|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$9,454.32
|
|
|
Service Code
|
APR-DRG 2482
|
| Min. Negotiated Rate |
$9,268.94 |
| Max. Negotiated Rate |
$9,454.32 |
| Rate for Payer: UnitedHealthcare Community & State |
$9,268.94
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$9,454.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9,268.94
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$25,020.44
|
|
|
Service Code
|
APR-DRG 2484
|
| Min. Negotiated Rate |
$24,529.84 |
| Max. Negotiated Rate |
$25,020.44 |
| Rate for Payer: UnitedHealthcare Community & State |
$24,529.84
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$25,020.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24,529.84
|
|
|
MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS
|
Facility
|
IP
|
$7,248.01
|
|
|
Service Code
|
APR-DRG 2481
|
| Min. Negotiated Rate |
$7,105.89 |
| Max. Negotiated Rate |
$7,248.01 |
| Rate for Payer: UnitedHealthcare Community & State |
$7,105.89
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$7,248.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7,105.89
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC
|
Facility
|
IP
|
$51,721.64
|
|
|
Service Code
|
MSDRG 372
|
| Min. Negotiated Rate |
$15,748.58 |
| Max. Negotiated Rate |
$51,721.64 |
| Rate for Payer: Aetna Commercial |
$38,695.26
|
| Rate for Payer: Aetna Medicare Advantage |
$51,721.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28,813.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28,813.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16,577.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28,813.20
|
| Rate for Payer: Cigna Commercial |
$22,761.15
|
| Rate for Payer: Cigna Medicare Advantage |
$16,577.45
|
| Rate for Payer: Clover Medicare Advantage |
$15,748.58
|
| Rate for Payer: EmblemHealth Commercial |
$49,732.35
|
| Rate for Payer: Humana Medicare Advantage |
$17,074.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16,577.45
|
| Rate for Payer: Oxford Commercial |
$17,990.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$24,080.28
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16,577.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$16,577.45
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC
|
Facility
|
IP
|
$75,483.19
|
|
|
Service Code
|
MSDRG 371
|
| Min. Negotiated Rate |
$22,983.66 |
| Max. Negotiated Rate |
$75,483.19 |
| Rate for Payer: Aetna Commercial |
$55,618.49
|
| Rate for Payer: Aetna Medicare Advantage |
$75,483.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48,483.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48,483.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24,193.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48,483.75
|
| Rate for Payer: Cigna Commercial |
$39,527.72
|
| Rate for Payer: Cigna Medicare Advantage |
$24,193.33
|
| Rate for Payer: Clover Medicare Advantage |
$22,983.66
|
| Rate for Payer: EmblemHealth Commercial |
$72,579.99
|
| Rate for Payer: Humana Medicare Advantage |
$24,919.13
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24,193.33
|
| Rate for Payer: Oxford Commercial |
$31,242.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$41,818.56
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24,193.33
|
| Rate for Payer: Wellcare Medicare Advantage |
$24,193.33
|
|
|
MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$42,445.79
|
|
|
Service Code
|
MSDRG 373
|
| Min. Negotiated Rate |
$12,816.79 |
| Max. Negotiated Rate |
$42,445.79 |
| Rate for Payer: Aetna Commercial |
$32,088.87
|
| Rate for Payer: Aetna Medicare Advantage |
$42,445.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19,947.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19,947.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,604.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19,947.60
|
| Rate for Payer: Cigna Commercial |
$16,215.93
|
| Rate for Payer: Cigna Medicare Advantage |
$13,604.42
|
| Rate for Payer: Clover Medicare Advantage |
$12,924.20
|
| Rate for Payer: EmblemHealth Commercial |
$40,813.26
|
| Rate for Payer: Humana Medicare Advantage |
$14,012.55
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,604.42
|
| Rate for Payer: Oxford Commercial |
$12,816.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$17,155.73
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,604.42
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,604.42
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITH CC
|
Facility
|
IP
|
$88,373.38
|
|
|
Service Code
|
MSDRG 141
|
| Min. Negotiated Rate |
$26,908.56 |
| Max. Negotiated Rate |
$88,373.38 |
| Rate for Payer: Aetna Commercial |
$64,799.03
|
| Rate for Payer: Aetna Medicare Advantage |
$88,373.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57,349.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57,349.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$28,324.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57,349.35
