|
ER OPEN DIS PHAL FINGER EACH
|
Facility
|
OP
|
$15,508.45
|
|
|
Service Code
|
HCPCS 26765
|
| Hospital Charge Code |
5700672
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$166.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,032.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,326.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$440.44
|
|
|
ER OPEN RED OF THUMB IP SUBLX
|
Facility
|
IP
|
$3,127.15
|
|
|
Service Code
|
HCPCS 26785
|
| Hospital Charge Code |
5700322
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$469.07 |
| Max. Negotiated Rate |
$469.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$469.07
|
|
|
ER OPEN RED OF THUMB IP SUBLX
|
Facility
|
OP
|
$3,127.15
|
|
|
Service Code
|
HCPCS 26785
|
| Hospital Charge Code |
5700322
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$88.81 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$140.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$813.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$469.07
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$88.81
|
|
|
ER ORBIT FX(NON-BLOWOUT)W/O MA
|
Facility
|
IP
|
$3,238.00
|
|
|
Service Code
|
HCPCS 21400
|
| Hospital Charge Code |
5700726
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$485.70 |
| Max. Negotiated Rate |
$485.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$485.70
|
|
|
ER ORBIT FX(NON-BLOWOUT)W/O MA
|
Facility
|
OP
|
$3,238.00
|
|
|
Service Code
|
HCPCS 21400
|
| Hospital Charge Code |
5700726
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$78.06 |
| Max. Negotiated Rate |
$2,324.28 |
| Rate for Payer: Aetna Commercial |
$1,742.81
|
| Rate for Payer: Aetna Medicare Advantage |
$2,076.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,324.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,324.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$640.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$78.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,324.28
|
| Rate for Payer: Cigna Commercial |
$1,284.36
|
| Rate for Payer: Cigna Medicare Advantage |
$640.74
|
| Rate for Payer: Clover Medicare Advantage |
$608.70
|
| Rate for Payer: EmblemHealth Commercial |
$1,922.22
|
| Rate for Payer: Humana Medicare Advantage |
$659.96
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$640.74
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$841.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$485.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$640.74
|
| Rate for Payer: Wellcare Medicare Advantage |
$640.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$91.96
|
|
|
ER PACER TEMP INSERTION SINGLE
|
Facility
|
IP
|
$21,350.00
|
|
|
Service Code
|
HCPCS 33210
|
| Hospital Charge Code |
5700414
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,202.50 |
| Max. Negotiated Rate |
$3,202.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,202.50
|
|
|
ER PACER TEMP INSERTION SINGLE
|
Facility
|
OP
|
$21,350.00
|
|
|
Service Code
|
HCPCS 33210
|
| Hospital Charge Code |
5700414
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$35,663.33 |
| Rate for Payer: Aetna Commercial |
$26,741.35
|
| Rate for Payer: Aetna Medicare Advantage |
$31,853.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35,663.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35,663.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9,831.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$188.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35,663.33
|
| Rate for Payer: Cigna Commercial |
$19,706.96
|
| Rate for Payer: Cigna Medicare Advantage |
$9,831.38
|
| Rate for Payer: Clover Medicare Advantage |
$9,339.81
|
| Rate for Payer: EmblemHealth Commercial |
$29,494.14
|
| Rate for Payer: Humana Medicare Advantage |
$10,126.32
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9,831.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,551.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,202.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9,831.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$9,831.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$606.34
|
|
|
ER PARACENTESIS W/O IMAGING
|
Facility
|
OP
|
$2,422.65
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
5700652
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$3,908.70 |
| Rate for Payer: Aetna Commercial |
$2,930.85
|
| Rate for Payer: Aetna Medicare Advantage |
$3,491.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,908.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,908.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,077.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$79.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,908.70
|
| Rate for Payer: Cigna Commercial |
$2,159.89
|
| Rate for Payer: Cigna Medicare Advantage |
$1,077.52
|
| Rate for Payer: Clover Medicare Advantage |
$1,023.64
|
| Rate for Payer: EmblemHealth Commercial |
$3,232.56
|
| Rate for Payer: Humana Medicare Advantage |
