|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$131,820.81
|
|
|
Service Code
|
MSDRG 271
|
| Min. Negotiated Rate |
$40,137.75 |
| Max. Negotiated Rate |
$131,820.81 |
| Rate for Payer: Aetna Commercial |
$95,742.81
|
| Rate for Payer: Aetna Medicare Advantage |
$131,820.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$95,859.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$95,859.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$42,250.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$95,859.30
|
| Rate for Payer: Cigna Commercial |
$79,280.60
|
| Rate for Payer: Cigna Medicare Advantage |
$42,250.26
|
| Rate for Payer: Clover Medicare Advantage |
$40,137.75
|
| Rate for Payer: EmblemHealth Commercial |
$126,750.78
|
| Rate for Payer: Humana Medicare Advantage |
$43,517.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$42,250.26
|
| Rate for Payer: Oxford Commercial |
$62,662.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$83,875.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$42,250.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$42,250.26
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$186,161.76
|
|
|
Service Code
|
MSDRG 270
|
| Min. Negotiated Rate |
$56,683.87 |
| Max. Negotiated Rate |
$186,161.76 |
| Rate for Payer: Aetna Commercial |
$134,445.05
|
| Rate for Payer: Aetna Medicare Advantage |
$186,161.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$140,187.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$140,187.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$59,667.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140,187.30
|
| Rate for Payer: Cigna Commercial |
$117,624.56
|
| Rate for Payer: Cigna Medicare Advantage |
$59,667.23
|
| Rate for Payer: Clover Medicare Advantage |
$56,683.87
|
| Rate for Payer: EmblemHealth Commercial |
$179,001.69
|
| Rate for Payer: Humana Medicare Advantage |
$61,457.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$59,667.23
|
| Rate for Payer: Oxford Commercial |
$92,968.41
|
| Rate for Payer: UnitedHealthcare Commercial |
$124,441.54
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$59,667.23
|
| Rate for Payer: Wellcare Medicare Advantage |
$59,667.23
|
|
|
OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$100,123.02
|
|
|
Service Code
|
MSDRG 272
|
| Min. Negotiated Rate |
$30,486.17 |
| Max. Negotiated Rate |
$100,123.02 |
| Rate for Payer: Aetna Commercial |
$73,167.27
|
| Rate for Payer: Aetna Medicare Advantage |
$100,123.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67,600.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67,600.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$32,090.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67,600.20
|
| Rate for Payer: Cigna Commercial |
$56,914.03
|
| Rate for Payer: Cigna Medicare Advantage |
$32,090.71
|
| Rate for Payer: Clover Medicare Advantage |
$30,486.17
|
| Rate for Payer: EmblemHealth Commercial |
$96,272.13
|
| Rate for Payer: Humana Medicare Advantage |
$33,053.43
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$32,090.71
|
| Rate for Payer: Oxford Commercial |
$44,983.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$60,212.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$32,090.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$32,090.71
|
|
|
OTHER MAJOR HEAD AND NECK PROCEDURES
|
Facility
|
IP
|
$87,984.50
|
|
|
Service Code
|
APR-DRG 0914
|
| Min. Negotiated Rate |
$86,259.31 |
| Max. Negotiated Rate |
$87,984.50 |
| Rate for Payer: UnitedHealthcare Community & State |
$86,259.31
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$87,984.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$86,259.31
|
|
|
OTHER MAJOR HEAD AND NECK PROCEDURES
|
Facility
|
IP
|
$54,876.20
|
|
|
Service Code
|
APR-DRG 0913
|
| Min. Negotiated Rate |
$53,800.20 |
| Max. Negotiated Rate |
$54,876.20 |
| Rate for Payer: UnitedHealthcare Community & State |
$53,800.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$54,876.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$53,800.20
|
|
|
OTHER MAJOR HEAD AND NECK PROCEDURES
|
Facility
|
IP
|
$20,730.05
|
|
|
Service Code
|
APR-DRG 0911
|
| Min. Negotiated Rate |
$20,323.58 |
| Max. Negotiated Rate |
$20,730.05 |
| Rate for Payer: UnitedHealthcare Community & State |
$20,323.58
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$20,730.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20,323.58
|
|
|
OTHER MAJOR HEAD AND NECK PROCEDURES
|
Facility
|
IP
|
$30,435.73
|
|
|
Service Code
|
APR-DRG 0912
|
| Min. Negotiated Rate |
$29,838.95 |
| Max. Negotiated Rate |
$30,435.73 |
| Rate for Payer: UnitedHealthcare Community & State |
$29,838.95
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$30,435.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29,838.95