|
| Rate for Payer: Cigna Commercial |
$48,623.26
|
| Rate for Payer: Cigna Medicare Advantage |
$28,324.80
|
| Rate for Payer: Clover Medicare Advantage |
$26,908.56
|
| Rate for Payer: EmblemHealth Commercial |
$84,974.40
|
| Rate for Payer: Humana Medicare Advantage |
$29,174.54
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$28,324.80
|
| Rate for Payer: Oxford Commercial |
$38,430.98
|
| Rate for Payer: UnitedHealthcare Commercial |
$51,441.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$28,324.80
|
| Rate for Payer: Wellcare Medicare Advantage |
$28,324.80
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITH MCC
|
Facility
|
IP
|
$154,220.63
|
|
|
Service Code
|
MSDRG 140
|
| Min. Negotiated Rate |
$46,958.21 |
| Max. Negotiated Rate |
$154,220.63 |
| Rate for Payer: Aetna Commercial |
$111,696.23
|
| Rate for Payer: Aetna Medicare Advantage |
$154,220.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$104,724.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$104,724.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$49,429.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$104,724.90
|
| Rate for Payer: Cigna Commercial |
$95,086.33
|
| Rate for Payer: Cigna Medicare Advantage |
$49,429.69
|
| Rate for Payer: Clover Medicare Advantage |
$46,958.21
|
| Rate for Payer: EmblemHealth Commercial |
$148,289.07
|
| Rate for Payer: Humana Medicare Advantage |
$50,912.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$49,429.69
|
| Rate for Payer: Oxford Commercial |
$75,154.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$100,597.10
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$49,429.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$49,429.69
|
|
|
MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$69,900.67
|
|
|
Service Code
|
MSDRG 142
|
| Min. Negotiated Rate |
$21,283.86 |
| Max. Negotiated Rate |
$69,900.67 |
| Rate for Payer: Aetna Commercial |
$51,642.56
|
| Rate for Payer: Aetna Medicare Advantage |
$69,900.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42,942.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42,942.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$22,404.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42,942.75
|
| Rate for Payer: Cigna Commercial |
$35,588.55
|
| Rate for Payer: Cigna Medicare Advantage |
$22,404.06
|
| Rate for Payer: Clover Medicare Advantage |
$21,283.86
|
| Rate for Payer: EmblemHealth Commercial |
$67,212.18
|
| Rate for Payer: Humana Medicare Advantage |
$23,076.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$22,404.06
|
| Rate for Payer: Oxford Commercial |
$28,128.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$37,651.09
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$22,404.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$22,404.06
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC
|
Facility
|
IP
|
$59,458.93
|
|
|
Service Code
|
MSDRG 809
|
| Min. Negotiated Rate |
$18,104.48 |
| Max. Negotiated Rate |
$59,458.93 |
| Rate for Payer: Aetna Commercial |
$44,205.84
|
| Rate for Payer: Aetna Medicare Advantage |
$59,458.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33,246.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33,246.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$19,057.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33,246.00
|
| Rate for Payer: Cigna Commercial |
$28,220.71
|
| Rate for Payer: Cigna Medicare Advantage |
$19,057.35
|
| Rate for Payer: Clover Medicare Advantage |
$18,104.48
|
| Rate for Payer: EmblemHealth Commercial |
$57,172.05
|
| Rate for Payer: Humana Medicare Advantage |
$19,629.07
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$19,057.35
|
| Rate for Payer: Oxford Commercial |
$22,305.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$29,856.25
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$19,057.35
|
| Rate for Payer: Wellcare Medicare Advantage |
$19,057.35
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC
|
Facility
|
IP
|
$89,220.05
|
|
|
Service Code
|
MSDRG 808
|
| Min. Negotiated Rate |
$27,166.36 |
| Max. Negotiated Rate |
$89,220.05 |
| Rate for Payer: Aetna Commercial |
$65,402.04
|
| Rate for Payer: Aetna Medicare Advantage |
$89,220.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60,673.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60,673.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$28,596.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60,673.95
|
| Rate for Payer: Cigna Commercial |
$49,220.71
|
| Rate for Payer: Cigna Medicare Advantage |
$28,596.17
|
| Rate for Payer: Clover Medicare Advantage |
$27,166.36
|
| Rate for Payer: EmblemHealth Commercial |
$85,788.51
|
| Rate for Payer: Humana Medicare Advantage |
$29,454.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$28,596.17
