|
TREAT FRACTURE OF RADIUS
|
Facility
|
IP
|
$9,423.70
|
|
|
Service Code
|
HCPCS 25520
|
| Hospital Charge Code |
1600000477
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,413.56 |
| Max. Negotiated Rate |
$1,413.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,413.56
|
|
|
TREAT FRACTURE OF RADIUS
|
Facility
|
OP
|
$9,423.70
|
|
|
Service Code
|
HCPCS 25520
|
| Hospital Charge Code |
1600000477
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,225.08 |
| Max. Negotiated Rate |
$3,829.26 |
| Rate for Payer: Aetna Commercial |
$2,827.11
|
| Rate for Payer: Aetna Medicare Advantage |
$2,827.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,403.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,403.04
|
| 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 |
$2,403.04
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,225.08
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,413.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,686.00
|
|
|
TREAT FRACTURE OF RADUIS
|
Facility
|
OP
|
$42,064.45
|
|
|
Service Code
|
HCPCS 25526
|
| Hospital Charge Code |
1600000359
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$17,279.91 |
| Rate for Payer: Aetna Commercial |
$12,619.33
|
| Rate for Payer: Aetna Medicare Advantage |
$12,619.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10,726.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10,726.43
|
| 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 |
$10,726.43
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,468.38
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,309.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$9,851.00
|
|
|
TREAT FRACTURE OF RADUIS
|
Facility
|
IP
|
$42,064.45
|
|
|
Service Code
|
HCPCS 25526
|
| Hospital Charge Code |
1600000359
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,309.67 |
| Max. Negotiated Rate |
$6,309.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,309.67
|
|
|
TREAT FX DISTAL RADIAL RT
|
Facility
|
OP
|
$23,899.60
|
|
|
Service Code
|
HCPCS 25606
|
| Hospital Charge Code |
16000311
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$7,791.93 |
| Rate for Payer: Aetna Commercial |
$7,169.88
|
| Rate for Payer: Aetna Medicare Advantage |
$7,169.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,094.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,094.40
|
| 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 |
$6,094.40
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,106.95
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,584.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,529.00
|
|
|
TREAT FX DISTAL RADIAL RT
|
Facility
|
IP
|
$23,899.60
|
|
|
Service Code
|
HCPCS 25606
|
| Hospital Charge Code |
16000311
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,584.94 |
| Max. Negotiated Rate |
$3,584.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,584.94
|
|
|
TREAT FX RAD EXTRA ARTICUL
|
Facility
|
OP
|
$63,943.60
|
|
|
Service Code
|
HCPCS 25607
|
| Hospital Charge Code |
16000329
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$19,183.08 |
| Rate for Payer: Aetna Commercial |
$19,183.08
|
| Rate for Payer: Aetna Medicare Advantage |
$19,183.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,305.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,305.62
|
| 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 |
$16,305.62
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,312.67
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,591.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$9,851.00
|
|
|
TREAT FX RAD EXTRA ARTICUL
|
Facility
|
IP
|
$63,943.60
|
|
|
Service Code
|
HCPCS 25607
|
| Hospital Charge Code |
16000329
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,591.54 |
| Max. Negotiated Rate |
$9,591.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,591.54
|
|
|
TREAT FX RADIAL 3+ FRAG
|
Facility
|
OP
|
$63,943.60
|
|
|
Service Code
|
HCPCS 25609
|
| Hospital Charge Code |
16000337
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$19,183.08 |
| Rate for Payer: Aetna Commercial |
$19,183.08
|
| Rate for Payer: Aetna Medicare Advantage |
$19,183.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,305.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,305.62
|
| 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 |
$16,305.62
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,312.67
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,591.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$9,851.00
|
|
|
TREAT FX RADIAL 3+ FRAG
|
Facility
|
IP
|
$63,943.60
|
|
|
Service Code
|
HCPCS 25609
|
| Hospital Charge Code |
16000337
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,591.54 |
| Max. Negotiated Rate |
$9,591.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,591.54
|
|
|
TREAT HEEL FRACTURE
|
Facility
|
OP
|
$63,943.60
|
|
|
Service Code
|
HCPCS 28415
|
| Hospital Charge Code |
16000453
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$19,183.08 |
| Rate for Payer: Aetna Commercial |
$19,183.08
|
| Rate for Payer: Aetna Medicare Advantage |
$19,183.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,305.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,305.62
|
| 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 |
$16,305.62
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,312.67
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,591.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$9,851.00
|
|
|
TREAT HEEL FRACTURE
|
Facility
|
IP
|
$63,943.60
|
|
|
Service Code
|
HCPCS 28415
|
| Hospital Charge Code |
16000453
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,591.54 |
| Max. Negotiated Rate |
$9,591.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,591.54
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
OP
|
$60,610.96
|
|
|
Service Code
|
HCPCS 24546
|
| Hospital Charge Code |
16000157
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$30,573.98 |
| Rate for Payer: Aetna Commercial |
$18,183.29
|
| Rate for Payer: Aetna Medicare Advantage |
$18,183.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,455.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,455.79
|
| 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 |
$15,455.79
|
| Rate for Payer: Cigna Commercial |
$30,573.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,879.42
