|
RECOMBX 2 MATA AUTOANTIBODY
|
Facility
|
OP
|
$3,025.00
|
|
|
Service Code
|
HCPCS 83500
|
| Hospital Charge Code |
401083500
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.12 |
| Max. Negotiated Rate |
$1,512.50 |
| Rate for Payer: Aetna Commercial |
$61.61
|
| Rate for Payer: Aetna Medicare Advantage |
$73.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$82.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$82.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$22.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$82.16
|
| Rate for Payer: Cigna Commercial |
$1,512.50
|
| Rate for Payer: Cigna Medicare Advantage |
$22.65
|
| Rate for Payer: Clover Medicare Advantage |
$21.52
|
| Rate for Payer: EmblemHealth Commercial |
$67.95
|
| Rate for Payer: Humana Medicare Advantage |
$23.33
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$22.65
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$786.50
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$453.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.12
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$22.65
|
| Rate for Payer: Wellcare Medicare Advantage |
$22.65
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$85.91
|
|
|
RECOMBX AMPHIPHYSIN AUTO AB
|
Facility
|
OP
|
$1,925.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
401083520
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$962.50 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: Aetna Medicare Advantage |
$55.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.65
|
| Rate for Payer: Cigna Commercial |
$962.50
|
| Rate for Payer: Cigna Medicare Advantage |
$17.27
|
| Rate for Payer: Clover Medicare Advantage |
$16.41
|
| Rate for Payer: EmblemHealth Commercial |
$51.81
|
| Rate for Payer: Humana Medicare Advantage |
$17.79
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$500.50
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$288.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$54.67
|
|
|
RECOMBX AMPHIPHYSIN AUTO AB
|
Facility
|
IP
|
$1,925.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
401083520
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$288.75 |
| Max. Negotiated Rate |
$288.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$288.75
|
|
|
RECOMBX MA TA AUTOANTIBODY TES
|
Facility
|
OP
|
$925.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
401183520A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$462.50 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: Aetna Medicare Advantage |
$55.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.65
|
| Rate for Payer: Cigna Commercial |
$462.50
|
| Rate for Payer: Cigna Medicare Advantage |
$17.27
|
| Rate for Payer: Clover Medicare Advantage |
$16.41
|
| Rate for Payer: EmblemHealth Commercial |
$51.81
|
| Rate for Payer: Humana Medicare Advantage |
$17.79
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$240.50
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.27
|
|
|
RECOMBX MA TA AUTOANTIBODY TES
|
Facility
|
IP
|
$925.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
401183520A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$138.75 |
| Max. Negotiated Rate |
$138.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$138.75
|
|
|
RECONSTR ANGLE TOE DEFORMITY S
|
Facility
|
IP
|
$19,998.60
|
|
|
Service Code
|
HCPCS 28313
|
| Hospital Charge Code |
1600000633
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,999.79 |
| Max. Negotiated Rate |
$2,999.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.79
|
|
|
RECONSTR ANGLE TOE DEFORMITY S
|
Facility
|
OP
|
$19,998.60
|
|
|
Service Code
|
HCPCS 28313
|
| Hospital Charge Code |
1600000633
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$567.96 |
| 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 |
$5,199.64
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$631.96
|
| 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 |
$567.96
|
|
|
RECONSTR DISLOC PATELLA W MSCL
|
Facility
|
IP
|
$28,255.00
|
|
|
Service Code
|
HCPCS 27422
|
| Hospital Charge Code |
1600000465
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,238.25 |
| Max. Negotiated Rate |
$4,238.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,238.25
|
|
|
RECONSTR DISLOC PATELLA W MSCL
|
Facility
|
OP
|
$28,255.00
|
|
|
Service Code
|
HCPCS 27422
|
| Hospital Charge Code |
1600000465
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$802.44 |
| 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 |
$7,346.30
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,238.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$892.86
|
| 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 |
$802.44
|
|
|
RECONSTRICTION KNEE
|
Facility
|
IP
|
$22,425.68
|
|
|
Service Code
|
HCPCS 27427
|
| Hospital Charge Code |
16000563
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,363.85 |
| Max. Negotiated Rate |
$3,363.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,363.85
|
|
|
RECONSTRICTION KNEE
|
Facility
|
OP
|
$22,425.68
|
|
|
Service Code
|
HCPCS 27427
|
| Hospital Charge Code |
16000563
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$636.89 |
| 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 |
$5,830.68
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,363.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$708.65
|
| 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 |
$636.89
|
|
|
RECONSTR MCP JNT COLL LIGAM W
|
Facility
|
OP
|
$12,831.32
|
|
|
Service Code
|
HCPCS 26542
|
| Hospital Charge Code |
16000854
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$364.41 |
| 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 |
$3,336.14