$1,109.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,077.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$629.89
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,077.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$68.80
|
|
|
ER PARACENTESIS W/O IMAGING
|
Facility
|
IP
|
$2,422.65
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
5700652
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$363.40 |
| Max. Negotiated Rate |
$363.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$363.40
|
|
|
ER PARING SKIN LESION
|
Facility
|
OP
|
$1,170.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
5700475
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$864.65 |
| Rate for Payer: Aetna Commercial |
$648.34
|
| Rate for Payer: Aetna Medicare Advantage |
$772.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$864.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$864.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$238.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$864.65
|
| Rate for Payer: Cigna Commercial |
$477.79
|
| Rate for Payer: Cigna Medicare Advantage |
$238.36
|
| Rate for Payer: Clover Medicare Advantage |
$226.44
|
| Rate for Payer: EmblemHealth Commercial |
$715.08
|
| Rate for Payer: Humana Medicare Advantage |
$245.51
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$238.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$304.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$238.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.23
|
|
|
ER PARING SKIN LESION
|
Facility
|
IP
|
$1,170.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
5700475
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$175.50 |
| Max. Negotiated Rate |
$175.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$175.50
|
|
|
ER PRIMARY TENDON REPAIR
|
Facility
|
OP
|
$3,290.85
|
|
|
Service Code
|
HCPCS 26433
|
| Hospital Charge Code |
5700234
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$93.46 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$137.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$855.62
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$493.63
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$93.46
|
|
|
ER PRIMARY TENDON REPAIR
|
Facility
|
IP
|
$3,290.85
|
|
|
Service Code
|
HCPCS 26433
|
| Hospital Charge Code |
5700234
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$493.63 |
| Max. Negotiated Rate |
$493.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$493.63
|
|
|
ER PSYC DX EVAL W/MED SERVICES
|
Facility
|
IP
|
$642.10
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
5792255
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$96.31 |
| Max. Negotiated Rate |
$96.31 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.31
|
|
|
ER PSYC DX EVAL W/MED SERVICES
|
Facility
|
OP
|
$642.10
|
|
|
Service Code
|
HCPCS 90792
|
| Hospital Charge Code |
5792255
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$18.24 |
| Max. Negotiated Rate |
$3,080.00 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$612.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$166.95
|
| Rate for Payer: Oxford Commercial |
$2,715.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.31
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,080.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$437.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.24
|
|
|
ER PSYCHIATRIC DIAGNOSTIC EVAL
|
Facility
|
IP
|
$623.75
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
5792250
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$93.56 |
| Max. Negotiated Rate |
$93.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.56
|
|
|
ER PSYCHIATRIC DIAGNOSTIC EVAL
|
Facility
|
OP
|
$623.75
|
|
|
Service Code
|
HCPCS 90791
|
| Hospital Charge Code |
5792250
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$17.71 |
| Max. Negotiated Rate |
$764.93 |
| Rate for Payer: Aetna Commercial |
$573.57
|
| Rate for Payer: Aetna Medicare Advantage |
$683.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$764.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$210.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$764.93
|
| Rate for Payer: Cigna Commercial |
$422.69
|
| Rate for Payer: Cigna Medicare Advantage |
$210.87
|
| Rate for Payer: Clover Medicare Advantage |
$200.33
|
| Rate for Payer: EmblemHealth Commercial |
$632.61
|
| Rate for Payer: Humana Medicare Advantage |
$217.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$210.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$162.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.56
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$210.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.71
|
|
|
ER PULSE OXIMETRY-CONTINOUS
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
HCPCS 94761
|
| Hospital Charge Code |
5780305
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$118.94
|
| Rate for Payer: Aetna Medicare Advantage |
