|
STRAPPING CHEST-TORAX
|
Facility
|
OP
|
$458.00
|
|
|
Service Code
|
HCPCS 29200
|
| Hospital Charge Code |
9108001
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.54 |
| Max. Negotiated Rate |
$686.00 |
| Rate for Payer: Aetna Commercial |
$137.40
|
| Rate for Payer: Aetna Medicare Advantage |
$137.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$116.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$116.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$116.79
|
| Rate for Payer: Cigna Commercial |
$386.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.54
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$686.00
|
|
|
STRAPPING CHEST-TORAX
|
Facility
|
IP
|
$458.00
|
|
|
Service Code
|
HCPCS 29200
|
| Hospital Charge Code |
9108001
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.70 |
| Max. Negotiated Rate |
$68.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
|
|
STRAPPING HAND/FINGER
|
Facility
|
IP
|
$458.00
|
|
|
Service Code
|
HCPCS 29280
|
| Hospital Charge Code |
9108010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.70 |
| Max. Negotiated Rate |
$68.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
|
|
STRAPPING HAND/FINGER
|
Facility
|
OP
|
$458.00
|
|
|
Service Code
|
HCPCS 29280
|
| Hospital Charge Code |
9108010
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.54 |
| Max. Negotiated Rate |
$686.00 |
| Rate for Payer: Aetna Commercial |
$137.40
|
| Rate for Payer: Aetna Medicare Advantage |
$137.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$116.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$116.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$116.79
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.54
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$686.00
|
|
|
STRAPPING HIP
|
Facility
|
OP
|
$458.00
|
|
|
Service Code
|
HCPCS 29520
|
| Hospital Charge Code |
9108015
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.54 |
| Max. Negotiated Rate |
$686.00 |
| Rate for Payer: Aetna Commercial |
$137.40
|
| Rate for Payer: Aetna Medicare Advantage |
$137.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$116.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$116.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$116.79
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.54
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$686.00
|
|
|
STRAPPING HIP
|
Facility
|
IP
|
$458.00
|
|
|
Service Code
|
HCPCS 29520
|
| Hospital Charge Code |
9108015
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.70 |
| Max. Negotiated Rate |
$68.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
|
|
STRAPPING HIP
|
Facility
|
IP
|
$458.00
|
|
|
Service Code
|
HCPCS 29520
|
| Hospital Charge Code |
412329520
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.70 |
| Max. Negotiated Rate |
$68.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
|
|
STRAPPING HIP
|
Facility
|
OP
|
$458.00
|
|
|
Service Code
|
HCPCS 29520
|
| Hospital Charge Code |
412329520
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$59.54 |
| Max. Negotiated Rate |
$1,864.00 |
| Rate for Payer: Aetna Commercial |
$137.40
|
| Rate for Payer: Aetna Medicare Advantage |
$137.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$116.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$116.79
|
| 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 |
$116.79
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.54
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,686.00
|
|
|
STRAPPING KNEE
|
Facility
|
IP
|
$614.91
|
|
|
Service Code
|
HCPCS 29530
|
| Hospital Charge Code |
9108020
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$92.24 |
| Max. Negotiated Rate |
$92.24 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.24
|
|
|
STRAPPING KNEE
|
Facility
|
IP
|
$614.91
|
|
|
Service Code
|
HCPCS 29530
|
| Hospital Charge Code |
412329530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$92.24 |
| Max. Negotiated Rate |
$92.24 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.24
|
|
|
STRAPPING KNEE
|
Facility
|
OP
|
$614.91
|
|
|
Service Code
|
HCPCS 29530
|
| Hospital Charge Code |
9108020
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$79.94 |
| Max. Negotiated Rate |
$686.00 |
| Rate for Payer: Aetna Commercial |
$184.47
|
| Rate for Payer: Aetna Medicare Advantage |
$184.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$156.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$156.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$156.80
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.94
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$686.00
|
|
|
STRAPPING KNEE
|
Facility
|
OP
|
$614.91
|
|
|
Service Code
|
HCPCS 29530
|
| Hospital Charge Code |
412329530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$79.94 |
| Max. Negotiated Rate |
$1,864.00 |
| Rate for Payer: Aetna Commercial |
$184.47
|
| Rate for Payer: Aetna Medicare Advantage |
$184.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$156.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$156.80
|
| 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 |
$156.80
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.94
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,686.00
|
|
|
STRAPPING LOW BACK
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
HCPCS 29799
|
| Hospital Charge Code |
9108035
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$52.50 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.50
