|
EXC HIP/PELV TUM DEEP < 5 CM
|
Facility
|
OP
|
$16,680.90
|
|
|
Service Code
|
HCPCS 27048
|
| Hospital Charge Code |
16000862
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$473.74 |
| Max. Negotiated Rate |
$12,518.07 |
| Rate for Payer: Aetna Commercial |
$9,386.39
|
| Rate for Payer: Aetna Medicare Advantage |
$11,180.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,450.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12,518.07
|
| Rate for Payer: Cigna Commercial |
$6,917.28
|
| Rate for Payer: Cigna Medicare Advantage |
$3,450.88
|
| Rate for Payer: Clover Medicare Advantage |
$3,278.34
|
| Rate for Payer: EmblemHealth Commercial |
$10,352.64
|
| Rate for Payer: Humana Medicare Advantage |
$3,554.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,450.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,337.03
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,502.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$527.12
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$473.74
|
|
|
EXC INTRASP LESION SGL SEGM;
|
Facility
|
OP
|
$4,130.44
|
|
|
Service Code
|
HCPCS 63300
|
| Hospital Charge Code |
1600000723
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$117.30 |
| Max. Negotiated Rate |
$10,269.00 |
| Rate for Payer: Aetna Commercial |
$1,569.57
|
| Rate for Payer: Aetna Medicare Advantage |
$1,239.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,053.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,053.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,053.26
|
| Rate for Payer: Cigna Commercial |
$2,065.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,073.91
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$619.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$130.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$117.30
|
|
|
EXC INTRASP LESION SGL SEGM;
|
Facility
|
IP
|
$4,130.44
|
|
|
Service Code
|
HCPCS 63300
|
| Hospital Charge Code |
1600000723
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$619.57 |
| Max. Negotiated Rate |
$619.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$619.57
|
|
|
EXC INTRDIG MRTN NEUROM EA SGL
|
Facility
|
IP
|
$19,998.60
|
|
|
Service Code
|
HCPCS 28080
|
| Hospital Charge Code |
16000294
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,999.79 |
| Max. Negotiated Rate |
$2,999.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.79
|
|
|
EXC INTRDIG MRTN NEUROM EA SGL
|
Facility
|
OP
|
$19,998.60
|
|
|
Service Code
|
HCPCS 28080
|
| Hospital Charge Code |
16000294
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$567.96 |
| Max. Negotiated Rate |
$8,192.00 |
| 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 |
$3,536.00
|
| 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 |
$5,199.64
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$631.96
|
| 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 |
$567.96
|
|
|
EXCISE ANAL EXT TAG/PAPILLA
|
Facility
|
OP
|
$19,596.70
|
|
|
Service Code
|
HCPCS 46220
|
| Hospital Charge Code |
16000749
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$556.55 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5,157.00
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,095.14
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,939.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$619.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$556.55
|
|
|
EXCISE ANAL EXT TAG/PAPILLA
|
Facility
|
IP
|
$19,596.70
|
|
|
Service Code
|
HCPCS 46220
|
| Hospital Charge Code |
16000749
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,939.51 |
| Max. Negotiated Rate |
$2,939.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,939.51
|
|
|
EXCISE EXCESS SKIN TISSUE,ARM
|
Facility
|
OP
|
$13,615.50
|
|
|
Service Code
|
HCPCS 15836
|
| Hospital Charge Code |
16000600
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$386.68 |
| Max. Negotiated Rate |
$12,518.07 |
| Rate for Payer: Aetna Commercial |
$9,386.39
|
| Rate for Payer: Aetna Medicare Advantage |
$11,180.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,450.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12,518.07
|
| Rate for Payer: Cigna Commercial |
$6,917.28
|
| Rate for Payer: Cigna Medicare Advantage |
$3,450.88
|
| Rate for Payer: Clover Medicare Advantage |
$3,278.34
|
| Rate for Payer: EmblemHealth Commercial |
$10,352.64
|
| Rate for Payer: Humana Medicare Advantage |
$3,554.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,450.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,540.03
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,042.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$430.25
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$386.68
|
|
|
EXCISE EXCESS SKIN TISSUE,ARM
|
Facility
|
IP
|
$13,615.50
|
|
|
Service Code
|
HCPCS 15836
|
| Hospital Charge Code |
16000600
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,042.33 |
| Max. Negotiated Rate |
$2,042.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,042.33
|
|
|
EXCISE EXCESS SKIN TISSUE,OTH
|
Facility
|
OP
|
$16,853.95
|
|
|
Service Code
|
HCPCS 15839
|
| Hospital Charge Code |
16000250