|
| Rate for Payer: Oxford Commercial |
$38,903.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$52,073.32
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$28,596.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$28,596.17
|
|
|
MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$52,530.41
|
|
|
Service Code
|
MSDRG 810
|
| Min. Negotiated Rate |
$15,994.84 |
| Max. Negotiated Rate |
$52,530.41 |
| Rate for Payer: Aetna Commercial |
$39,271.28
|
| Rate for Payer: Aetna Medicare Advantage |
$52,530.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27,705.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27,705.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16,836.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27,705.00
|
| Rate for Payer: Cigna Commercial |
$23,331.85
|
| Rate for Payer: Cigna Medicare Advantage |
$16,836.67
|
| Rate for Payer: Clover Medicare Advantage |
$15,994.84
|
| Rate for Payer: EmblemHealth Commercial |
$50,510.01
|
| Rate for Payer: Humana Medicare Advantage |
$17,341.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16,836.67
|
| Rate for Payer: Oxford Commercial |
$18,441.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$24,684.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16,836.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$16,836.67
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$8,399.57
|
|
|
Service Code
|
APR-DRG 6601
|
| Min. Negotiated Rate |
$8,234.87 |
| Max. Negotiated Rate |
$8,399.57 |
| Rate for Payer: UnitedHealthcare Community & State |
$8,234.87
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$8,399.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8,234.87
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$9,865.76
|
|
|
Service Code
|
APR-DRG 6602
|
| Min. Negotiated Rate |
$9,672.31 |
| Max. Negotiated Rate |
$9,865.76 |
| Rate for Payer: UnitedHealthcare Community & State |
$9,672.31
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$9,865.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9,672.31
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$31,691.25
|
|
|
Service Code
|
APR-DRG 6604
|
| Min. Negotiated Rate |
$31,069.85 |
| Max. Negotiated Rate |
$31,691.25 |
| Rate for Payer: UnitedHealthcare Community & State |
$31,069.85
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$31,691.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31,069.85
|
|
|
MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION
|
Facility
|
IP
|
$15,056.40
|
|
|
Service Code
|
APR-DRG 6603
|
| Min. Negotiated Rate |
$14,761.18 |
| Max. Negotiated Rate |
$15,056.40 |
| Rate for Payer: UnitedHealthcare Community & State |
$14,761.18
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$15,056.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14,761.18
|
|
|
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT
|
Facility
|
IP
|
$115,294.23
|
|
|
Service Code
|
MSDRG 469
|
| Min. Negotiated Rate |
$35,105.62 |
| Max. Negotiated Rate |
$115,294.23 |
| Rate for Payer: Aetna Commercial |
$83,972.37
|
| Rate for Payer: Aetna Medicare Advantage |
$115,294.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$92,257.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$92,257.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$36,953.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$92,257.65
|
| Rate for Payer: Cigna Commercial |
$67,619.13
|
| Rate for Payer: Cigna Medicare Advantage |
$36,953.28
|
| Rate for Payer: Clover Medicare Advantage |
$35,105.62
|
| Rate for Payer: EmblemHealth Commercial |
$110,859.84
|
| Rate for Payer: Humana Medicare Advantage |
$38,061.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$36,953.28
|
| Rate for Payer: Oxford Commercial |
$53,444.98
|
| Rate for Payer: UnitedHealthcare Commercial |
$71,538.02
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$36,953.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$36,953.28
|
|
|
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC
|
Facility
|
IP
|
$80,405.46
|
|
|
Service Code
|
MSDRG 470
|
| Min. Negotiated Rate |
$24,482.43 |
| Max. Negotiated Rate |
$80,405.46 |
| Rate for Payer: Aetna Commercial |
$59,124.19
|
| Rate for Payer: Aetna Medicare Advantage |
$80,405.46
|
| 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 |
$25,770.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52,085.40
|
| Rate for Payer: Cigna Commercial |
$43,000.97
|
| Rate for Payer: Cigna Medicare Advantage |
$25,770.98
|
| Rate for Payer: Clover Medicare Advantage |
$24,482.43
|
| Rate for Payer: EmblemHealth Commercial |
$77,312.94
|
| Rate for Payer: Humana Medicare Advantage |
$26,544.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$25,770.98
|
| Rate for Payer: Oxford Commercial |
$33,987.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$45,493.11