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,091.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$9,851.00
|
|
|
TREAT HUMERUS FRACTURE
|
Facility
|
IP
|
$60,610.96
|
|
|
Service Code
|
HCPCS 24546
|
| Hospital Charge Code |
16000157
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,091.64 |
| Max. Negotiated Rate |
$9,091.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,091.64
|
|
|
TREAT KNEE DISLOCATION
|
Facility
|
IP
|
$9,423.70
|
|
|
Service Code
|
HCPCS 27552
|
| Hospital Charge Code |
1600000360
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,413.56 |
| Max. Negotiated Rate |
$1,413.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,413.56
|
|
|
TREAT KNEE DISLOCATION
|
Facility
|
OP
|
$9,423.70
|
|
|
Service Code
|
HCPCS 27552
|
| Hospital Charge Code |
1600000360
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,225.08 |
| Max. Negotiated Rate |
$3,829.26 |
| Rate for Payer: Aetna Commercial |
$2,827.11
|
| Rate for Payer: Aetna Medicare Advantage |
$2,827.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,403.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,403.04
|
| 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 |
$2,403.04
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,225.08
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,413.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,687.00
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
IP
|
$23,899.60
|
|
|
Service Code
|
HCPCS 26715
|
| Hospital Charge Code |
16000558
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,584.94 |
| Max. Negotiated Rate |
$3,584.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,584.94
|
|
|
TREAT KNUCKLE DISLOCATION
|
Facility
|
OP
|
$23,899.60
|
|
|
Service Code
|
HCPCS 26715
|
| Hospital Charge Code |
16000558
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$7,791.93 |
| Rate for Payer: Aetna Commercial |
$7,169.88
|
| Rate for Payer: Aetna Medicare Advantage |
$7,169.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,094.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,094.40
|
| 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 |
$6,094.40
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,106.95
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,584.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,529.00
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
OP
|
$8,575.05
|
|
|
Service Code
|
HCPCS 27825
|
| Hospital Charge Code |
5701006
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$249.86 |
| Max. Negotiated Rate |
$3,829.26 |
| Rate for Payer: Aetna Commercial |
$2,572.51
|
| Rate for Payer: Aetna Medicare Advantage |
$2,572.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,186.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,186.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$249.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,186.64
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,114.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,286.26
|
|
|
TREAT LOWER LEG FRACTURE
|
Facility
|
IP
|
$8,575.05
|
|
|
Service Code
|
HCPCS 27825
|
| Hospital Charge Code |
5701006
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,286.26 |
| Max. Negotiated Rate |
$1,286.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,286.26
|
|
|
TREAT LOWER LEG JOINT
|
Facility
|
IP
|
$63,197.33
|
|
|
Service Code
|
HCPCS 27829
|
| Hospital Charge Code |
16000234
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,479.60 |
| Max. Negotiated Rate |
$9,479.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,479.60
|
|
|
TREAT LOWER LEG JOINT
|
Facility
|
OP
|
$63,197.33
|
|
|
Service Code
|
HCPCS 27829
|
| Hospital Charge Code |
16000234
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,864.00 |
| Max. Negotiated Rate |
$18,959.20 |
| Rate for Payer: Aetna Commercial |
$18,959.20
|
| Rate for Payer: Aetna Medicare Advantage |
$18,959.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,115.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,115.32
|
| 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 |
$16,115.32
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,215.65
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,479.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$9,851.00
|
|
|
TREATMENT BONE CYST
|
Facility
|
IP
|
$3,358.50
|
|
|
Service Code
|
HCPCS 20615
|
| Hospital Charge Code |
412320615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$503.77 |
| Max. Negotiated Rate |
$503.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$503.77
|
|
|
TREATMENT BONE CYST
|
Facility
|
OP
|
$3,358.50
|
|
|
Service Code
|
HCPCS 20615
|
| Hospital Charge Code |
412320615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$436.61 |
| Max. Negotiated Rate |
$2,575.00 |
| Rate for Payer: Aetna Better Health Medicaid |
$1,912.33
|
| Rate for Payer: Aetna Commercial |
$1,007.55
|
| Rate for Payer: Aetna Medicare Advantage |
$1,007.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$856.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$856.42
|
| 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 |
$856.42
|
| Rate for Payer: Cigna Commercial |
$1,686.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$436.61
|
| Rate for Payer: Oxford Commercial |
$2,269.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$503.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,575.00
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$1,950.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,912.33
|
|
|
TREATMENT KNEE FRACTURE
|
Facility
|
OP
|
$1,412.50
|
|
|
Service Code
|
HCPCS 27538
|
| Hospital Charge Code |
1600000718
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$183.62 |
| Max. Negotiated Rate |
$1,864.00 |
| Rate for Payer: Aetna Better Health Medicaid |
$708.84
|
| Rate for Payer: Aetna Commercial |
$423.75
|
| Rate for Payer: Aetna Medicare Advantage |
$423.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$360.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$360.19
|
| 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 |
$360.19
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$183.62
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$211.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,686.00
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$723.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$708.84
|
|