|
ARTHROSCOPY,SHLDR W REM FB/LB
|
Facility
|
IP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29819
|
| Hospital Charge Code |
16000455
|
|
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
|
|
|
ARTHROSCOPY WST C SYNOVECTOMY
|
Facility
|
OP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29845
|
| Hospital Charge Code |
16000577
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$640.28 |
| 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: Wellcare New Jersey Medicaid/Family Care |
$653.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$640.28
|
|
|
ARTHROSCOPY WST C SYNOVECTOMY
|
Facility
|
IP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29845
|
| Hospital Charge Code |
16000577
|
|
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
|
|
|
ARTHROSCOPY WST EXC/REP CARTIL
|
Facility
|
OP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29846
|
| Hospital Charge Code |
16000366
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$649.28 |
| 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: Wellcare New Jersey Medicaid/Family Care |
$662.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$649.28
|
|
|
ARTHROSCOPY WST EXC/REP CARTIL
|
Facility
|
IP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29846
|
| Hospital Charge Code |
16000366
|
|
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
|
|
|
ARTHROSCOPY WST,INT FIX FX LT
|
Facility
|
IP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29847
|
| Hospital Charge Code |
16000919
|
|
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
|
|
|
ARTHROSCOPY WST,INT FIX FX LT
|
Facility
|
OP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29847
|
| Hospital Charge Code |
16000919
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,598.52 |
| 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 |
$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 |
$8,620.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$15,880.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15,569.19
|
|
|
ARTHROSCOPY WST P SYNOVECTOMY
|
Facility
|
IP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29844
|
| Hospital Charge Code |
16000918
|
|
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
|
|
|
ARTHROSCOPY WST P SYNOVECTOMY
|
Facility
|
OP
|
$25,603.80
|
|
|
Service Code
|
HCPCS 29844
|
| Hospital Charge Code |
16000918
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$809.08 |
| 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: Wellcare New Jersey Medicaid/Family Care |
$8,822.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8,649.28
|
|
|
ARTHROSCPY HIP REM LOOSE OR FB
|
Facility
|
OP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29861
|
| Hospital Charge Code |
16000920
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,436.64 |
| 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 |
$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 |
$8,620.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,436.64
|
|
|
ARTHROSCPY HIP REM LOOSE OR FB
|
Facility
|
IP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29861
|
| Hospital Charge Code |
16000920
|
|
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 RPIR O.D. LESION O FX
|
Facility
|
IP
|
$82,959.70
|
|
|
Service Code
|
HCPCS 29892
|
| Hospital Charge Code |
16000456
|
|
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 RPIR O.D. LESION O FX
|
Facility
|
OP
|
$82,959.70
|
|
|
Service Code
|
HCPCS 29892
|
| Hospital Charge Code |
16000456
|
|
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 |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12,443.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| 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,SHLDR DECOM SA SP WPA
|
Facility
|
OP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29826
|
| Hospital Charge Code |
16000191
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,436.64 |
| Max. Negotiated Rate |
$25,293.00 |
| Rate for Payer: Aetna Commercial |
$19,222.68
|
| Rate for Payer: Aetna Medicare Advantage |
$15,175.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,899.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,899.43
|
| 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 |
$12,899.43
|
| Rate for Payer: Cigna Commercial |
$25,293.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13,152.36
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,587.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,598.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,436.64
|
|
|
ARTHROSC,SHLDR DECOM SA SP WPA
|
Facility
|
IP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29826
|
| Hospital Charge Code |
16000191
|
|
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,SHLDR,W LYSIS OF ADH
|
Facility
|
IP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29825
|
| Hospital Charge Code |
16000231
|
|
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,SHLDR,W LYSIS OF ADH
|
Facility
|
OP
|
$50,586.00
|
|
|
Service Code
|
HCPCS 29825
|
| Hospital Charge Code |
16000231
|
|
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
|
|
|
ARTHROT KNEE W MENISC,MEDORLAT
|
Facility
|
OP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27332
|
| Hospital Charge Code |
16000879
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$868.90 |
| 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 |
$7,954.70
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$966.80
|
| 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 |
$868.90
|
|
|
ARTHROT KNEE W MENISC,MEDORLAT
|
Facility
|
IP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27332
|
| Hospital Charge Code |
16000879
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,589.25 |
| Max. Negotiated Rate |
$4,589.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
|
|
ARTHROT KNEE W SYNOV, ANT/POST
|
Facility
|
OP
|
$30,651.00
|
|
|
Service Code
|
HCPCS 27334
|
| Hospital Charge Code |
1600000707
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$870.49 |
| 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 |
$7,969.26
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,597.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$968.57
|
| 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 |
$870.49
|
|
|
ARTHROT KNEE W SYNOV, ANT/POST
|
Facility
|
IP
|
$30,651.00
|
|
|
Service Code
|
HCPCS 27334
|
| Hospital Charge Code |
1600000707
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,597.65 |
| Max. Negotiated Rate |
$4,597.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,597.65
|
|
|
ARTHROTOMY ANKLE W SYNOVECTOMY
|
Facility
|
IP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27625
|
| Hospital Charge Code |
16000710
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,589.25 |
| Max. Negotiated Rate |
$4,589.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
|
|
ARTHROTOMY ANKLE W SYNOVECTOMY
|
Facility
|
OP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27625
|
| Hospital Charge Code |
16000710
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$868.90 |
| 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 |
$7,954.70
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$966.80
|
| 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 |
$868.90
|
|
|
ARTHROTOMY,KNEE
|
Facility
|
OP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27331
|
| Hospital Charge Code |
16000878
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$868.90 |
| 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 |
$7,954.70
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$966.80
|
| 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 |
$868.90
|
|
|
ARTHROTOMY,KNEE
|
Facility
|
IP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27331
|
| Hospital Charge Code |
16000878
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,589.25 |
| Max. Negotiated Rate |
$4,589.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
|