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,873.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,873.64
|
| 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 |
$7,873.64
|
| Rate for Payer: Cigna Commercial |
$15,438.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,014.01
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,631.55
|
|
|
REP RECURR FEMORAL HERNIA; INC
|
Facility
|
IP
|
$15,383.24
|
|
|
Service Code
|
HCPCS 49557
|
| Hospital Charge Code |
1600000709
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,307.49 |
| Max. Negotiated Rate |
$2,307.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,307.49
|
|
|
REP RECURR FEMORAL HERNIA; INC
|
Facility
|
OP
|
$15,383.24
|
|
|
Service Code
|
HCPCS 49557
|
| Hospital Charge Code |
1600000709
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$8,526.35 |
| Rate for Payer: Aetna Commercial |
$4,614.97
|
| Rate for Payer: Aetna Medicare Advantage |
$4,614.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,922.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,922.73
|
| 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 |
$3,922.73
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,999.82
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,307.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REPR ELBOW LAT LIGMNT W/TISS
|
Facility
|
OP
|
$30,663.00
|
|
|
Service Code
|
HCPCS 24343
|
| Hospital Charge Code |
16000548
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$9,198.90 |
| Rate for Payer: Aetna Commercial |
$9,198.90
|
| Rate for Payer: Aetna Medicare Advantage |
$9,198.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,819.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,819.06
|
| 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 |
$7,819.06
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,986.19
|
| Rate for Payer: Oxford Commercial |
$6,055.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,599.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$6,873.00
|
|
|
REPR ELBOW LAT LIGMNT W/TISS
|
Facility
|
IP
|
$30,663.00
|
|
|
Service Code
|
HCPCS 24343
|
| Hospital Charge Code |
16000548
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,599.45 |
| Max. Negotiated Rate |
$4,599.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,599.45
|
|
|
REPR FOOT EXTENSOR TENDON EA
|
Facility
|
OP
|
$19,998.60
|
|
|
Service Code
|
HCPCS 28208
|
| Hospital Charge Code |
16000451
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$7,791.93 |
| Rate for Payer: Aetna Commercial |
$5,999.58
|
| Rate for Payer: Aetna Medicare Advantage |
$5,999.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,099.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,099.64
|
| 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 |
$5,099.64
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,599.82
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,529.00
|
|
