|
MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY
|
Facility
|
IP
|
$46,763.08
|
|
|
Service Code
|
APR-DRG 1602
|
| Min. Negotiated Rate |
$45,846.16 |
| Max. Negotiated Rate |
$46,763.08 |
| Rate for Payer: UnitedHealthcare Community & State |
$45,846.16
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$46,763.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$45,846.16
|
|
|
MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY
|
Facility
|
IP
|
$72,230.13
|
|
|
Service Code
|
APR-DRG 1603
|
| Min. Negotiated Rate |
$70,813.85 |
| Max. Negotiated Rate |
$72,230.13 |
| Rate for Payer: UnitedHealthcare Community & State |
$70,813.85
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$72,230.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$70,813.85
|
|
|
MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY
|
Facility
|
IP
|
$152,920.24
|
|
|
Service Code
|
APR-DRG 1604
|
| Min. Negotiated Rate |
$149,921.80 |
| Max. Negotiated Rate |
$152,920.24 |
| Rate for Payer: UnitedHealthcare Community & State |
$149,921.80
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$152,920.24
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$149,921.80
|
|
|
MAJOR CHEST AND RESPIRATORY TRAUMA
|
Facility
|
IP
|
$9,627.06
|
|
|
Service Code
|
APR-DRG 1351
|
| Min. Negotiated Rate |
$9,438.29 |
| Max. Negotiated Rate |
$9,627.06 |
| Rate for Payer: UnitedHealthcare Community & State |
$9,438.29
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$9,627.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9,438.29
|
|
|
MAJOR CHEST AND RESPIRATORY TRAUMA
|
Facility
|
IP
|
$15,964.97
|
|
|
Service Code
|
APR-DRG 1353
|
| Min. Negotiated Rate |
$15,651.93 |
| Max. Negotiated Rate |
$15,964.97 |
| Rate for Payer: UnitedHealthcare Community & State |
$15,651.93
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$15,964.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15,651.93
|
|
|
MAJOR CHEST AND RESPIRATORY TRAUMA
|
Facility
|
IP
|
$11,010.33
|
|
|
Service Code
|
APR-DRG 1352
|
| Min. Negotiated Rate |
$10,794.44 |
| Max. Negotiated Rate |
$11,010.33 |
| Rate for Payer: UnitedHealthcare Community & State |
$10,794.44
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$11,010.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10,794.44
|
|
|
MAJOR CHEST AND RESPIRATORY TRAUMA
|
Facility
|
IP
|
$27,886.78
|
|
|
Service Code
|
APR-DRG 1354
|
| Min. Negotiated Rate |
$27,339.98 |
| Max. Negotiated Rate |
$27,886.78 |
| Rate for Payer: UnitedHealthcare Community & State |
$27,339.98
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27,886.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27,339.98
|
|
|
MAJOR CHEST PROCEDURES WITH CC
|
Facility
|
IP
|
$99,206.80
|
|
|
Service Code
|
MSDRG 164
|
| Min. Negotiated Rate |
$30,207.20 |
| Max. Negotiated Rate |
$99,206.80 |
| Rate for Payer: Aetna Commercial |
$72,514.74
|
| Rate for Payer: Aetna Medicare Advantage |
$99,206.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70,647.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70,647.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$31,797.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70,647.75
|
| Rate for Payer: Cigna Commercial |
$56,267.53
|
| Rate for Payer: Cigna Medicare Advantage |
$31,797.05
|
| Rate for Payer: Clover Medicare Advantage |
$30,207.20
|
| Rate for Payer: EmblemHealth Commercial |
$95,391.15
|
| Rate for Payer: Humana Medicare Advantage |
$32,750.96
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$31,797.05
|
| Rate for Payer: Oxford Commercial |
$44,472.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$59,528.54
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$31,797.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$31,797.05
|
|
|
MAJOR CHEST PROCEDURES WITH MCC
|
Facility
|
IP
|
$161,060.67
|
|
|
Service Code
|
MSDRG 163
|
| Min. Negotiated Rate |
$49,040.91 |
| Max. Negotiated Rate |
$161,060.67 |
| Rate for Payer: Aetna Commercial |
$116,567.77
|
| Rate for Payer: Aetna Medicare Advantage |
$161,060.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$130,490.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$130,490.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$51,622.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$130,490.55
|
| Rate for Payer: Cigna Commercial |
$99,912.77
|
| Rate for Payer: Cigna Medicare Advantage |
$51,622.01
|
| Rate for Payer: Clover Medicare Advantage |
$49,040.91
|
| Rate for Payer: EmblemHealth Commercial |
$154,866.03
|
| Rate for Payer: Humana Medicare Advantage |
$53,170.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$51,622.01
|
| Rate for Payer: Oxford Commercial |
$78,969.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$105,703.25
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$51,622.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$51,622.01
|
|
|
MAJOR CHEST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$79,941.05
|
|
|
Service Code
|
MSDRG 165
|
| Min. Negotiated Rate |
$24,341.02 |
| Max. Negotiated Rate |
$79,941.05 |
| Rate for Payer: Aetna Commercial |
$58,793.44
|
| Rate for Payer: Aetna Medicare Advantage |
$79,941.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52,085.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52,085.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$25,622.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52,085.40
