|
OPIOIDS & OPIATE ANALOGS 3/4
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80363
|
| Hospital Charge Code |
38430032
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
OPIOIDS & OPIATE ANALOGS 3/4
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80363
|
| Hospital Charge Code |
39990232
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
OPIOIDS & OPIATE ANALOGS 3/4
|
Facility
|
IP
|
$190.45
|
|
|
Service Code
|
HCPCS 80363
|
| Hospital Charge Code |
3039032
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.57 |
| Max. Negotiated Rate |
$28.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.57
|
|
|
OPN BX/EXC LN,AXILLARY NODE
|
Facility
|
IP
|
$24,074.90
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
16000206
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,611.24 |
| Max. Negotiated Rate |
$3,611.24 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,611.24
|
|
|
OPN BX/EXC LN,AXILLARY NODE
|
Facility
|
OP
|
$24,074.90
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
16000206
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.73 |
| Max. Negotiated Rate |
$16,873.82 |
| Rate for Payer: Aetna Commercial |
$12,652.46
|
| Rate for Payer: Aetna Medicare Advantage |
$15,071.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,873.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,873.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,651.64
|
| 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 |
$16,873.82
|
| Rate for Payer: Cigna Commercial |
$9,324.19
|
| Rate for Payer: Cigna Medicare Advantage |
$4,651.64
|
| Rate for Payer: Clover Medicare Advantage |
$4,419.06
|
| Rate for Payer: EmblemHealth Commercial |
$13,954.92
|
| Rate for Payer: Humana Medicare Advantage |
$4,791.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,651.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,259.47
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,611.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$760.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,651.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,651.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$683.73
|
|
|
OPN BX/EXC LN,DEEPCERV NODE(S)
|
Facility
|
IP
|
$24,074.90
|
|
|
Service Code
|
HCPCS 38510
|
| Hospital Charge Code |
16000297
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,611.24 |
| Max. Negotiated Rate |
$3,611.24 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,611.24
|
|
|
OPN BX/EXC LN,DEEPCERV NODE(S)
|
Facility
|
OP
|
$24,074.90
|
|
|
Service Code
|
HCPCS 38510
|
| Hospital Charge Code |
16000297
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.73 |
| Max. Negotiated Rate |
$16,873.82 |
| Rate for Payer: Aetna Commercial |
$12,652.46
|
| Rate for Payer: Aetna Medicare Advantage |
$15,071.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,873.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,873.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,651.64
|
| 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 |
$16,873.82
|
| Rate for Payer: Cigna Commercial |
$9,324.19
|
| Rate for Payer: Cigna Medicare Advantage |
$4,651.64
|
| Rate for Payer: Clover Medicare Advantage |
$4,419.06
|
| Rate for Payer: EmblemHealth Commercial |
$13,954.92
|
| Rate for Payer: Humana Medicare Advantage |
$4,791.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,651.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,259.47
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,611.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$760.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,651.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,651.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$683.73
|
|
|
OPN RDL SHFT FX CLSD R/U JT
|
Facility
|
IP
|
$48,992.10
|
|
|
Service Code
|
HCPCS 25525
|
| Hospital Charge Code |
16000691
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,348.81 |
| Max. Negotiated Rate |
$7,348.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,348.81
|
|
|
OPN RDL SHFT FX CLSD R/U JT
|
Facility
|
OP
|
$48,992.10
|
|
|
Service Code
|
HCPCS 25525
|
| Hospital Charge Code |
16000691
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,391.38 |
| 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 |
$12,737.95
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,348.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,548.15
|
| 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 |
$1,391.38
|
|
|
OPN TX ACUTE SHOULDER DISLOCAT
|
Facility
|
OP
|
$48,992.10
|
|
|
Service Code
|
HCPCS 23660
|
| Hospital Charge Code |
16000818
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,391.38 |
| 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 |
$12,737.95
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,348.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,548.15
|
| 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 |
$1,391.38
|
|
|
OPN TX ACUTE SHOULDER DISLOCAT
|
Facility
|
IP
|
$48,992.10
|
|
|
Service Code
|
HCPCS 23660
|
| Hospital Charge Code |
16000818
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,348.81 |
| Max. Negotiated Rate |
$7,348.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,348.81
|
|
|
OPN TX ARTCL FRACT MCP/IP JNT
|
