|
HIP BIL W/WO PELVIS 3-4 VIEWS
|
Facility
|
IP
|
$593.26
|
|
|
Service Code
|
HCPCS 73522
|
| Hospital Charge Code |
75190636
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$88.99 |
| Max. Negotiated Rate |
$88.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$88.99
|
|
|
HIP BIL W/WO PELVIS 3-4 VIEWS
|
Facility
|
OP
|
$593.26
|
|
|
Service Code
|
HCPCS 73522
|
| Hospital Charge Code |
2011597
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$16.85 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$154.25
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$88.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.85
|
|
|
HIP BIL W/WO PELVIS 3-4 VIEWS
|
Facility
|
IP
|
$593.26
|
|
|
Service Code
|
HCPCS 73522
|
| Hospital Charge Code |
94270261
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$88.99 |
| Max. Negotiated Rate |
$88.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$88.99
|
|
|
HIP BIL W/WO PELVIS 3-4 VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 73522
|
| Hospital Charge Code |
2011561
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
HIP BIL W/WO PELVIS 3-4 VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 73522
|
| Hospital Charge Code |
2011561
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.65 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
HIP BIL W/WO PELVIS 3-4 VIEWS
|
Facility
|
IP
|
$593.26
|
|
|
Service Code
|
HCPCS 73522
|
| Hospital Charge Code |
2011597
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$88.99 |
| Max. Negotiated Rate |
$88.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$88.99
|
|
|
HIP BIL W/WO PELVIS 3-4 VIEWS
|
Facility
|
OP
|
$593.26
|
|
|
Service Code
|
HCPCS 73522
|
| Hospital Charge Code |
75190636
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$16.85 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$154.25
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$88.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.85
|
|
|
HIP BIL W/WO PELVIS 3-4 VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 73522
|
| Hospital Charge Code |
94061481
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.65 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
HIP BIL W/WO PELVIS 3-4 VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 73522
|
| Hospital Charge Code |
94061481
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
HIP BIL W/WO PELVIS 3-4 VIEWS
|
Facility
|
OP
|
$593.26
|
|
|
Service Code
|
HCPCS 73522
|
| Hospital Charge Code |
94270261
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$16.85 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$154.25
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$88.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.85
|
|
|
HIP BIPOLAR-HEMI-ARTHROPLASTY
|
Facility
|
IP
|
$28,463.40
|
|
| Hospital Charge Code |
270339080
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,269.51 |
| Max. Negotiated Rate |
$6,888.14 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,692.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,888.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,269.51
|
|
|
HIP BIPOLAR-HEMI-ARTHROPLASTY
|
Facility
|
OP
|
$28,463.40
|
|
| Hospital Charge Code |
270339080
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$808.36 |
| Max. Negotiated Rate |
$14,231.70 |
| Rate for Payer: Aetna Commercial |
$10,816.09
|
| Rate for Payer: Aetna Medicare Advantage |
$8,539.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,258.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,258.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5,692.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,258.17
|
| Rate for Payer: Cigna Commercial |
$14,231.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,888.14
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,269.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$899.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$808.36
|
|
|
HIP BI W/WO PELVIS =/> 5 VIEWS
|
Facility
|
OP
|
$1,131.07
|
|
|
Service Code
|
HCPCS 73523
|
| Hospital Charge Code |
94061482
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.12 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$51.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$294.08
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.74
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.12
|
|
|
HIP BI W/WO PELVIS =/> 5 VIEWS
|
Facility
|
OP
|
$1,131.07
|
|
|
Service Code
|
HCPCS 73523
|
| Hospital Charge Code |
75190637
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.12 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$51.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$294.08
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.74
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.12
|
|
|
HIP BI W/WO PELVIS =/> 5 VIEWS
|
Facility
|
IP
|
$1,131.07
|
|
|
Service Code
|
HCPCS 73523
|
| Hospital Charge Code |
94270262
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$169.66 |
| Max. Negotiated Rate |
$169.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.66
|
|
|
HIP BI W/WO PELVIS =/> 5 VIEWS
|
Facility
|
IP
|
$1,131.07
|
|
|
Service Code
|
HCPCS 73523
|
| Hospital Charge Code |
75190637
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$169.66 |
| Max. Negotiated Rate |
$169.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.66
|
|
|
HIP BI W/WO PELVIS =/> 5 VIEWS
|
Facility
|
IP
|
$1,131.07
|
|
|
Service Code
|
HCPCS 73523
|
| Hospital Charge Code |
94061482
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$169.66 |
| Max. Negotiated Rate |
$169.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.66
|
|
|
HIP BI W/WO PELVIS =/> 5 VIEWS
|
Facility
|
OP
|
$1,131.07
|
|
|
Service Code
|
HCPCS 73523
|
| Hospital Charge Code |
2011598
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.12 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$51.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$294.08
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.74
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.12
|
|
|
HIP BI W/WO PELVIS =/> 5 VIEWS
|
Facility
|
IP
|
$1,131.07
|
|
|
Service Code
|
HCPCS 73523
|
| Hospital Charge Code |
2011598
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$169.66 |
| Max. Negotiated Rate |
$169.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.66
|
|
|
HIP BI W/WO PELVIS =/> 5 VIEWS
|
Facility
|
OP
|
$1,131.07
|
|
|
Service Code
|
HCPCS 73523
|
| Hospital Charge Code |
94270262
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.12 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$51.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$294.08
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.74
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.12
|
|
|
HIP BI W/WO PELVIS =/> 5 VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 73523
|
| Hospital Charge Code |
2011562
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
HIP BI W/WO PELVIS =/> 5 VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 73523
|
| Hospital Charge Code |
2011562
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$51.89 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$51.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
HIP FIBER TAK SUTURE ANCH DL
|
Facility
|
OP
|
$2,008.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704866
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$57.04 |
| Max. Negotiated Rate |
$1,004.25 |
| Rate for Payer: Aetna Commercial |
$763.23
|
| Rate for Payer: Aetna Medicare Advantage |
$602.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$512.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$512.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$401.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$512.17
|
| Rate for Payer: Cigna Commercial |
$1,004.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$486.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$301.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$63.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$57.04
|
|
|
HIP FIBER TAK SUTURE ANCH DL
|
Facility
|
IP
|
$2,008.50
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270704866
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$301.27 |
| Max. Negotiated Rate |
$486.06 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$401.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$486.06
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$301.27
|
|
|
HIP FRACTURE NAIL LAG SCREW
|
Facility
|
OP
|
$2,640.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270683106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$74.98 |
| Max. Negotiated Rate |
$1,320.00 |
| Rate for Payer: Aetna Commercial |
$1,003.20
|
| Rate for Payer: Aetna Medicare Advantage |
$792.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$673.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$673.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$528.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$673.20
|
| Rate for Payer: Cigna Commercial |
$1,320.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$638.88
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$396.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$83.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$74.98
|
|