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$15,790.84
|
|
|
Service Code
|
APR-DRG 4841
|
| Min. Negotiated Rate |
$15,481.22 |
| Max. Negotiated Rate |
$15,790.84 |
| Rate for Payer: UnitedHealthcare Community & State |
$15,481.22
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$15,790.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15,481.22
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$51,564.64
|
|
|
Service Code
|
APR-DRG 4844
|
| Min. Negotiated Rate |
$50,553.57 |
| Max. Negotiated Rate |
$51,564.64 |
| Rate for Payer: UnitedHealthcare Community & State |
$50,553.57
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$51,564.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$50,553.57
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$23,144.19
|
|
|
Service Code
|
APR-DRG 4843
|
| Min. Negotiated Rate |
$22,690.38 |
| Max. Negotiated Rate |
$23,144.19 |
| Rate for Payer: UnitedHealthcare Community & State |
$22,690.38
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$23,144.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22,690.38
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES
|
Facility
|
IP
|
$19,186.63
|
|
|
Service Code
|
APR-DRG 4842
|
| Min. Negotiated Rate |
$18,810.42 |
| Max. Negotiated Rate |
$19,186.63 |
| Rate for Payer: UnitedHealthcare Community & State |
$18,810.42
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$19,186.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18,810.42
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC
|
Facility
|
IP
|
$52,912.77
|
|
|
Service Code
|
MSDRG 729
|
| Min. Negotiated Rate |
$16,111.26 |
| Max. Negotiated Rate |
$52,912.77 |
| Rate for Payer: Aetna Commercial |
$39,543.56
|
| Rate for Payer: Aetna Medicare Advantage |
$52,912.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27,705.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27,705.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16,959.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27,705.00
|
| Rate for Payer: Cigna Commercial |
$23,601.60
|
| Rate for Payer: Cigna Medicare Advantage |
$16,959.22
|
| Rate for Payer: Clover Medicare Advantage |
$16,111.26
|
| Rate for Payer: EmblemHealth Commercial |
$50,877.66
|
| Rate for Payer: Humana Medicare Advantage |
$17,468.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16,959.22
|
| Rate for Payer: Oxford Commercial |
$18,654.29
|
| Rate for Payer: UnitedHealthcare Commercial |
$24,969.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16,959.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$16,959.22
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC
|
Facility
|
IP
|
$40,695.53
|
|
|
Service Code
|
MSDRG 730
|
| Min. Negotiated Rate |
$11,840.64 |
| Max. Negotiated Rate |
$40,695.53 |
| Rate for Payer: Aetna Commercial |
$30,842.31
|
| Rate for Payer: Aetna Medicare Advantage |
$40,695.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17,177.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17,177.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,043.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17,177.10
|
| Rate for Payer: Cigna Commercial |
$14,980.90
|
| Rate for Payer: Cigna Medicare Advantage |
$13,043.44
|
| Rate for Payer: Clover Medicare Advantage |
$12,391.27
|
| Rate for Payer: EmblemHealth Commercial |
$39,130.32
|
| Rate for Payer: Humana Medicare Advantage |
$13,434.74
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,043.44
|
| Rate for Payer: Oxford Commercial |
$11,840.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$15,849.12
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,043.44
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,043.44
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$79,192.31
|
|
|
Service Code
|
MSDRG 717
|
| Min. Negotiated Rate |
$24,113.04 |
| Max. Negotiated Rate |
$79,192.31 |
| Rate for Payer: Aetna Commercial |
$58,260.18
|
| Rate for Payer: Aetna Medicare Advantage |
$79,192.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50,146.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50,146.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$25,382.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50,146.05
|
| Rate for Payer: Cigna Commercial |
$42,144.92
|
| Rate for Payer: Cigna Medicare Advantage |
$25,382.15
|
| Rate for Payer: Clover Medicare Advantage |
$24,113.04
|
| Rate for Payer: EmblemHealth Commercial |
$76,146.45
|
| Rate for Payer: Humana Medicare Advantage |
$26,143.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$25,382.15
|
| Rate for Payer: Oxford Commercial |
$33,310.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$44,587.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$25,382.15