|
| Rate for Payer: Cigna Commercial |
$42,673.26
|
| Rate for Payer: Cigna Medicare Advantage |
$25,622.13
|
| Rate for Payer: Clover Medicare Advantage |
$24,341.02
|
| Rate for Payer: EmblemHealth Commercial |
$76,866.39
|
| Rate for Payer: Humana Medicare Advantage |
$26,390.79
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$25,622.13
|
| Rate for Payer: Oxford Commercial |
$33,728.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$45,146.41
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$25,622.13
|
| Rate for Payer: Wellcare Medicare Advantage |
$25,622.13
|
|
|
MAJOR CHEST TRAUMA WITH CC
|
Facility
|
IP
|
$53,083.37
|
|
|
Service Code
|
MSDRG 184
|
| Min. Negotiated Rate |
$16,163.20 |
| Max. Negotiated Rate |
$53,083.37 |
| Rate for Payer: Aetna Commercial |
$39,665.10
|
| Rate for Payer: Aetna Medicare Advantage |
$53,083.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29,090.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29,090.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,013.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29,090.25
|
| Rate for Payer: Cigna Commercial |
$23,721.98
|
| Rate for Payer: Cigna Medicare Advantage |
$17,013.90
|
| Rate for Payer: Clover Medicare Advantage |
$16,163.20
|
| Rate for Payer: EmblemHealth Commercial |
$51,041.70
|
| Rate for Payer: Humana Medicare Advantage |
$17,524.32
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,013.90
|
| Rate for Payer: Oxford Commercial |
$18,749.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$25,096.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,013.90
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,013.90
|
|
|
MAJOR CHEST TRAUMA WITH MCC
|
Facility
|
IP
|
$67,799.63
|
|
|
Service Code
|
MSDRG 183
|
| Min. Negotiated Rate |
$20,644.12 |
| Max. Negotiated Rate |
$67,799.63 |
| Rate for Payer: Aetna Commercial |
$50,146.21
|
| Rate for Payer: Aetna Medicare Advantage |
$67,799.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43,496.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43,496.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,730.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43,496.85
|
| Rate for Payer: Cigna Commercial |
$34,106.06
|
| Rate for Payer: Cigna Medicare Advantage |
$21,730.65
|
| Rate for Payer: Clover Medicare Advantage |
$20,644.12
|
| Rate for Payer: EmblemHealth Commercial |
$65,191.95
|
| Rate for Payer: Humana Medicare Advantage |
$22,382.57
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,730.65
|
| Rate for Payer: Oxford Commercial |
$26,956.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$36,082.69
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,730.65
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,730.65
|
|
|
MAJOR CHEST TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$44,312.99
|
|
|
Service Code
|
MSDRG 185
|
| Min. Negotiated Rate |
$13,492.74 |
| Max. Negotiated Rate |
$44,312.99 |
| Rate for Payer: Aetna Commercial |
$33,418.73
|
| Rate for Payer: Aetna Medicare Advantage |
$44,312.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21,055.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21,055.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14,202.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21,055.80
|
| Rate for Payer: Cigna Commercial |
$17,533.44
|
| Rate for Payer: Cigna Medicare Advantage |
$14,202.88
|
| Rate for Payer: Clover Medicare Advantage |
$13,492.74
|
| Rate for Payer: EmblemHealth Commercial |
$42,608.64
|
| Rate for Payer: Humana Medicare Advantage |
$14,628.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14,202.88
|
| Rate for Payer: Oxford Commercial |
$13,858.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$18,549.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14,202.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$14,202.88
|
|
|
MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$20,746.94
|
|
|
Service Code
|
APR-DRG 0891
|
| Min. Negotiated Rate |
$20,340.14 |
| Max. Negotiated Rate |
$20,746.94 |
| Rate for Payer: UnitedHealthcare Community & State |
$20,340.14
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$20,746.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20,340.14
|
|
|
MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$27,552.58
|
|
|
Service Code
|
APR-DRG 0892
|
| Min. Negotiated Rate |
$27,012.33 |
| Max. Negotiated Rate |
$27,552.58 |
| Rate for Payer: UnitedHealthcare Community & State |
$27,012.33
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27,552.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27,012.33
|
|
|
MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$74,647.10
|
|
|
Service Code
|
APR-DRG 0894
|
| Min. Negotiated Rate |
$73,183.43 |
| Max. Negotiated Rate |
$74,647.10 |
| Rate for Payer: UnitedHealthcare Community & State |
$73,183.43
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$74,647.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$73,183.43
|
|
|
MAJOR CRANIAL OR FACIAL BONE PROCEDURES
|
Facility
|
IP
|
$52,596.88
|
|
|
Service Code
|
APR-DRG 0893
|
| Min. Negotiated Rate |
$51,565.57 |
| Max. Negotiated Rate |
$52,596.88 |
| Rate for Payer: UnitedHealthcare Community & State |