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$25,770.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$25,770.98
|
|
|
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES
|
Facility
|
IP
|
$107,038.81
|
|
|
Service Code
|
MSDRG 483
|
| Min. Negotiated Rate |
$32,591.94 |
| Max. Negotiated Rate |
$107,038.81 |
| Rate for Payer: Aetna Commercial |
$78,092.78
|
| Rate for Payer: Aetna Medicare Advantage |
$107,038.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68,708.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68,708.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$34,307.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68,708.40
|
| Rate for Payer: Cigna Commercial |
$61,793.97
|
| Rate for Payer: Cigna Medicare Advantage |
$34,307.31
|
| Rate for Payer: Clover Medicare Advantage |
$32,591.94
|
| Rate for Payer: EmblemHealth Commercial |
$102,921.93
|
| Rate for Payer: Humana Medicare Advantage |
$35,336.53
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$34,307.31
|
| Rate for Payer: Oxford Commercial |
$48,840.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$65,375.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$34,307.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$34,307.31
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$57,088.11
|
|
|
Service Code
|
APR-DRG 2314
|
| Min. Negotiated Rate |
$55,968.74 |
| Max. Negotiated Rate |
$57,088.11 |
| Rate for Payer: UnitedHealthcare Community & State |
$55,968.74
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$57,088.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$55,968.74
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$25,384.20
|
|
|
Service Code
|
APR-DRG 2312
|
| Min. Negotiated Rate |
$24,886.47 |
| Max. Negotiated Rate |
$25,384.20 |
| Rate for Payer: UnitedHealthcare Community & State |
$24,886.47
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$25,384.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24,886.47
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$35,603.89
|
|
|
Service Code
|
APR-DRG 2313
|
| Min. Negotiated Rate |
$34,905.77 |
| Max. Negotiated Rate |
$35,603.89 |
| Rate for Payer: UnitedHealthcare Community & State |
$34,905.77
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$35,603.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$34,905.77
|
|
|
MAJOR LARGE BOWEL PROCEDURES
|
Facility
|
IP
|
$20,769.36
|
|
|
Service Code
|
APR-DRG 2311
|
| Min. Negotiated Rate |
$20,362.12 |
| Max. Negotiated Rate |
$20,769.36 |
| Rate for Payer: UnitedHealthcare Community & State |
$20,362.12
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$20,769.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20,362.12
|
|
|
MAJOR MALE PELVIC PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$82,661.28
|
|
|
Service Code
|
MSDRG 707
|
| Min. Negotiated Rate |
$25,169.30 |
| Max. Negotiated Rate |
$82,661.28 |
| Rate for Payer: Aetna Commercial |
$60,730.82
|
| Rate for Payer: Aetna Medicare Advantage |
$82,661.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54,301.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54,301.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$26,494.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54,301.80
|
| Rate for Payer: Cigna Commercial |
$44,592.69
|
| Rate for Payer: Cigna Medicare Advantage |
$26,494.00
|
| Rate for Payer: Clover Medicare Advantage |
$25,169.30
|
| Rate for Payer: EmblemHealth Commercial |
$79,482.00
|
| Rate for Payer: Humana Medicare Advantage |
$27,288.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$26,494.00
|
| Rate for Payer: Oxford Commercial |
$35,245.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$47,177.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$26,494.00
|
| Rate for Payer: Wellcare Medicare Advantage |
$26,494.00
|
|
|
MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$67,935.44
|
|
|
Service Code
|
MSDRG 708
|
| Min. Negotiated Rate |
$20,685.47 |
| Max. Negotiated Rate |
$67,935.44 |
| Rate for Payer: Aetna Commercial |
$50,242.90
|
| Rate for Payer: Aetna Medicare Advantage |
$67,935.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$40,449.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$40,449.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,774.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$40,449.30
|
| Rate for Payer: Cigna Commercial |
$34,201.92
|
| Rate for Payer: Cigna Medicare Advantage |
$21,774.18
|
| Rate for Payer: Clover Medicare Advantage |
$20,685.47
|
| Rate for Payer: EmblemHealth Commercial |
$65,322.54
|
| Rate for Payer: Humana Medicare Advantage |
$22,427.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,774.18
|
| Rate for Payer: Oxford Commercial |
$27,032.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$36,184.11
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,774.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,774.18
|
|