|
| Rate for Payer: Wellcare Medicare Advantage |
$25,382.15
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$61,897.99
|
|
|
Service Code
|
MSDRG 718
|
| Min. Negotiated Rate |
$18,847.15 |
| Max. Negotiated Rate |
$61,897.99 |
| Rate for Payer: Aetna Commercial |
$45,942.98
|
| Rate for Payer: Aetna Medicare Advantage |
$61,897.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32,691.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32,691.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$19,839.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32,691.90
|
| Rate for Payer: Cigna Commercial |
$29,941.73
|
| Rate for Payer: Cigna Medicare Advantage |
$19,839.10
|
| Rate for Payer: Clover Medicare Advantage |
$18,847.15
|
| Rate for Payer: EmblemHealth Commercial |
$59,517.30
|
| Rate for Payer: Humana Medicare Advantage |
$20,434.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$19,839.10
|
| Rate for Payer: Oxford Commercial |
$23,665.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$31,677.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$19,839.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$19,839.10
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC
|
Facility
|
IP
|
$90,148.94
|
|
|
Service Code
|
MSDRG 715
|
| Min. Negotiated Rate |
$27,449.20 |
| Max. Negotiated Rate |
$90,148.94 |
| Rate for Payer: Aetna Commercial |
$66,063.61
|
| Rate for Payer: Aetna Medicare Advantage |
$90,148.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61,228.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61,228.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$28,893.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61,228.05
|
| Rate for Payer: Cigna Commercial |
$49,876.13
|
| Rate for Payer: Cigna Medicare Advantage |
$28,893.89
|
| Rate for Payer: Clover Medicare Advantage |
$27,449.20
|
| Rate for Payer: EmblemHealth Commercial |
$86,681.67
|
| Rate for Payer: Humana Medicare Advantage |
$29,760.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$28,893.89
|
| Rate for Payer: Oxford Commercial |
$39,421.23
|
| Rate for Payer: UnitedHealthcare Commercial |
$52,766.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$28,893.89
|
| Rate for Payer: Wellcare Medicare Advantage |
$28,893.89
|
|
|
OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$65,938.77
|
|
|
Service Code
|
MSDRG 716
|
| Min. Negotiated Rate |
$20,077.51 |
| Max. Negotiated Rate |
$65,938.77 |
| Rate for Payer: Aetna Commercial |
$48,820.84
|
| Rate for Payer: Aetna Medicare Advantage |
$65,938.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39,341.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39,341.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,134.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39,341.10
|
| Rate for Payer: Cigna Commercial |
$32,793.00
|
| Rate for Payer: Cigna Medicare Advantage |
$21,134.22
|
| Rate for Payer: Clover Medicare Advantage |
$20,077.51
|
| Rate for Payer: EmblemHealth Commercial |
$63,402.66
|
| Rate for Payer: Humana Medicare Advantage |
$21,768.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,134.22
|
| Rate for Payer: Oxford Commercial |
$25,919.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$34,693.54
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,134.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,134.22
|
|
|
OTHER MENTAL DISORDER DIAGNOSES
|
Facility
|
IP
|
$53,298.21
|
|
|
Service Code
|
MSDRG 887
|
| Min. Negotiated Rate |
$7,161.00 |
| Max. Negotiated Rate |
$53,298.21 |
| Rate for Payer: Aetna Commercial |
$39,818.09
|
| Rate for Payer: Aetna Medicare Advantage |
$53,298.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36,016.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,756.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36,016.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,161.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,082.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,756.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36,016.50
|
| Rate for Payer: Cigna Commercial |
$23,873.57
|
| Rate for Payer: Cigna Medicare Advantage |
$17,082.76
|
| Rate for Payer: Clover Medicare Advantage |
$16,228.62
|
| Rate for Payer: EmblemHealth Commercial |
$51,248.28
|
| Rate for Payer: Humana Medicare Advantage |
$17,595.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,082.76
|
| Rate for Payer: Oxford Commercial |
$18,869.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$25,257.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,082.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,082.76
|
|
|
OTHER MENTAL HEALTH CONDITIONS AND DISORDERS
|
Facility
|
IP
|
$6,079.56
|
|
|
Service Code
|
