|
ARTHROPLASTY PATELLA,W PROSTH
|
Facility
|
IP
|
$55,895.68
|
|
|
Service Code
|
HCPCS 27438
|
| Hospital Charge Code |
1600000558
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$8,384.35 |
| Max. Negotiated Rate |
$8,384.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8,384.35
|
|
|
ARTHROPLASTY PATELLA,W PROSTH
|
Facility
|
OP
|
$55,895.68
|
|
|
Service Code
|
HCPCS 27438
|
| Hospital Charge Code |
1600000558
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,587.44 |
| Max. Negotiated Rate |
$55,329.13 |
| Rate for Payer: Aetna Commercial |
$41,487.32
|
| Rate for Payer: Aetna Medicare Advantage |
$49,418.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55,329.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55,329.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15,252.69
|
| 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 |
$55,329.13
|
| Rate for Payer: Cigna Commercial |
$30,573.98
|
| Rate for Payer: Cigna Medicare Advantage |
$15,252.69
|
| Rate for Payer: Clover Medicare Advantage |
$14,490.06
|
| Rate for Payer: EmblemHealth Commercial |
$45,758.07
|
| Rate for Payer: Humana Medicare Advantage |
$15,710.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15,252.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14,532.88
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8,384.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,766.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,587.44
|
|
|
ARTHROPLASTY WRIST
|
Facility
|
OP
|
$44,916.00
|
|
|
Service Code
|
HCPCS 25332
|
| Hospital Charge Code |
16000617
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,275.61 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| 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 |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,678.16
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,737.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,419.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,275.61
|
|
|
ARTHROPLASTY WRIST
|
Facility
|
IP
|
$44,916.00
|
|
|
Service Code
|
HCPCS 25332
|
| Hospital Charge Code |
16000617
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,737.40 |
| Max. Negotiated Rate |
$6,737.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,737.40
|
|
|
ARTHROPLASY, ANKLE W/IMPLANT
|
Facility
|
OP
|
$11,481.10
|
|
|
Service Code
|
HCPCS 27702
|
| Hospital Charge Code |
16000896
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$326.06 |
| Max. Negotiated Rate |
$116,935.87 |
| Rate for Payer: Aetna Commercial |
$87,681.76
|
| Rate for Payer: Aetna Medicare Advantage |
$104,444.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$116,935.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$116,935.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$32,235.94
|
| 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 |
$116,935.87
|
| Rate for Payer: Cigna Commercial |
$64,616.81
|
| Rate for Payer: Cigna Medicare Advantage |
$32,235.94
|
| Rate for Payer: Clover Medicare Advantage |
$30,624.14
|
| Rate for Payer: EmblemHealth Commercial |
$96,707.82
|
| Rate for Payer: Humana Medicare Advantage |
$33,203.02
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$32,235.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,985.09
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,722.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$362.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$32,235.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$32,235.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$326.06
|
|
|
ARTHROPLASY, ANKLE W/IMPLANT
|
Facility
|
IP
|
$11,481.10
|
|
|
Service Code
|
HCPCS 27702
|
| Hospital Charge Code |
16000896
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,722.16 |
| Max. Negotiated Rate |
$1,722.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,722.16
|
|
|
ARTHROSC,ANKLE,EXC OSCHON DFCT
|
Facility
|
IP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29891
|
| Hospital Charge Code |
16000483
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,587.90 |
| Max. Negotiated Rate |
$7,587.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,587.90
|
|
|
ARTHROSC,ANKLE,EXC OSCHON DFCT
|
Facility
|
OP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29891
|
| Hospital Charge Code |
16000483
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,436.64 |
| Max. Negotiated Rate |
$14,869.00 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| 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 |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13,152.36
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,587.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,598.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,436.64
|
|
|
ARTHROSC ANT CRUC LIG REP/AUG
|
Facility
|
OP
|
$82,959.70
|
|
|
Service Code
|
HCPCS 29888
|
| Hospital Charge Code |
16000193
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,356.06 |
| Max. Negotiated Rate |
$31,271.12 |
| Rate for Payer: Aetna Commercial |
$23,447.95
|
| Rate for Payer: Aetna Medicare Advantage |
$27,930.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31,271.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31,271.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,620.57
|
| 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 |
$31,271.12
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: Cigna Medicare Advantage |
$8,620.57
|
| Rate for Payer: Clover Medicare Advantage |
$8,189.54
|
| Rate for Payer: EmblemHealth Commercial |
$25,861.71
|
| Rate for Payer: Humana Medicare Advantage |
$8,879.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,620.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21,569.52
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12,443.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,621.53
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,356.06
|
|
|
ARTHROSC ANT CRUC LIG REP/AUG
|
Facility
|
IP
|
$82,959.70
|
|
|
Service Code
|
HCPCS 29888
|
| Hospital Charge Code |
16000193
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,443.95 |
| Max. Negotiated Rate |
