|
MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE
|
Facility
|
IP
|
$26,033.03
|
|
|
Service Code
|
APR-DRG 2064
|
| Min. Negotiated Rate |
$25,522.58 |
| Max. Negotiated Rate |
$26,033.03 |
| Rate for Payer: UnitedHealthcare Community & State |
$25,522.58
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$26,033.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25,522.58
|
|
|
MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE
|
Facility
|
IP
|
$19,363.60
|
|
|
Service Code
|
APR-DRG 4664
|
| Min. Negotiated Rate |
$18,983.92 |
| Max. Negotiated Rate |
$19,363.60 |
| Rate for Payer: UnitedHealthcare Community & State |
$18,983.92
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$19,363.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18,983.92
|
|
|
MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE
|
Facility
|
IP
|
$11,758.89
|
|
|
Service Code
|
APR-DRG 4663
|
| Min. Negotiated Rate |
$11,528.32 |
| Max. Negotiated Rate |
$11,758.89 |
| Rate for Payer: UnitedHealthcare Community & State |
$11,528.32
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$11,758.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11,528.32
|
|
|
MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE
|
Facility
|
IP
|
$8,336.38
|
|
|
Service Code
|
APR-DRG 4662
|
| Min. Negotiated Rate |
$8,172.92 |
| Max. Negotiated Rate |
$8,336.38 |
| Rate for Payer: UnitedHealthcare Community & State |
$8,172.92
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$8,336.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8,172.92
|
|
|
MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE
|
Facility
|
IP
|
$5,925.09
|
|
|
Service Code
|
APR-DRG 4661
|
| Min. Negotiated Rate |
$5,808.91 |
| Max. Negotiated Rate |
$5,925.09 |
| Rate for Payer: UnitedHealthcare Community & State |
$5,808.91
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$5,925.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5,808.91
|
|
|
MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE
|
Facility
|
IP
|
$24,551.41
|
|
|
Service Code
|
APR-DRG 3494
|
| Min. Negotiated Rate |
$24,070.01 |
| Max. Negotiated Rate |
$24,551.41 |
| Rate for Payer: UnitedHealthcare Community & State |
$24,070.01
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$24,551.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24,070.01
|
|
|
MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE
|
Facility
|
IP
|
$7,190.43
|
|
|
Service Code
|
APR-DRG 3491
|
| Min. Negotiated Rate |
$7,049.44 |
| Max. Negotiated Rate |
$7,190.43 |
| Rate for Payer: UnitedHealthcare Community & State |
$7,049.44
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$7,190.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7,049.44
|
|
|
MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE
|
Facility
|
IP
|
$14,670.15
|
|
|
Service Code
|
APR-DRG 3493
|
| Min. Negotiated Rate |
$14,382.50 |
| Max. Negotiated Rate |
$14,670.15 |
| Rate for Payer: UnitedHealthcare Community & State |
$14,382.50
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$14,670.15
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14,382.50
|
|
|
MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE
|
Facility
|
IP
|
$10,195.82
|
|
|
Service Code
|
APR-DRG 3492
|
| Min. Negotiated Rate |
$9,995.90 |
| Max. Negotiated Rate |
$10,195.82 |
| Rate for Payer: UnitedHealthcare Community & State |
$9,995.90
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$10,195.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9,995.90
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$53,832.11
|
|
|
Service Code
|
MSDRG 755
|
| Min. Negotiated Rate |
$16,391.19 |
| Max. Negotiated Rate |
$53,832.11 |
| Rate for Payer: Aetna Commercial |
$40,198.36
|
| Rate for Payer: Aetna Medicare Advantage |
$53,832.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29,921.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29,921.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,253.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29,921.40
|
| Rate for Payer: Cigna Commercial |
$24,250.33
|
| Rate for Payer: Cigna Medicare Advantage |
$17,253.88
|
| Rate for Payer: Clover Medicare Advantage |
$16,391.19
|
| Rate for Payer: EmblemHealth Commercial |
$51,761.64
|
| Rate for Payer: Humana Medicare Advantage |
$17,771.50
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,253.88
|
| Rate for Payer: Oxford Commercial |
$19,167.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$25,655.76
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,253.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,253.88
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$77,650.56
|
|
|
Service Code
|
MSDRG 754
|
| Min. Negotiated Rate |
$23,643.60 |
| Max. Negotiated Rate |
$77,650.56 |
| Rate for Payer: Aetna Commercial |
$57,162.12
|
| Rate for Payer: Aetna Medicare Advantage |
$77,650.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51,254.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51,254.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24,888.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51,254.25
