|
OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES
|
Facility
|
IP
|
$34,605.35
|
|
|
Service Code
|
APR-DRG 0293
|
| Min. Negotiated Rate |
$33,926.81 |
| Max. Negotiated Rate |
$34,605.35 |
| Rate for Payer: UnitedHealthcare Community & State |
$33,926.81
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$34,605.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33,926.81
|
|
|
OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES
|
Facility
|
IP
|
$27,399.48
|
|
|
Service Code
|
APR-DRG 0291
|
| Min. Negotiated Rate |
$26,862.24 |
| Max. Negotiated Rate |
$27,399.48 |
| Rate for Payer: UnitedHealthcare Community & State |
$26,862.24
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27,399.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26,862.24
|
|
|
OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES
|
Facility
|
IP
|
$58,366.12
|
|
|
Service Code
|
APR-DRG 1824
|
| Min. Negotiated Rate |
$57,221.69 |
| Max. Negotiated Rate |
$58,366.12 |
| Rate for Payer: UnitedHealthcare Community & State |
$57,221.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$58,366.12
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$57,221.69
|
|
|
OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES
|
Facility
|
IP
|
$25,047.15
|
|
|
Service Code
|
APR-DRG 1821
|
| Min. Negotiated Rate |
$24,556.03 |
| Max. Negotiated Rate |
$25,047.15 |
| Rate for Payer: UnitedHealthcare Community & State |
$24,556.03
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$25,047.15
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$24,556.03
|
|
|
OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES
|
Facility
|
IP
|
$27,643.86
|
|
|
Service Code
|
APR-DRG 1822
|
| Min. Negotiated Rate |
$27,101.82 |
| Max. Negotiated Rate |
$27,643.86 |
| Rate for Payer: UnitedHealthcare Community & State |
$27,101.82
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$27,643.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$27,101.82
|
|
|
OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES
|
Facility
|
IP
|
$33,223.46
|
|
|
Service Code
|
APR-DRG 1823
|
| Min. Negotiated Rate |
$32,572.02 |
| Max. Negotiated Rate |
$33,223.46 |
| Rate for Payer: UnitedHealthcare Community & State |
$32,572.02
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$33,223.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32,572.02
|
|
|
OTHER PNEUMONIA
|
Facility
|
IP
|
$20,987.10
|
|
|
Service Code
|
APR-DRG 1394
|
| Min. Negotiated Rate |
$20,575.59 |
| Max. Negotiated Rate |
$20,987.10 |
| Rate for Payer: UnitedHealthcare Community & State |
$20,575.59
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$20,987.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20,575.59
|
|
|
OTHER PNEUMONIA
|
Facility
|
IP
|
$12,160.50
|
|
|
Service Code
|
APR-DRG 1393
|
| Min. Negotiated Rate |
$11,922.06 |
| Max. Negotiated Rate |
$12,160.50 |
| Rate for Payer: UnitedHealthcare Community & State |
$11,922.06
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$12,160.50
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11,922.06
|
|
|
OTHER PNEUMONIA
|
Facility
|
IP
|
$6,249.47
|
|
|
Service Code
|
APR-DRG 1391
|
| Min. Negotiated Rate |
$6,126.93 |
| Max. Negotiated Rate |
$6,249.47 |
| Rate for Payer: UnitedHealthcare Community & State |
$6,126.93
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$6,249.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6,126.93
|
|
|
OTHER PNEUMONIA
|
Facility
|
IP
|
$8,526.02
|
|
|
Service Code
|
APR-DRG 1392
|
| Min. Negotiated Rate |
$8,358.84 |
| Max. Negotiated Rate |
$8,526.02 |
| Rate for Payer: UnitedHealthcare Community & State |
$8,358.84
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$8,526.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8,358.84
|
|
|
OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS
|
Facility
|
IP
|
$17,470.47
|
|
|
Service Code
|
APR-DRG 4051
|
| Min. Negotiated Rate |
$17,127.91 |
| Max. Negotiated Rate |
$17,470.47 |
| Rate for Payer: UnitedHealthcare Community & State |
$17,127.91
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$17,470.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17,127.91
|
|
|
OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS
|
Facility
|
IP
|
$59,106.16
|
|
|
Service Code
|
APR-DRG 4054
|
| Min. Negotiated Rate |
$57,947.22 |
| Max. Negotiated Rate |
$59,106.16 |
| Rate for Payer: UnitedHealthcare Community & State |
