|
ER STRAPPING UNNA BOOT
|
Facility
|
OP
|
$458.00
|
|
|
Service Code
|
HCPCS 29580
|
| Hospital Charge Code |
5700617
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$700.29 |
| Rate for Payer: Aetna Commercial |
$525.10
|
| Rate for Payer: Aetna Medicare Advantage |
$625.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$700.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$700.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$193.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$700.29
|
| Rate for Payer: Cigna Commercial |
$386.97
|
| Rate for Payer: Cigna Medicare Advantage |
$193.05
|
| Rate for Payer: Clover Medicare Advantage |
$183.40
|
| Rate for Payer: EmblemHealth Commercial |
$579.15
|
| Rate for Payer: Humana Medicare Advantage |
$198.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$193.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$119.08
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$193.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$193.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.01
|
|
|
ER STRAPPING UNNA BOOT
|
Facility
|
IP
|
$458.00
|
|
|
Service Code
|
HCPCS 29580
|
| Hospital Charge Code |
5700617
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$68.70 |
| Max. Negotiated Rate |
$68.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.70
|
|
|
ER TEMP TRANSCUTANEOUS PACING
|
Facility
|
OP
|
$968.00
|
|
|
Service Code
|
HCPCS 92953
|
| Hospital Charge Code |
5700812
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$20.90 |
| Max. Negotiated Rate |
$2,848.39 |
| Rate for Payer: Aetna Commercial |
$2,135.80
|
| Rate for Payer: Aetna Medicare Advantage |
$2,544.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,848.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,848.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$785.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,848.39
|
| Rate for Payer: Cigna Commercial |
$1,573.96
|
| Rate for Payer: Cigna Medicare Advantage |
$785.22
|
| Rate for Payer: Clover Medicare Advantage |
$745.96
|
| Rate for Payer: EmblemHealth Commercial |
$2,355.66
|
| Rate for Payer: Humana Medicare Advantage |
$808.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$785.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$251.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$785.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$785.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.49
|
|
|
ER TEMP TRANSCUTANEOUS PACING
|
Facility
|
IP
|
$968.00
|
|
|
Service Code
|
HCPCS 92953
|
| Hospital Charge Code |
5700812
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$145.20 |
| Max. Negotiated Rate |
$145.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.20
|
|
|
ER THROMBO CRBRAL BY IV INFN
|
Facility
|
OP
|
$1,643.40
|
|
|
Service Code
|
HCPCS 37195
|
| Hospital Charge Code |
5700785
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$46.67 |
| Max. Negotiated Rate |
$1,423.47 |
| Rate for Payer: Aetna Commercial |
$1,067.36
|
| Rate for Payer: Aetna Medicare Advantage |
$1,271.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,423.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,423.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$392.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,423.47
|
| Rate for Payer: Cigna Commercial |
$786.58
|
| Rate for Payer: Cigna Medicare Advantage |
$392.41
|
| Rate for Payer: Clover Medicare Advantage |
$372.79
|
| Rate for Payer: EmblemHealth Commercial |
$1,177.23
|
| Rate for Payer: Humana Medicare Advantage |
$404.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$392.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$427.28
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$246.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$392.41
|
| Rate for Payer: Wellcare Medicare Advantage |
$392.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$46.67
|
|
|
ER THROMBO CRBRAL BY IV INFN
|
Facility
|
IP
|
$1,643.40
|
|
|
Service Code
|
HCPCS 37195
|
| Hospital Charge Code |
5700785
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$246.51 |
| Max. Negotiated Rate |
$246.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$246.51
|
|
|
ER-THROMBOLYTIC THERAPY
|
Facility
|
OP
|
$960.00
|
|
|
Service Code
|
HCPCS 92977
|
| Hospital Charge Code |
5780285
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$27.26 |
| Max. Negotiated Rate |
$2,770.00 |
| Rate for Payer: Aetna Commercial |
$364.80
|
| Rate for Payer: Aetna Medicare Advantage |
$288.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$244.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$244.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$244.80
|
| Rate for Payer: Cigna Commercial |
$480.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$249.60
|
| Rate for Payer: Oxford Commercial |
$2,441.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$144.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,770.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$30.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27.26
|
|
|
ER-THROMBOLYTIC THERAPY
|
Facility
|
IP
|
$960.00
|
|
|
Service Code
|
HCPCS 92977
|
| Hospital Charge Code |
5780285
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$144.00 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$144.00
|
|
|
ER TOOTH EXTRACTION/ANESTHESIA
|
Facility
|
IP
|
$463.00
|
|
|
Service Code
|
HCPCS 41899
|
| Hospital Charge Code |
5770055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$69.45 |
| Max. Negotiated Rate |
$69.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.45
|
|
|
ER TOOTH EXTRACTION/ANESTHESIA
|
Facility
|
OP
|
$463.00
|
|
|
Service Code
|
HCPCS 41899
|
| Hospital Charge Code |
5770055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$13.15 |
| Max. Negotiated Rate |
$1,020.71 |
| Rate for Payer: Aetna Commercial |
$765.35
|
| Rate for Payer: Aetna Medicare Advantage |
$911.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,020.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,020.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$281.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,020.71
|
| Rate for Payer: Cigna Commercial |
$564.04
|
| Rate for Payer: Cigna Medicare Advantage |
$281.38
|
| Rate for Payer: Clover Medicare Advantage |
$267.31
|
| Rate for Payer: EmblemHealth Commercial |
$844.14
|
| Rate for Payer: Humana Medicare Advantage |
$289.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$281.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$120.38
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.45
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$281.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$281.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.15
|
|
|
ER TREAT ANKLE DISLOCATION
|
Facility
|
OP
|
$717.00
|
|
|
Service Code