|
| Rate for Payer: Cigna Commercial |
$41,057.02
|
| Rate for Payer: Cigna Medicare Advantage |
$24,888.00
|
| Rate for Payer: Clover Medicare Advantage |
$23,643.60
|
| Rate for Payer: EmblemHealth Commercial |
$74,664.00
|
| Rate for Payer: Humana Medicare Advantage |
$25,634.64
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24,888.00
|
| Rate for Payer: Oxford Commercial |
$32,450.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$43,436.49
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24,888.00
|
| Rate for Payer: Wellcare Medicare Advantage |
$24,888.00
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$49,810.30
|
|
|
Service Code
|
MSDRG 756
|
| Min. Negotiated Rate |
$15,166.60 |
| Max. Negotiated Rate |
$49,810.30 |
| Rate for Payer: Aetna Commercial |
$37,333.98
|
| Rate for Payer: Aetna Medicare Advantage |
$49,810.30
|
| 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 |
$15,964.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27,427.95
|
| Rate for Payer: Cigna Commercial |
$21,412.43
|
| Rate for Payer: Cigna Medicare Advantage |
$15,964.84
|
| Rate for Payer: Clover Medicare Advantage |
$15,166.60
|
| Rate for Payer: EmblemHealth Commercial |
$47,894.52
|
| Rate for Payer: Humana Medicare Advantage |
$16,443.79
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15,964.84
|
| Rate for Payer: Oxford Commercial |
$16,924.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$22,653.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15,964.84
|
| Rate for Payer: Wellcare Medicare Advantage |
$15,964.84
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM
|
Facility
|
IP
|
$26,010.53
|
|
|
Service Code
|
APR-DRG 5004
|
| Min. Negotiated Rate |
$25,500.52 |
| Max. Negotiated Rate |
$26,010.53 |
| Rate for Payer: UnitedHealthcare Community & State |
$25,500.52
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$26,010.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25,500.52
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM
|
Facility
|
IP
|
$9,271.74
|
|
|
Service Code
|
APR-DRG 5002
|
| Min. Negotiated Rate |
$9,089.94 |
| Max. Negotiated Rate |
$9,271.74 |
| Rate for Payer: UnitedHealthcare Community & State |
$9,089.94
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$9,271.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9,089.94
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM
|
Facility
|
IP
|
$7,358.95
|
|
|
Service Code
|
APR-DRG 5001
|
| Min. Negotiated Rate |
$7,214.66 |
| Max. Negotiated Rate |
$7,358.95 |
| Rate for Payer: UnitedHealthcare Community & State |
$7,214.66
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$7,358.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7,214.66
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM
|
Facility
|
IP
|
$14,227.77
|
|
|
Service Code
|
APR-DRG 5003
|
| Min. Negotiated Rate |
$13,948.79 |
| Max. Negotiated Rate |
$14,227.77 |
| Rate for Payer: UnitedHealthcare Community & State |
$13,948.79
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$14,227.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13,948.79
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$55,566.64
|
|
|
Service Code
|
MSDRG 723
|
| Min. Negotiated Rate |
$16,919.33 |
| Max. Negotiated Rate |
$55,566.64 |
| Rate for Payer: Aetna Commercial |
$41,433.69
|
| Rate for Payer: Aetna Medicare Advantage |
$55,566.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30,752.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30,752.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,809.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30,752.55
|
| Rate for Payer: Cigna Commercial |
$25,474.21
|
| Rate for Payer: Cigna Medicare Advantage |
$17,809.82
|
| Rate for Payer: Clover Medicare Advantage |
$16,919.33
|
| Rate for Payer: EmblemHealth Commercial |
$53,429.46
|
| Rate for Payer: Humana Medicare Advantage |
$18,344.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,809.82
|
| Rate for Payer: Oxford Commercial |
$20,134.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$26,950.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,809.82
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,809.82
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$76,639.52
|
|
|
Service Code
|
MSDRG 722
|
| Min. Negotiated Rate |
$23,335.75 |
| Max. Negotiated Rate |
$76,639.52 |
| Rate for Payer: Aetna Commercial |
$56,442.05
|
| Rate for Payer: Aetna Medicare Advantage |
$76,639.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51,808.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51,808.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24,563.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51,808.35
|
| Rate for Payer: Cigna Commercial |
$40,343.64
|
| Rate for Payer: Cigna Medicare Advantage |
$24,563.95
|
| Rate for Payer: Clover Medicare Advantage |
$23,335.75
|
| Rate for Payer: EmblemHealth Commercial |
$73,691.85
|
| Rate for Payer: Humana Medicare Advantage |
$25,300.87
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24,563.95
|