$57,947.22
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$59,106.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$57,947.22
|
|
|
OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS
|
Facility
|
IP
|
$19,940.80
|
|
|
Service Code
|
APR-DRG 4052
|
| Min. Negotiated Rate |
$19,549.80 |
| Max. Negotiated Rate |
$19,940.80 |
| Rate for Payer: UnitedHealthcare Community & State |
$19,549.80
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$19,940.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19,549.80
|
|
|
OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS
|
Facility
|
IP
|
$30,097.30
|
|
|
Service Code
|
APR-DRG 4053
|
| Min. Negotiated Rate |
$29,507.16 |
| Max. Negotiated Rate |
$30,097.30 |
| Rate for Payer: UnitedHealthcare Community & State |
$29,507.16
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$30,097.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$29,507.16
|
|
|
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS
|
Facility
|
IP
|
$20,951.93
|
|
|
Service Code
|
APR-DRG 6512
|
| Min. Negotiated Rate |
$20,541.11 |
| Max. Negotiated Rate |
$20,951.93 |
| Rate for Payer: UnitedHealthcare Community & State |
$20,541.11
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$20,951.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20,541.11
|
|
|
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS
|
Facility
|
IP
|
$14,451.10
|
|
|
Service Code
|
APR-DRG 6511
|
| Min. Negotiated Rate |
$14,167.75 |
| Max. Negotiated Rate |
$14,451.10 |
| Rate for Payer: UnitedHealthcare Community & State |
$14,167.75
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$14,451.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14,167.75
|
|
|
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS
|
Facility
|
IP
|
$29,458.30
|
|
|
Service Code
|
APR-DRG 6513
|
| Min. Negotiated Rate |
$28,880.69 |
| Max. Negotiated Rate |
$29,458.30 |
| Rate for Payer: UnitedHealthcare Community & State |
$28,880.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$29,458.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28,880.69
|
|
|
OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS
|
Facility
|
IP
|
$58,616.02
|
|
|
Service Code
|
APR-DRG 6514
|
| Min. Negotiated Rate |
$57,466.69 |
| Max. Negotiated Rate |
$58,616.02 |
| Rate for Payer: UnitedHealthcare Community & State |
$57,466.69
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$58,616.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$57,466.69
|
|
|
OTHER PT CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8990GP
|
| Hospital Charge Code |
9109142
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$933.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
OTHER PT CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8990GP
|
| Hospital Charge Code |
9109142
|
|
Hospital Revenue Code
|
420
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
OTHER PT D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8992GP
|
| Hospital Charge Code |
9109144
|
|
Hospital Revenue Code
|
420
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
OTHER PT D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8992GP
|
| Hospital Charge Code |
9109144
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$933.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
OTHER PT GOAL STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS G8991GP
|
| Hospital Charge Code |
9109143
|
|
Hospital Revenue Code
|
420
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
|
|
OTHER PT GOAL STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8991GP
|
| Hospital Charge Code |
9109143
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$933.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|
|
OTHER PT/OT CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS G8990GP
|
| Hospital Charge Code |
84202060
|
|
Hospital Revenue Code
|
429
|
| Max. Negotiated Rate |
$1,060.00 |
| Rate for Payer: Aetna Commercial |
$0.00
|
| Rate for Payer: Aetna Medicare Advantage |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$69.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.00
|
| Rate for Payer: Cigna Commercial |
$0.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.00
|
| Rate for Payer: Oxford Commercial |
$933.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,060.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.00
|
|