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$405.47
|
| 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 |
$364.41
|
|
|
RECONSTR MCP JNT COLL LIGAM W
|
Facility
|
IP
|
$12,831.32
|
|
|
Service Code
|
HCPCS 26542
|
| Hospital Charge Code |
16000854
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,924.70 |
| Max. Negotiated Rate |
$1,924.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.70
|
|
|
RECONSTR QUAD/HAMSTRING MSCL R
|
Facility
|
OP
|
$28,042.44
|
|
|
Service Code
|
HCPCS 27386
|
| Hospital Charge Code |
16000883
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$796.41 |
| 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 |
$7,291.03
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,206.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$886.14
|
| 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 |
$796.41
|
|
|
RECONSTR QUAD/HAMSTRING MSCL R
|
Facility
|
IP
|
$28,042.44
|
|
|
Service Code
|
HCPCS 27386
|
| Hospital Charge Code |
16000883
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,206.37 |
| Max. Negotiated Rate |
$4,206.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,206.37
|
|
|
RECONSTR RC AVULSION CHRONIC
|
Facility
|
IP
|
$44,916.00
|
|
|
Service Code
|
HCPCS 23420
|
| Hospital Charge Code |
16000677
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,737.40 |
| Max. Negotiated Rate |
$6,737.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,737.40
|
|
|
RECONSTR RC AVULSION CHRONIC
|
Facility
|
OP
|
$44,916.00
|
|
|
Service Code
|
HCPCS 23420
|
| Hospital Charge Code |
16000677
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,275.61 |
| 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 |
$11,678.16
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,737.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,419.35
|
| 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 |
$1,275.61
|
|
|
RECONSTRUCTION KNEE
|
Facility
|
IP
|
$60,854.80
|
|
|
Service Code
|
HCPCS 27429
|
| Hospital Charge Code |
1600000884
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,128.22 |
| Max. Negotiated Rate |
$9,128.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,128.22
|
|
|
RECONSTRUCTION KNEE
|
Facility
|
OP
|
$60,854.80
|
|
|
Service Code
|
HCPCS 27429
|
| Hospital Charge Code |
1600000884
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,728.28 |
| 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 |
$15,822.25
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9,128.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,923.01
|
| 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 |
$1,728.28
|
|
|
RECONSTRUCT TOE(S), SYNDACTYLY
|
Facility
|
IP
|
$19,998.60
|
|
|
Service Code
|
HCPCS 28345
|
| Hospital Charge Code |
16000911
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,999.79 |
| Max. Negotiated Rate |
$2,999.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.79
|
|
|
RECONSTRUCT TOE(S), SYNDACTYLY
|
Facility
|
OP
|
$19,998.60
|
|
|
Service Code
|
HCPCS 28345
|
| Hospital Charge Code |
16000911
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$567.96 |
| Max. Negotiated Rate |
$8,192.00 |
| Rate for Payer: Aetna Commercial |
$5,196.12
|
| Rate for Payer: Aetna Medicare Advantage |
$6,189.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,910.34
|
| 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 |
$6,929.76
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: Cigna Medicare Advantage |
$1,910.34
|
| Rate for Payer: Clover Medicare Advantage |
$1,814.82
|
| Rate for Payer: EmblemHealth Commercial |
$5,731.02
|
| Rate for Payer: Humana Medicare Advantage |
$1,967.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,910.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,199.64
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$631.96
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$567.96
|
|
|
Reconstruct ulna/radioulnar
|
Facility
|
OP
|
$33,092.48
|
|
|
Service Code
|
HCPCS 25337
|
| Hospital Charge Code |
16000835
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$939.83 |
| 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 |
$8,604.04
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,963.87
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,045.72
|
| 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 |
$939.83
|
|
|
Reconstruct ulna/radioulnar
|
Facility
|
IP
|
$33,092.48
|
|
|
Service Code
|
HCPCS 25337
|
| Hospital Charge Code |
16000835
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,963.87 |
| Max. Negotiated Rate |
$4,963.87 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,963.87
|
|
|
RECONSTRUCT VENA CAVA
|
Facility
|
IP
|
$16,048.50
|
|
|
Service Code
|
HCPCS 34502
|
| Hospital Charge Code |
1600000688
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,407.28 |
| Max. Negotiated Rate |
$2,407.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,407.28
|
|
|
RECONSTRUCT VENA CAVA
|
Facility
|
OP
|
$16,048.50
|
|
|
Service Code
|
HCPCS 34502
|
| Hospital Charge Code |
1600000688
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$455.78 |
| Max. Negotiated Rate |
$10,269.00 |
| Rate for Payer: Aetna Commercial |
$6,098.43
|
| Rate for Payer: Aetna Medicare Advantage |
$4,814.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,092.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,092.37
|
| 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 |
$4,092.37
|
| Rate for Payer: Cigna Commercial |
$8,024.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,172.61
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,407.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$507.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$455.78
|
|