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$478.65 |
| Max. Negotiated Rate |
$12,518.07 |
| Rate for Payer: Aetna Commercial |
$9,386.39
|
| Rate for Payer: Aetna Medicare Advantage |
$11,180.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,450.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12,518.07
|
| Rate for Payer: Cigna Commercial |
$6,917.28
|
| Rate for Payer: Cigna Medicare Advantage |
$3,450.88
|
| Rate for Payer: Clover Medicare Advantage |
$3,278.34
|
| Rate for Payer: EmblemHealth Commercial |
$10,352.64
|
| Rate for Payer: Humana Medicare Advantage |
$3,554.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,450.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,382.03
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,528.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$532.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$478.65
|
|
|
EXCISE EXCESS SKIN TISSUE,OTH
|
Facility
|
IP
|
$16,853.95
|
|
|
Service Code
|
HCPCS 15839
|
| Hospital Charge Code |
16000250
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,528.09 |
| Max. Negotiated Rate |
$2,528.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,528.09
|
|
|
EXCISE EXCESS SKIN TISSUE,THI
|
Facility
|
IP
|
$22,280.35
|
|
|
Service Code
|
HCPCS 15832
|
| Hospital Charge Code |
16000495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,342.05 |
| Max. Negotiated Rate |
$3,342.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,342.05
|
|
|
EXCISE EXCESS SKIN TISSUE,THI
|
Facility
|
OP
|
$22,280.35
|
|
|
Service Code
|
HCPCS 15832
|
| Hospital Charge Code |
16000495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$632.76 |
| Max. Negotiated Rate |
$12,518.07 |
| Rate for Payer: Aetna Commercial |
$9,386.39
|
| Rate for Payer: Aetna Medicare Advantage |
$11,180.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,450.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$12,518.07
|
| Rate for Payer: Cigna Commercial |
$6,917.28
|
| Rate for Payer: Cigna Medicare Advantage |
$3,450.88
|
| Rate for Payer: Clover Medicare Advantage |
$3,278.34
|
| Rate for Payer: EmblemHealth Commercial |
$10,352.64
|
| Rate for Payer: Humana Medicare Advantage |
$3,554.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,450.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,792.89
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,342.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$704.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$632.76
|
|
|
EXCISE HYDROCELE; UNILATERAL
|
Facility
|
OP
|
$30,814.20
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
160000207
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$875.12 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,011.69
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,622.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$973.73
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$875.12
|
|
|
EXCISE HYDROCELE; UNILATERAL
|
Facility
|
IP
|
$30,814.20
|
|
|
Service Code
|
HCPCS 55040
|
| Hospital Charge Code |
160000207
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,622.13 |
| Max. Negotiated Rate |
$4,622.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,622.13
|
|
|
EXCISE INFEOR TURBINATE
|
Facility
|
OP
|
$22,083.40
|
|
|
Service Code
|
HCPCS 30130
|
| Hospital Charge Code |
1600000284
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$627.17 |
| Max. Negotiated Rate |
$14,288.18 |
| Rate for Payer: Aetna Commercial |
$10,713.67
|
| Rate for Payer: Aetna Medicare Advantage |
$12,761.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,288.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,288.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,938.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14,288.18
|
| Rate for Payer: Cigna Commercial |
$7,895.42
|
| Rate for Payer: Cigna Medicare Advantage |
$3,938.85
|
| Rate for Payer: Clover Medicare Advantage |
$3,741.91
|
| Rate for Payer: EmblemHealth Commercial |
$11,816.55
|
| Rate for Payer: Humana Medicare Advantage |
$4,057.02
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,938.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,741.68
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,312.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$697.84
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,938.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,938.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$627.17
|
|
|
EXCISE INFEOR TURBINATE
|
Facility
|
IP
|
$22,083.40
|
|
|
Service Code
|
HCPCS 30130
|
| Hospital Charge Code |
1600000284
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,312.51 |
| Max. Negotiated Rate |
$3,312.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,312.51
|
|
|
EXCISE INTESTINE 1+LESIONS(S)
|
Facility
|
IP
|
$9,477.40
|
|
|
Service Code
|
HCPCS 44110
|
| Hospital Charge Code |
160000206
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,421.61 |
| Max. Negotiated Rate |
$1,421.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,421.61
|
|
|
EXCISE INTESTINE 1+LESIONS(S)
|
Facility
|
OP
|
$9,477.40
|
|
|
Service Code