|
HCPCS 27840
|
| Hospital Charge Code |
5700325
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$1,063.04 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| 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 |
$1,063.04
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$186.42
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.36
|
|
|
ER TREAT ANKLE DISLOCATION
|
Facility
|
IP
|
$717.00
|
|
|
Service Code
|
HCPCS 27840
|
| Hospital Charge Code |
5700325
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$107.55 |
| Max. Negotiated Rate |
$107.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.55
|
|
|
ER TREAT ELBOW DISLOCATION
|
Facility
|
IP
|
$645.00
|
|
|
Service Code
|
HCPCS 24600
|
| Hospital Charge Code |
5700313
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$96.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.75
|
|
|
ER TREAT ELBOW DISLOCATION
|
Facility
|
OP
|
$645.00
|
|
|
Service Code
|
HCPCS 24600
|
| Hospital Charge Code |
5700313
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$1,063.04 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| 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 |
$1,063.04
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$167.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.32
|
|
|
ER TREAT FINGER DISLOCATION
|
Facility
|
IP
|
$645.00
|
|
|
Service Code
|
HCPCS 26700
|
| Hospital Charge Code |
5700323
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$96.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.75
|
|
|
ER TREAT FINGER DISLOCATION
|
Facility
|
IP
|
$11,949.75
|
|
|
Service Code
|
HCPCS 26785
|
| Hospital Charge Code |
5790900
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,792.46 |
| Max. Negotiated Rate |
$1,792.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,792.46
|
|
|
ER TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$11,949.75
|
|
|
Service Code
|
HCPCS 26785
|
| Hospital Charge Code |
5790900
|
|
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 |
$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 |
$3,106.93
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,792.46
|
| 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 |
$339.37
|
|
|
ER TREAT FINGER DISLOCATION
|
Facility
|
OP
|
$645.00
|
|
|
Service Code
|
HCPCS 26700
|
| Hospital Charge Code |
5700323
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$18.32 |
| Max. Negotiated Rate |
$1,063.04 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,063.04
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$167.70
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.32
|
|
|
ER TREAT HAND DISLOCATION
|
Facility
|
OP
|
$1,175.15
|
|
|
Service Code
|
HCPCS 26670
|
| Hospital Charge Code |
5700580
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$33.37 |
| Max. Negotiated Rate |
$1,063.04 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$59.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,063.04
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$305.54
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$176.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.37
|
|
|
ER TREAT HAND DISLOCATION
|
Facility
|
IP
|
$1,175.15
|
|
|
Service Code
|
HCPCS 26670
|
| Hospital Charge Code |
5700580
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.27 |
| Max. Negotiated Rate |
$176.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$176.27
|
|
|
ER TREAT HIP DISLOATION W ANES
|
Facility
|
IP
|
$6,125.00
|
|
|
Service Code
|
HCPCS 27252
|
| Hospital Charge Code |
5700688
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$918.75 |
| Max. Negotiated Rate |
$918.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$918.75
|
|
|
ER TREAT HIP DISLOATION W ANES
|
Facility
|
OP
|
$6,125.00
|
|
|
Service Code
|
HCPCS 27252
|
| Hospital Charge Code |
5700688
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$6,929.76 |
| Rate for Payer: Aetna Commercial |
$5,196.12
|
| Rate for Payer: Aetna Medicare Advantage |
$6,189.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,910.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$346.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,929.76
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: Cigna Medicare Advantage |
$1,910.34
|
| Rate for Payer: Clover Medicare Advantage |
$1,814.82
|
| Rate for Payer: EmblemHealth Commercial |
$5,731.02
|
| Rate for Payer: Humana Medicare Advantage |
$1,967.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,910.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,592.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$918.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$173.95
|
|
|
ER TREAT KNUCKLE DISLOCATION
|
Facility
|
IP
|
$7,690.80
|
|
|
Service Code
|
HCPCS 26705
|
| Hospital Charge Code |
5792265
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,153.62 |
| Max. Negotiated Rate |
$1,153.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,153.62
|
|
|
ER TREAT KNUCKLE DISLOCATION
|
Facility
|
OP
|
$7,690.80
|
|
|
Service Code
|
HCPCS 26705
|
| Hospital Charge Code |
5792265
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$6,929.76 |
| Rate for Payer: Aetna Commercial |
$5,196.12
|
| Rate for Payer: Aetna Medicare Advantage |
$6,189.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,910.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$147.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,929.76
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: Cigna Medicare Advantage |
$1,910.34
|
| Rate for Payer: Clover Medicare Advantage |
$1,814.82
|
| Rate for Payer: EmblemHealth Commercial |
$5,731.02
|
| Rate for Payer: Humana Medicare Advantage |
$1,967.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,910.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,999.61
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,153.62
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$218.42
|
|
|
ER TREAT SHOULDER DISLOCATION
|
Facility
|
OP
|
$5,408.58
|
|
|
Service Code
|
HCPCS 23655
|
| Hospital Charge Code |
5700315
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$6,929.76 |
| Rate for Payer: Aetna Commercial |
$5,196.12
|
| Rate for Payer: Aetna Medicare Advantage |
$6,189.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,910.34
|
| 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 |
$6,929.76
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: Cigna Medicare Advantage |
$1,910.34
|
| Rate for Payer: Clover Medicare Advantage |
$1,814.82
|
| Rate for Payer: EmblemHealth Commercial |
$5,731.02
|
| Rate for Payer: Humana Medicare Advantage |
$1,967.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,910.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,406.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$811.29
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$153.60
|
|