|
NASAL BONES MIN 3 VW
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 70160
|
| Hospital Charge Code |
94061007
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$27.23 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$281.22
|
| Rate for Payer: Aetna Medicare Advantage |
$334.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$103.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$375.05
|
| Rate for Payer: Cigna Commercial |
$207.24
|
| Rate for Payer: Cigna Medicare Advantage |
$72.37
|
| Rate for Payer: Clover Medicare Advantage |
$98.22
|
| Rate for Payer: EmblemHealth Commercial |
$310.17
|
| Rate for Payer: Humana Medicare Advantage |
$106.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$103.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$216.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
NASAL BONES MIN 3 VW
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 70160
|
| Hospital Charge Code |
94061007
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
NASAL ENDO ETHMODIDECT,PATAL
|
Facility
|
OP
|
$31,826.31
|
|
|
Service Code
|
HCPCS 31254
|
| Hospital Charge Code |
1600000610
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$903.87 |
| Max. Negotiated Rate |
$30,414.59 |
| Rate for Payer: Aetna Commercial |
$22,805.70
|
| Rate for Payer: Aetna Medicare Advantage |
$27,165.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30,414.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30,414.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,384.45
|
| 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 |
$30,414.59
|
| Rate for Payer: Cigna Commercial |
$16,806.60
|
| Rate for Payer: Cigna Medicare Advantage |
$8,384.45
|
| Rate for Payer: Clover Medicare Advantage |
$7,965.23
|
| Rate for Payer: EmblemHealth Commercial |
$25,153.35
|
| Rate for Payer: Humana Medicare Advantage |
$8,635.98
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,384.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,274.84
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,773.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,005.71
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,384.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,384.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$903.87
|
|
|
NASAL ENDO ETHMODIDECT,PATAL
|
Facility
|
IP
|
$31,826.31
|
|
|
Service Code
|
HCPCS 31254
|
| Hospital Charge Code |
1600000610
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,773.95 |
| Max. Negotiated Rate |
$4,773.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,773.95
|
|
|
NASAL ENDOSCOPY-DX
|
Facility
|
IP
|
$1,644.90
|
|
|
Service Code
|
HCPCS 31231
|
| Hospital Charge Code |
1600000347
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$246.74 |
| Max. Negotiated Rate |
$246.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$246.74
|
|
|
NASAL ENDOSCOPY-DX
|
Facility
|
OP
|
$1,644.90
|
|
|
Service Code
|
HCPCS 31231
|
| Hospital Charge Code |
1600000347
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$46.72 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$645.02
|
| Rate for Payer: Aetna Medicare Advantage |
$768.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$860.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$860.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$237.14
|
| 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 |
$860.23
|
| Rate for Payer: Cigna Commercial |
$475.34
|
| Rate for Payer: Cigna Medicare Advantage |
$237.14
|
| Rate for Payer: Clover Medicare Advantage |
$225.28
|
| Rate for Payer: EmblemHealth Commercial |
$711.42
|
| Rate for Payer: Humana Medicare Advantage |
$244.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$237.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$427.67
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$246.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$51.98
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$237.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$237.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$46.72
|
|
|
NASAL ENDO W BLD CNTRL
|
Facility
|
IP
|
$14,446.50
|
|
|
Service Code
|
HCPCS 31238
|
| Hospital Charge Code |
1600000319
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,166.97 |
| Max. Negotiated Rate |
$2,166.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,166.97
|
|
|
NASAL ENDO W BLD CNTRL
|
Facility
|
OP
|
$14,446.50
|
|
|
Service Code
|
HCPCS 31238
|
| Hospital Charge Code |
1600000319
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$410.28 |
| Max. Negotiated Rate |
$7,670.60 |
| Rate for Payer: Aetna Commercial |
$5,751.63
|
| Rate for Payer: Aetna Medicare Advantage |
$6,851.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,670.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,670.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,114.57
|
| 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 |
$7,670.60
|
| Rate for Payer: Cigna Commercial |
$4,238.63
|
| Rate for Payer: Cigna Medicare Advantage |
$2,114.57
|
| Rate for Payer: Clover Medicare Advantage |
$2,008.84
|
| Rate for Payer: EmblemHealth Commercial |
$6,343.71
|
| Rate for Payer: Humana Medicare Advantage |
$2,178.01
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,114.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,756.09
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,166.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$456.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,114.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,114.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$410.28
|
|
|
NASAL ENDO,W BX POLYPECT/DEBD
|
Facility
|
IP
|
$14,446.50
|
|
|
Service Code
|
HCPCS 31237
|
| Hospital Charge Code |
16000924
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,166.97 |