$12,443.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12,443.95
|
|
|
ARTHROSC HIP W REM FB W SYNVCT
|
Facility
|
IP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29863
|
| Hospital Charge Code |
16000417
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,587.90 |
| Max. Negotiated Rate |
$7,587.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,587.90
|
|
|
ARTHROSC HIP W REM FB W SYNVCT
|
Facility
|
OP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29863
|
| Hospital Charge Code |
16000417
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,436.64 |
| Max. Negotiated Rate |
$14,869.00 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| 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 |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13,152.36
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,587.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,598.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,436.64
|
|
|
ARTHROSC,KNEE FR INF/LAVAGE/DR
|
Facility
|
IP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29871
|
| Hospital Charge Code |
16000730
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,840.57 |
| Max. Negotiated Rate |
$3,840.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
|
|
ARTHROSC,KNEE FR INF/LAVAGE/DR
|
Facility
|
OP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29871
|
| Hospital Charge Code |
16000730
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$727.15 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| 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 |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,656.99
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$809.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$727.15
|
|
|
ARTHROSC KNEE,LIM SYNOVECTMY
|
Facility
|
IP
|
$32,775.00
|
|
|
Service Code
|
HCPCS 29875
|
| Hospital Charge Code |
16000312
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,916.25 |
| Max. Negotiated Rate |
$4,916.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,916.25
|
|
|
ARTHROSC KNEE,LIM SYNOVECTMY
|
Facility
|
OP
|
$32,775.00
|
|
|
Service Code
|
HCPCS 29875
|
| Hospital Charge Code |
16000312
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$930.81 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| 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 |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,521.50
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,916.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,035.69
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$930.81
|
|
|
ARTHROSC,KNEE REM LOOSE OR FM
|
Facility
|
OP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29874
|
| Hospital Charge Code |
16000731
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$727.15 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| 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 |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,656.99
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$809.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$727.15
|
|
|
ARTHROSC,KNEE REM LOOSE OR FM
|
Facility
|
IP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29874
|
| Hospital Charge Code |
16000731
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,840.57 |
| Max. Negotiated Rate |
$3,840.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
|
|
ARTHROSC KNEE,W LYSIS OF ADHES
|
Facility
|
OP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29884
|
| Hospital Charge Code |
16000232
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$727.15 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| 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 |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,656.99
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$809.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$727.15
|
|
|
ARTHROSC KNEE,W LYSIS OF ADHES
|
Facility
|
IP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29884
|
| Hospital Charge Code |
16000232
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,840.57 |
| Max. Negotiated Rate |
$3,840.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,840.57
|
|
|
ARTHROSC KNEE W/MENISC MED/LAT
|
Facility
|
IP
|
$35,454.57
|
|
|
Service Code
|
HCPCS 29881
|
| Hospital Charge Code |
16000186
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,318.19 |
| Max. Negotiated Rate |
$5,318.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,318.19
|
|
|
ARTHROSC KNEE W/MENISC MED/LAT
|
Facility
|
OP
|
$35,454.57
|
|
|
Service Code
|
HCPCS 29881
|
| Hospital Charge Code |
16000186
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,006.91 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| 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 |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,218.19
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,318.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,120.36
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,006.91
|
|
|
ARTHROSC,KNEE,W MENISC-MED&LAT
|
Facility
|
OP
|
$35,454.57
|
|
|
Service Code
|
HCPCS 29880
|
| Hospital Charge Code |
16000178
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,006.91 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| 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 |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,218.19
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,318.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,120.36
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,006.91
|
|
|
ARTHROSC,KNEE,W MENISC-MED&LAT
|
Facility
|
IP
|
$35,454.57
|
|
|
Service Code
|
HCPCS 29880
|
| Hospital Charge Code |
16000178
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,318.19 |
| Max. Negotiated Rate |
$5,318.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,318.19
|
|
|
ARTHROSC,KNEE,W MEN REP-MED&LA
|
Facility
|
IP
|
$32,775.00
|
|
|
Service Code
|
HCPCS 29882
|
| Hospital Charge Code |
16000307
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,916.25 |
| Max. Negotiated Rate |
$4,916.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,916.25
|
|