$93.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.81
|
| Rate for Payer: Cigna Commercial |
$156.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$81.38
|
| Rate for Payer: Oxford Commercial |
$2,184.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.89
|
|
|
ER PULSE OXIMETRY-CONTINOUS
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
HCPCS 94761
|
| Hospital Charge Code |
5780305
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$46.95 |
| Max. Negotiated Rate |
$46.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.95
|
|
|
ER PULSE OXIMETRY CONT OVERNIG
|
Facility
|
OP
|
$393.00
|
|
|
Service Code
|
HCPCS 94762
|
| Hospital Charge Code |
5780310
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$11.16 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$415.81
|
| Rate for Payer: Aetna Medicare Advantage |
$495.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$554.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$554.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$152.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$60.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$554.54
|
| Rate for Payer: Cigna Commercial |
$306.43
|
| Rate for Payer: Cigna Medicare Advantage |
$152.87
|
| Rate for Payer: Clover Medicare Advantage |
$145.23
|
| Rate for Payer: EmblemHealth Commercial |
$458.61
|
| Rate for Payer: Humana Medicare Advantage |
$157.46
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$152.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.18
|
| Rate for Payer: Oxford Commercial |
$2,184.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$152.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$152.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.16
|
|
|
ER PULSE OXIMETRY CONT OVERNIG
|
Facility
|
IP
|
$393.00
|
|
|
Service Code
|
HCPCS 94762
|
| Hospital Charge Code |
5780310
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$58.95 |
| Max. Negotiated Rate |
$58.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.95
|
|
|
ER RABIES VACCINE, IM
|
Facility
|
IP
|
$1,010.10
|
|
|
Service Code
|
HCPCS 90675
|
| Hospital Charge Code |
5700448
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$151.51 |
| Max. Negotiated Rate |
$244.44 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$244.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.51
|
|
|
ER RABIES VACCINE, IM
|
Facility
|
OP
|
$1,010.10
|
|
|
Service Code
|
HCPCS 90675
|
| Hospital Charge Code |
5700448
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.69 |
| Max. Negotiated Rate |
$1,143.46 |
| Rate for Payer: Aetna Commercial |
$857.40
|
| Rate for Payer: Aetna Medicare Advantage |
$1,021.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,143.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,143.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$315.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$334.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,143.46
|
| Rate for Payer: Cigna Medicare Advantage |
$315.22
|
| Rate for Payer: Clover Medicare Advantage |
$299.46
|
| Rate for Payer: EmblemHealth Commercial |
$945.66
|
| Rate for Payer: Humana Medicare Advantage |
$324.68
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$315.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$244.44
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$31.92
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$315.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$315.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.69
|
|
|
ER-RECTUM PROCED OTHER
|
Facility
|
IP
|
$2,462.25
|
|
|
Service Code
|
HCPCS 45999
|
| Hospital Charge Code |
5790150
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$369.34 |
| Max. Negotiated Rate |
$369.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$369.34
|
|
|
ER-RECTUM PROCED OTHER
|
Facility
|
OP
|
$2,462.25
|
|
|
Service Code
|
HCPCS 45999
|
| Hospital Charge Code |
5790150
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$69.93 |
| Max. Negotiated Rate |
$4,007.70 |
| Rate for Payer: Aetna Commercial |
$3,005.08
|
| Rate for Payer: Aetna Medicare Advantage |
$3,579.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,007.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,007.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,104.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,007.70
|
| Rate for Payer: Cigna Commercial |
$2,214.60
|
| Rate for Payer: Cigna Medicare Advantage |
$1,104.81
|
| Rate for Payer: Clover Medicare Advantage |
$1,049.57
|
| Rate for Payer: EmblemHealth Commercial |
$3,314.43
|
| Rate for Payer: Humana Medicare Advantage |
$1,137.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,104.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$640.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$369.34
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,104.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,104.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$69.93
|
|