| Max. Negotiated Rate |
$2,166.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,166.97
|
|
|
NASAL ENDO,W BX POLYPECT/DEBD
|
Facility
|
OP
|
$14,446.50
|
|
|
Service Code
|
HCPCS 31237
|
| Hospital Charge Code |
16000924
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$410.28 |
| Max. Negotiated Rate |
$7,670.60 |
| Rate for Payer: Aetna Commercial |
$5,751.63
|
| Rate for Payer: Aetna Medicare Advantage |
$6,851.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,670.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,670.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,114.57
|
| 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 |
$7,670.60
|
| Rate for Payer: Cigna Commercial |
$4,238.63
|
| Rate for Payer: Cigna Medicare Advantage |
$2,114.57
|
| Rate for Payer: Clover Medicare Advantage |
$2,008.84
|
| Rate for Payer: EmblemHealth Commercial |
$6,343.71
|
| Rate for Payer: Humana Medicare Advantage |
$2,178.01
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,114.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,756.09
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,166.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$456.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,114.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,114.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$410.28
|
|
|
NASAL ENDO,W CONCHA BULLA RES
|
Facility
|
IP
|
$22,334.60
|
|
|
Service Code
|
HCPCS 31240
|
| Hospital Charge Code |
1600000708
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,350.19 |
| Max. Negotiated Rate |
$3,350.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,350.19
|
|
|
NASAL ENDO,W CONCHA BULLA RES
|
Facility
|
OP
|
$22,334.60
|
|
|
Service Code
|
HCPCS 31240
|
| Hospital Charge Code |
1600000708
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$634.30 |
| Max. Negotiated Rate |
$8,192.00 |
| Rate for Payer: Aetna Commercial |
$5,751.63
|
| Rate for Payer: Aetna Medicare Advantage |
$6,851.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,670.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,670.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,114.57
|
| 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 |
$7,670.60
|
| Rate for Payer: Cigna Commercial |
$4,238.63
|
| Rate for Payer: Cigna Medicare Advantage |
$2,114.57
|
| Rate for Payer: Clover Medicare Advantage |
$2,008.84
|
| Rate for Payer: EmblemHealth Commercial |
$6,343.71
|
| Rate for Payer: Humana Medicare Advantage |
$2,178.01
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,114.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,807.00
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,350.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$705.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,114.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,114.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$634.30
|
|
|
NASAL ENDOW ETHMOIDEC BL
|
Facility
|
OP
|
$36,247.00
|
|
|
Service Code
|
HCPCS 31255
|
| Hospital Charge Code |
1600000478
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,029.41 |
| Max. Negotiated Rate |
$30,414.59 |
| Rate for Payer: Aetna Commercial |
$22,805.70
|
| Rate for Payer: Aetna Medicare Advantage |
$27,165.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30,414.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30,414.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,384.45
|
| 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 |
$30,414.59
|
| Rate for Payer: Cigna Commercial |
$16,806.60
|
| Rate for Payer: Cigna Medicare Advantage |
$8,384.45
|
| Rate for Payer: Clover Medicare Advantage |
$7,965.23
|
| Rate for Payer: EmblemHealth Commercial |
$25,153.35
|
| Rate for Payer: Humana Medicare Advantage |
$8,635.98
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,384.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9,424.22
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,437.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,145.41
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,384.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,384.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,029.41
|
|
|
NASAL ENDOW ETHMOIDEC BL
|
Facility
|
IP
|
$36,247.00
|
|
|
Service Code
|
HCPCS 31255
|
| Hospital Charge Code |
1600000478
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,437.05 |
| Max. Negotiated Rate |
$5,437.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,437.05
|
|
|
NASAL ENDO W MAXILL ANTROSTMY
|
Facility
|
OP
|
$43,275.35
|
|
|
Service Code
|
HCPCS 31256
|
| Hospital Charge Code |
1600000312
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$855.69 |
| Max. Negotiated Rate |
$16,067.54 |
| Rate for Payer: Aetna Commercial |
$12,047.89
|
| Rate for Payer: Aetna Medicare Advantage |
$14,351.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,067.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,067.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,429.37
|
| 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 |
$16,067.54
|
| Rate for Payer: Cigna Commercial |
$8,878.66
|
| Rate for Payer: Cigna Medicare Advantage |
$4,429.37
|
| Rate for Payer: Clover Medicare Advantage |
$4,207.90
|
| Rate for Payer: EmblemHealth Commercial |
$13,288.11
|
| Rate for Payer: Humana Medicare Advantage |
$4,562.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,429.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,251.59
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,491.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,367.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,429.37
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,429.37
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$872.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$855.69