$51,565.57
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$52,596.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$51,565.57
|
|
|
MAJOR ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$28,287.01
|
|
|
Service Code
|
APR-DRG 2424
|
| Min. Negotiated Rate |
$27,732.36 |
| Max. Negotiated Rate |
$28,287.01 |
| Rate for Payer: UnitedHealthcare Community & State |
$27,732.36
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$28,287.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27,732.36
|
|
|
MAJOR ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$14,048.03
|
|
|
Service Code
|
APR-DRG 2423
|
| Min. Negotiated Rate |
$13,772.58 |
| Max. Negotiated Rate |
$14,048.03 |
| Rate for Payer: UnitedHealthcare Community & State |
$13,772.58
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$14,048.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13,772.58
|
|
|
MAJOR ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$9,775.92
|
|
|
Service Code
|
APR-DRG 2422
|
| Min. Negotiated Rate |
$9,584.24 |
| Max. Negotiated Rate |
$9,775.92 |
| Rate for Payer: UnitedHealthcare Community & State |
$9,584.24
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$9,775.92
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9,584.24
|
|
|
MAJOR ESOPHAGEAL DISORDERS
|
Facility
|
IP
|
$7,451.62
|
|
|
Service Code
|
APR-DRG 2421
|
| Min. Negotiated Rate |
$7,305.51 |
| Max. Negotiated Rate |
$7,451.62 |
| Rate for Payer: UnitedHealthcare Community & State |
$7,305.51
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$7,451.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7,305.51
|
|
|
MAJOR ESOPHAGEAL DISORDERS WITH CC
|
Facility
|
IP
|
$51,064.54
|
|
|
Service Code
|
MSDRG 369
|
| Min. Negotiated Rate |
$15,548.50 |
| Max. Negotiated Rate |
$51,064.54 |
| Rate for Payer: Aetna Commercial |
$38,227.24
|
| Rate for Payer: Aetna Medicare Advantage |
$51,064.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27,427.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27,427.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16,366.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27,427.95
|
| Rate for Payer: Cigna Commercial |
$22,297.46
|
| Rate for Payer: Cigna Medicare Advantage |
$16,366.84
|
| Rate for Payer: Clover Medicare Advantage |
$15,548.50
|
| Rate for Payer: EmblemHealth Commercial |
$49,100.52
|
| Rate for Payer: Humana Medicare Advantage |
$16,857.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16,366.84
|
| Rate for Payer: Oxford Commercial |
$17,623.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$23,589.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16,366.84
|
| Rate for Payer: Wellcare Medicare Advantage |
$16,366.84
|
|
|
MAJOR ESOPHAGEAL DISORDERS WITH MCC
|
Facility
|
IP
|
$69,758.46
|
|
|
Service Code
|
MSDRG 368
|
| Min. Negotiated Rate |
$21,240.56 |
| Max. Negotiated Rate |
$69,758.46 |
| Rate for Payer: Aetna Commercial |
$51,541.28
|
| Rate for Payer: Aetna Medicare Advantage |
$69,758.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$45,713.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$45,713.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$22,358.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$45,713.25
|
| Rate for Payer: Cigna Commercial |
$35,488.23
|
| Rate for Payer: Cigna Medicare Advantage |
$22,358.48
|
| Rate for Payer: Clover Medicare Advantage |
$21,240.56
|
| Rate for Payer: EmblemHealth Commercial |
$67,075.44
|
| Rate for Payer: Humana Medicare Advantage |
$23,029.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$22,358.48
|
| Rate for Payer: Oxford Commercial |
$28,049.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$37,544.96
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$22,358.48
|
| Rate for Payer: Wellcare Medicare Advantage |
$22,358.48
|
|
|
MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$41,605.39
|
|
|
Service Code
|
MSDRG 370
|
| Min. Negotiated Rate |
$12,348.10 |
| Max. Negotiated Rate |
$41,605.39 |
| Rate for Payer: Aetna Commercial |
$31,490.32
|
| Rate for Payer: Aetna Medicare Advantage |
$41,605.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20,501.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20,501.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,335.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20,501.70
|
| Rate for Payer: Cigna Commercial |
$15,622.93
|
| Rate for Payer: Cigna Medicare Advantage |
$13,335.06
|
| Rate for Payer: Clover Medicare Advantage |
$12,668.31
|
| Rate for Payer: EmblemHealth Commercial |
$40,005.18
|
| Rate for Payer: Humana Medicare Advantage |
$13,735.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,335.06
|
| Rate for Payer: Oxford Commercial |
$12,348.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,528.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,335.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,335.06
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$13,958.13
|
|
|
Service Code
|
APR-DRG 2483
|
| Min. Negotiated Rate |
$13,684.44 |
| Max. Negotiated Rate |
$13,958.13 |
| Rate for Payer: UnitedHealthcare Community & State |
$13,684.44
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$13,958.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13,684.44
|
|