APR-DRG 7601
|
| Min. Negotiated Rate |
$5,960.35 |
| Max. Negotiated Rate |
$6,079.56 |
| Rate for Payer: UnitedHealthcare Community & State |
$5,960.35
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$6,079.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5,960.35
|
|
|
OTHER MENTAL HEALTH CONDITIONS AND DISORDERS
|
Facility
|
IP
|
$12,601.51
|
|
|
Service Code
|
APR-DRG 7603
|
| Min. Negotiated Rate |
$12,354.42 |
| Max. Negotiated Rate |
$12,601.51 |
| Rate for Payer: UnitedHealthcare Community & State |
$12,354.42
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$12,601.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12,354.42
|
|
|
OTHER MENTAL HEALTH CONDITIONS AND DISORDERS
|
Facility
|
IP
|
$8,603.25
|
|
|
Service Code
|
APR-DRG 7602
|
| Min. Negotiated Rate |
$8,434.56 |
| Max. Negotiated Rate |
$8,603.25 |
| Rate for Payer: UnitedHealthcare Community & State |
$8,434.56
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$8,603.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8,434.56
|
|
|
OTHER MENTAL HEALTH CONDITIONS AND DISORDERS
|
Facility
|
IP
|
$23,548.65
|
|
|
Service Code
|
APR-DRG 7604
|
| Min. Negotiated Rate |
$23,086.91 |
| Max. Negotiated Rate |
$23,548.65 |
| Rate for Payer: UnitedHealthcare Community & State |
$23,086.91
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$23,548.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23,086.91
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC
|
Facility
|
IP
|
$67,884.93
|
|
|
Service Code
|
MSDRG 964
|
| Min. Negotiated Rate |
$20,670.09 |
| Max. Negotiated Rate |
$67,884.93 |
| Rate for Payer: Aetna Commercial |
$50,206.94
|
| Rate for Payer: Aetna Medicare Advantage |
$67,884.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41,557.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41,557.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21,757.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41,557.50
|
| Rate for Payer: Cigna Commercial |
$34,166.25
|
| Rate for Payer: Cigna Medicare Advantage |
$21,757.99
|
| Rate for Payer: Clover Medicare Advantage |
$20,670.09
|
| Rate for Payer: EmblemHealth Commercial |
$65,273.97
|
| Rate for Payer: Humana Medicare Advantage |
$22,410.73
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21,757.99
|
| Rate for Payer: Oxford Commercial |
$27,004.41
|
| Rate for Payer: UnitedHealthcare Commercial |
$36,146.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21,757.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$21,757.99
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC
|
Facility
|
IP
|
$105,835.14
|
|
|
Service Code
|
MSDRG 963
|
| Min. Negotiated Rate |
$32,225.44 |
| Max. Negotiated Rate |
$105,835.14 |
| Rate for Payer: Aetna Commercial |
$77,235.51
|
| Rate for Payer: Aetna Medicare Advantage |
$105,835.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75,634.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75,634.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$33,921.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75,634.65
|
| Rate for Payer: Cigna Commercial |
$60,944.60
|
| Rate for Payer: Cigna Medicare Advantage |
$33,921.52
|
| Rate for Payer: Clover Medicare Advantage |
$32,225.44
|
| Rate for Payer: EmblemHealth Commercial |
$101,764.56
|
| Rate for Payer: Humana Medicare Advantage |
$34,939.17
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$33,921.52
|
| Rate for Payer: Oxford Commercial |
$48,169.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$64,476.67
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$33,921.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$33,921.52
|
|
|
OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$49,178.38
|
|
|
Service Code
|
MSDRG 965
|
| Min. Negotiated Rate |
$14,974.18 |
| Max. Negotiated Rate |
$49,178.38 |
| Rate for Payer: Aetna Commercial |
$36,883.93
|
| Rate for Payer: Aetna Medicare Advantage |
$49,178.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26,596.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26,596.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15,762.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26,596.80
|
| Rate for Payer: Cigna Commercial |
$20,966.57
|
| Rate for Payer: Cigna Medicare Advantage |
$15,762.30
|
| Rate for Payer: Clover Medicare Advantage |
$14,974.18
|
| Rate for Payer: EmblemHealth Commercial |
$47,286.90
|
| Rate for Payer: Humana Medicare Advantage |
$16,235.17
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15,762.30
|
| Rate for Payer: Oxford Commercial |
$16,571.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$22,181.69
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15,762.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$15,762.30
|
|