|
|
|
STRAPPING LOW BACK
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
HCPCS 29799
|
| Hospital Charge Code |
9108035
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$45.50 |
| Max. Negotiated Rate |
$686.00 |
| Rate for Payer: Aetna Commercial |
$105.00
|
| Rate for Payer: Aetna Medicare Advantage |
$105.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$89.25
|
| Rate for Payer: Cigna Commercial |
$386.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.50
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$686.00
|
|
|
STRAPPING SHOULDER
|
Facility
|
OP
|
$458.00
|
|
|
Service Code
|
HCPCS 29240
|
| Hospital Charge Code |
9108005
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.54 |
| Max. Negotiated Rate |
$686.00 |
| Rate for Payer: Aetna Commercial |
$137.40
|
| Rate for Payer: Aetna Medicare Advantage |
$137.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$116.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$116.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$116.79
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.54
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$686.00
|
|
|
STRAPPING SHOULDER
|
Facility
|
IP
|
$458.00
|
|
|
Service Code
|
HCPCS 29240
|
| Hospital Charge Code |
9108005
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.70 |
| Max. Negotiated Rate |
$68.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
|
|
STRAPPING, THORAX
|
Facility
|
OP
|
$468.75
|
|
|
Service Code
|
HCPCS 29200
|
| Hospital Charge Code |
5780135
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$27.25 |
| Max. Negotiated Rate |
$386.97 |
| Rate for Payer: Aetna Commercial |
$140.62
|
| Rate for Payer: Aetna Medicare Advantage |
$140.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.53
|
| Rate for Payer: Cigna Commercial |
$386.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.31
|
|
|
STRAPPING, THORAX
|
Facility
|
IP
|
$468.75
|
|
|
Service Code
|
HCPCS 29200
|
| Hospital Charge Code |
5780135
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$70.31 |
| Max. Negotiated Rate |
$70.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.31
|
|
|
STRAPPING WRIST
|
Facility
|
OP
|
$458.00
|
|
|
Service Code
|
HCPCS 29260GP
|
| Hospital Charge Code |
9108050
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.54 |
| Max. Negotiated Rate |
$686.00 |
| Rate for Payer: Aetna Commercial |
$137.40
|
| Rate for Payer: Aetna Medicare Advantage |
$137.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$116.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$116.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$116.79
|
| Rate for Payer: Cigna Commercial |
$229.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.54
|
| Rate for Payer: Oxford Commercial |
$604.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$686.00
|
|
|
STRAPPING WRIST
|
Facility
|
IP
|
$458.00
|
|
|
Service Code
|
HCPCS 29260GP
|
| Hospital Charge Code |
9108050
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.70 |
| Max. Negotiated Rate |
$68.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
|
|
STRAP SECURE OPEN
|
Facility
|
OP
|
$2,731.37
|
|
| Hospital Charge Code |
270676653
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$355.08 |
| Max. Negotiated Rate |
$1,365.68 |
| Rate for Payer: Aetna Commercial |
$819.41
|
| Rate for Payer: Aetna Medicare Advantage |
$819.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$696.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$696.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$696.50
|
| Rate for Payer: Cigna Commercial |
$1,365.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$355.08
|
| Rate for Payer: Oxford Commercial |
$1,365.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$409.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,365.68
|
|
|
STRAP SECURE OPEN
|
Facility
|
IP
|
$2,731.37
|
|
| Hospital Charge Code |
270676653
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$409.71 |
| Max. Negotiated Rate |
$409.71 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$409.71
|
|
|
STRAP TOE 2ND LT
|
Facility
|
OP
|
$468.75
|
|
|
Service Code
|
HCPCS 29550T1
|
| Hospital Charge Code |
5792195
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$60.94 |
| Max. Negotiated Rate |
$234.38 |
| Rate for Payer: Aetna Commercial |
$140.62
|
| Rate for Payer: Aetna Medicare Advantage |
$140.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.53
|
| Rate for Payer: Cigna Commercial |
$234.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.31
|
|
|
STRAP TOE 2ND LT
|
Facility
|
IP
|
$468.75
|
|
|
Service Code
|
HCPCS 29550T1
|
| Hospital Charge Code |
5792195
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$70.31 |
| Max. Negotiated Rate |
$70.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.31
|
|
|
STRAP TOE 2ND RT
|
Facility
|
OP
|
$468.75
|
|
|
Service Code
|
HCPCS 29550T6
|
| Hospital Charge Code |
5792220
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$60.94 |
| Max. Negotiated Rate |
$234.38 |
| Rate for Payer: Aetna Commercial |
$140.62
|
| Rate for Payer: Aetna Medicare Advantage |
$140.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$119.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$119.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$119.53
|
| Rate for Payer: Cigna Commercial |
$234.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.31
|
|