Facility
|
IP
|
$23,899.60
|
|
|
Service Code
|
HCPCS 26746
|
| Hospital Charge Code |
16000424
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,584.94 |
| Max. Negotiated Rate |
$3,584.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,584.94
|
|
|
OPN TX ARTCL FRACT MCP/IP JNT
|
Facility
|
OP
|
$23,899.60
|
|
|
Service Code
|
HCPCS 26746
|
| Hospital Charge Code |
16000424
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$678.75 |
| 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 |
$6,213.90
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,584.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$755.23
|
| 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 |
$678.75
|
|
|
OPN TX BIMALLEOLAR ANKLE FRACT
|
Facility
|
IP
|
$48,992.10
|
|
|
Service Code
|
HCPCS 27814
|
| Hospital Charge Code |
16000305
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,348.81 |
| Max. Negotiated Rate |
$7,348.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,348.81
|
|
|
OPN TX BIMALLEOLAR ANKLE FRACT
|
Facility
|
OP
|
$48,992.10
|
|
|
Service Code
|
HCPCS 27814
|
| Hospital Charge Code |
16000305
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,391.38 |
| 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 |
$12,737.95
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,348.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,548.15
|
| 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 |
$1,391.38
|
|
|
OPN TX CRPL BN FRACT O/T SCPD
|
Facility
|
OP
|
$22,174.50
|
|
|
Service Code
|
HCPCS 25645
|
| Hospital Charge Code |
16000619
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$629.76 |
| 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 |
$5,765.37
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,326.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$700.71
|
| 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 |
$629.76
|
|
|
OPN TX CRPL BN FRACT O/T SCPD
|
Facility
|
IP
|
$22,174.50
|
|
|
Service Code
|
HCPCS 25645
|
| Hospital Charge Code |
16000619
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,326.18 |
| Max. Negotiated Rate |
$3,326.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,326.18
|
|
|
OPN TXCRPL SCPD NAVICULAR FRAC
|
Facility
|
IP
|
$48,992.10
|
|
|
Service Code
|
HCPCS 25628
|
| Hospital Charge Code |
16000553
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,348.81 |
| Max. Negotiated Rate |
$7,348.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,348.81
|
|
|
OPN TXCRPL SCPD NAVICULAR FRAC
|
Facility
|
OP
|
$48,992.10
|
|
|
Service Code
|
HCPCS 25628
|
| Hospital Charge Code |
16000553
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,391.38 |
| 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 |
$12,737.95
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,348.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,548.15
|
| 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 |
$1,391.38
|
|
|
OPN TX DISTL PHLNG FRACT EA
|
Facility
|
OP
|
$25,094.58
|
|
|
Service Code
|
HCPCS 26765
|
| Hospital Charge Code |
1600000425
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$712.69 |
| 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 |
$6,524.59
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,764.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$792.99
|
| 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 |
$712.69
|
|
|
OPN TX DISTL PHLNG FRACT EA
|
Facility
|
IP
|
$25,094.58
|
|
|
Service Code
|
HCPCS 26765
|
| Hospital Charge Code |
1600000425
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,764.19 |
| Max. Negotiated Rate |
$3,764.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,764.19
|
|
|
OPN TX DSTL FBLR FX LAT MALS
|
Facility
|
OP
|
$48,992.10
|
|
|
Service Code
|
HCPCS 27792
|
| Hospital Charge Code |
16000221
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,548.15 |
| Max. Negotiated Rate |
$77,080.57 |
| 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 |
$12,737.95
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,348.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,548.15
|
| 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 |
$77,080.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$75,569.19
|
|
|
OPN TX DSTL FBLR FX LAT MALS
|
Facility
|
IP
|
$48,992.10
|
|
|
Service Code
|
HCPCS 27792
|
| Hospital Charge Code |
16000221
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,348.81 |
| Max. Negotiated Rate |
$7,348.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,348.81
|
|
|
OPN TX FMRL FRAC DSTL M/L CNDY
|
Facility
|
IP
|
$15,278.28
|
|
|
Service Code
|
HCPCS 27514
|
| Hospital Charge Code |
16000708
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,291.74 |
| Max. Negotiated Rate |
$2,291.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,291.74
|
|
|
OPN TX FMRL FRAC DSTL M/L CNDY
|
Facility
|
OP
|
$15,278.28
|
|
|
Service Code
|
HCPCS 27514
|
| Hospital Charge Code |
16000708
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$433.90 |
| 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 |
$3,972.35
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,291.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$482.79
|
| 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 |
$433.90
|
|