|
HCPCS 44110
|
| Hospital Charge Code |
160000206
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$269.16 |
| Max. Negotiated Rate |
$10,269.00 |
| Rate for Payer: Aetna Commercial |
$3,601.41
|
| Rate for Payer: Aetna Medicare Advantage |
$2,843.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,416.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,416.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,416.74
|
| Rate for Payer: Cigna Commercial |
$4,738.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,464.12
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,421.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$299.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$269.16
|
|
|
EXCISE LESION CORNEA NOT PTRGM
|
Facility
|
IP
|
$14,711.60
|
|
|
Service Code
|
HCPCS 65400
|
| Hospital Charge Code |
16000658
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,206.74 |
| Max. Negotiated Rate |
$2,206.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,206.74
|
|
|
EXCISE LESION CORNEA NOT PTRGM
|
Facility
|
OP
|
$14,711.60
|
|
|
Service Code
|
HCPCS 65400
|
| Hospital Charge Code |
16000658
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$417.81 |
| Max. Negotiated Rate |
$5,347.00 |
| Rate for Payer: Aetna Commercial |
$3,221.35
|
| Rate for Payer: Aetna Medicare Advantage |
$3,837.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,296.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,296.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,184.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,296.12
|
| Rate for Payer: Cigna Commercial |
$2,373.97
|
| Rate for Payer: Cigna Medicare Advantage |
$1,184.32
|
| Rate for Payer: Clover Medicare Advantage |
$1,125.10
|
| Rate for Payer: EmblemHealth Commercial |
$3,552.96
|
| Rate for Payer: Humana Medicare Advantage |
$1,219.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,184.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,825.02
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,206.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$464.89
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,184.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,184.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$417.81
|
|
|
EXCISE LESION OF SPERMATIC COR
|
Facility
|
IP
|
$22,128.35
|
|
|
Service Code
|
HCPCS 55520
|
| Hospital Charge Code |
1600000269
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,319.25 |
| Max. Negotiated Rate |
$3,319.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,319.25
|
|
|
EXCISE LESION OF SPERMATIC COR
|
Facility
|
OP
|
$22,128.35
|
|
|
Service Code
|
HCPCS 55520
|
| Hospital Charge Code |
1600000269
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$628.45 |
| Max. Negotiated Rate |
$15,191.14 |
| Rate for Payer: Aetna Commercial |
$11,390.73
|
| Rate for Payer: Aetna Medicare Advantage |
$13,568.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,191.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,191.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,187.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15,191.14
|
| Rate for Payer: Cigna Commercial |
$8,394.37
|
| Rate for Payer: Cigna Medicare Advantage |
$4,187.77
|
| Rate for Payer: Clover Medicare Advantage |
$3,978.38
|
| Rate for Payer: EmblemHealth Commercial |
$12,563.31
|
| Rate for Payer: Humana Medicare Advantage |
$4,313.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,187.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,753.37
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,319.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$699.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$628.45
|
|
|
EXCISE LESION TESTIS
|
Facility
|
OP
|
$21,225.75
|
|
|
Service Code
|
HCPCS 54512
|
| Hospital Charge Code |
1600000817
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$602.81 |
| Max. Negotiated Rate |
$15,191.14 |
| Rate for Payer: Aetna Commercial |
$11,390.73
|
| Rate for Payer: Aetna Medicare Advantage |
$13,568.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,191.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,191.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,187.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15,191.14
|
| Rate for Payer: Cigna Commercial |
$8,394.37
|
| Rate for Payer: Cigna Medicare Advantage |
$4,187.77
|
| Rate for Payer: Clover Medicare Advantage |
$3,978.38
|
| Rate for Payer: EmblemHealth Commercial |
$12,563.31
|
| Rate for Payer: Humana Medicare Advantage |
$4,313.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,187.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,518.69
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,183.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$670.73
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$602.81
|
|
|
EXCISE LESION TESTIS
|
Facility
|
IP
|
$21,225.75
|
|
|
Service Code
|
HCPCS 54512
|
| Hospital Charge Code |
1600000817
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,183.86 |
| Max. Negotiated Rate |
$3,183.86 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,183.86
|
|