| Rate for Payer: Oxford Commercial |
$31,886.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$42,681.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24,563.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$24,563.95
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$40,180.55
|
|
|
Service Code
|
MSDRG 724
|
| Min. Negotiated Rate |
$10,778.15 |
| Max. Negotiated Rate |
$40,180.55 |
| Rate for Payer: Aetna Commercial |
$30,475.54
|
| Rate for Payer: Aetna Medicare Advantage |
$40,180.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22,441.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22,441.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12,878.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22,441.05
|
| Rate for Payer: Cigna Commercial |
$13,636.63
|
| Rate for Payer: Cigna Medicare Advantage |
$12,878.38
|
| Rate for Payer: Clover Medicare Advantage |
$12,234.46
|
| Rate for Payer: EmblemHealth Commercial |
$38,635.14
|
| Rate for Payer: Humana Medicare Advantage |
$13,264.73
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12,878.38
|
| Rate for Payer: Oxford Commercial |
$10,778.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,426.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12,878.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$12,878.38
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS
|
Facility
|
IP
|
$14,935.56
|
|
|
Service Code
|
APR-DRG 2813
|
| Min. Negotiated Rate |
$14,642.71 |
| Max. Negotiated Rate |
$14,935.56 |
| Rate for Payer: UnitedHealthcare Community & State |
$14,642.71
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$14,935.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14,642.71
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS
|
Facility
|
IP
|
$22,019.27
|
|
|
Service Code
|
APR-DRG 2814
|
| Min. Negotiated Rate |
$21,587.52 |
| Max. Negotiated Rate |
$22,019.27 |
| Rate for Payer: UnitedHealthcare Community & State |
$21,587.52
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$22,019.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21,587.52
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS
|
Facility
|
IP
|
$8,305.52
|
|
|
Service Code
|
APR-DRG 2811
|
| Min. Negotiated Rate |
$8,142.67 |
| Max. Negotiated Rate |
$8,305.52 |
| Rate for Payer: UnitedHealthcare Community & State |
$8,142.67
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$8,305.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8,142.67
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS
|
Facility
|
IP
|
$11,469.60
|
|
|
Service Code
|
APR-DRG 2812
|
| Min. Negotiated Rate |
$11,244.71 |
| Max. Negotiated Rate |
$11,469.60 |
| Rate for Payer: UnitedHealthcare Community & State |
$11,244.71
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$11,469.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11,244.71
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC
|
Facility
|
IP
|
$55,200.19
|
|
|
Service Code
|
MSDRG 436
|
| Min. Negotiated Rate |
$16,807.75 |
| Max. Negotiated Rate |
$55,200.19 |
| Rate for Payer: Aetna Commercial |
$41,172.72
|
| Rate for Payer: Aetna Medicare Advantage |
$55,200.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30,475.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30,475.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,692.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30,475.50
|
| Rate for Payer: Cigna Commercial |
$25,215.61
|
| Rate for Payer: Cigna Medicare Advantage |
$17,692.37
|
| Rate for Payer: Clover Medicare Advantage |
$16,807.75
|
| Rate for Payer: EmblemHealth Commercial |
$53,077.11
|
| Rate for Payer: Humana Medicare Advantage |
$18,223.14
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,692.37
|
| Rate for Payer: Oxford Commercial |
$19,929.98
|
| Rate for Payer: UnitedHealthcare Commercial |
$26,676.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,692.37
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,692.37
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC
|
Facility
|
IP
|
$77,492.50
|
|
|
Service Code
|
MSDRG 435
|
| Min. Negotiated Rate |
$23,595.47 |
| Max. Negotiated Rate |
$77,492.50 |
| Rate for Payer: Aetna Commercial |
$57,049.55
|
| Rate for Payer: Aetna Medicare Advantage |
$77,492.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48,760.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48,760.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24,837.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48,760.80
|
| Rate for Payer: Cigna Commercial |
$40,945.55
|
| Rate for Payer: Cigna Medicare Advantage |
$24,837.34
|
| Rate for Payer: Clover Medicare Advantage |
$23,595.47
|
| Rate for Payer: EmblemHealth Commercial |
$74,512.02
|
| Rate for Payer: Humana Medicare Advantage |
$25,582.46
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24,837.34
|
| Rate for Payer: Oxford Commercial |
$32,362.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$43,318.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24,837.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$24,837.34
|
|