|
|
|
NASAL ENDO W MAXILL ANTROSTMY
|
Facility
|
IP
|
$43,275.35
|
|
|
Service Code
|
HCPCS 31256
|
| Hospital Charge Code |
1600000312
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,491.30 |
| Max. Negotiated Rate |
$6,491.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,491.30
|
|
|
NASAL END W MA,W RM TISS MS RT
|
Facility
|
IP
|
$28,850.55
|
|
|
Service Code
|
HCPCS 31267
|
| Hospital Charge Code |
1600000492
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,327.58 |
| Max. Negotiated Rate |
$4,327.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,327.58
|
|
|
NASAL END W MA,W RM TISS MS RT
|
Facility
|
OP
|
$28,850.55
|
|
|
Service Code
|
HCPCS 31267
|
| Hospital Charge Code |
1600000492
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$911.68 |
| Max. Negotiated Rate |
$30,414.59 |
| Rate for Payer: Aetna Commercial |
$22,805.70
|
| Rate for Payer: Aetna Medicare Advantage |
$27,165.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30,414.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30,414.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,384.45
|
| 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 |
$30,414.59
|
| Rate for Payer: Cigna Commercial |
$16,806.60
|
| Rate for Payer: Cigna Medicare Advantage |
$8,384.45
|
| Rate for Payer: Clover Medicare Advantage |
$7,965.23
|
| Rate for Payer: EmblemHealth Commercial |
$25,153.35
|
| Rate for Payer: Humana Medicare Advantage |
$8,635.98
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,384.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,501.14
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,327.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$911.68
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,384.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,384.45
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$14,355.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14,074.35
|
|
|
NASAL SEPTAL BUTTON 3.2CM
|
Facility
|
IP
|
$204.00
|
|
| Hospital Charge Code |
270335719
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.60 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.60
|
|
|
NASAL SEPTAL BUTTON 3.2CM
|
Facility
|
OP
|
$204.00
|
|
| Hospital Charge Code |
270335719
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Aetna Commercial |
$77.52
|
| Rate for Payer: Aetna Medicare Advantage |
$61.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.02
|
| Rate for Payer: Cigna Commercial |
$102.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.04
|
| Rate for Payer: Oxford Commercial |
$40.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$40.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.79
|
|
|
NASAL SEPTAL BUTTON 5.0CM
|
Facility
|
IP
|
$255.00
|
|
| Hospital Charge Code |
270335718
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$38.25 |
| Max. Negotiated Rate |
$38.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.25
|
|
|
NASAL SEPTAL BUTTON 5.0CM
|
Facility
|
OP
|
$255.00
|
|
| Hospital Charge Code |
270335718
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: Aetna Medicare Advantage |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$65.03
|
| Rate for Payer: Cigna Commercial |
$127.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.30
|
| Rate for Payer: Oxford Commercial |
$51.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$51.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.24
|
|
|
NASAL/SINUS ENDOSCOPY SURG
|
Facility
|
OP
|
$40,761.60
|
|
|
Service Code
|
HCPCS 31287
|
| Hospital Charge Code |
1600000722
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,157.63 |
| Max. Negotiated Rate |
$30,414.59 |
| Rate for Payer: Aetna Commercial |
$22,805.70
|
| Rate for Payer: Aetna Medicare Advantage |
$27,165.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30,414.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30,414.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,384.45
|
| 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 |
$30,414.59
|
| Rate for Payer: Cigna Commercial |
$16,806.60
|
| Rate for Payer: Cigna Medicare Advantage |
$8,384.45
|
| Rate for Payer: Clover Medicare Advantage |
$7,965.23
|
| Rate for Payer: EmblemHealth Commercial |
$25,153.35
|
| Rate for Payer: Humana Medicare Advantage |
$8,635.98
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,384.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10,598.02
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,114.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,288.07
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,384.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,384.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,157.63
|
|
|
NASAL/SINUS ENDOSCOPY SURG
|
Facility
|
OP
|
$13,338.00
|
|
|
Service Code
|
HCPCS 31291
|
| Hospital Charge Code |
1600000662
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$378.80 |
| Max. Negotiated Rate |
$10,269.00 |
| Rate for Payer: Aetna Commercial |
$5,068.44
|
| Rate for Payer: Aetna Medicare Advantage |
$4,001.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,401.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,401.19
|
| 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 |
$3,401.19
|
| Rate for Payer: Cigna Commercial |
$6,669.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,467.88
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,000.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$421.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$378.80
|
|
|
NASAL/SINUS ENDOSCOPY SURG
|
Facility
|
IP
|
$13,338.00
|
|
|
Service Code
|
HCPCS 31291
|
| Hospital Charge Code |
1600000662
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,000.70 |
| Max. Negotiated Rate |
$2,000.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,000.70
|
|
