|
REMOVAL FB DEEP/COMP
|
Facility
|
IP
|
$13,630.25
|
|
|
Service Code
|
HCPCS 20525
|
| Hospital Charge Code |
412320525
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,044.54 |
| Max. Negotiated Rate |
$2,044.54 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,044.54
|
|
|
REMOVAL FB DEEP/COMP
|
Facility
|
OP
|
$13,630.25
|
|
|
Service Code
|
HCPCS 20525
|
| Hospital Charge Code |
412320525
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$387.10 |
| Max. Negotiated Rate |
$12,518.07 |
| Rate for Payer: Aetna Commercial |
$9,386.39
|
| Rate for Payer: Aetna Medicare Advantage |
$11,180.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,450.88
|
| 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 |
$12,518.07
|
| Rate for Payer: Cigna Commercial |
$6,917.28
|
| Rate for Payer: Cigna Medicare Advantage |
$3,450.88
|
| Rate for Payer: Clover Medicare Advantage |
$3,278.34
|
| Rate for Payer: EmblemHealth Commercial |
$10,352.64
|
| Rate for Payer: Humana Medicare Advantage |
$3,554.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,450.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,543.86
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,044.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$430.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$387.10
|
|
|
REMOVAL FB SIMPLE
|
Facility
|
IP
|
$7,903.25
|
|
|
Service Code
|
HCPCS 20520
|
| Hospital Charge Code |
412320520
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,185.49 |
| Max. Negotiated Rate |
$1,185.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,185.49
|
|
|
REMOVAL FB SIMPLE
|
Facility
|
OP
|
$7,903.25
|
|
|
Service Code
|
HCPCS 20520
|
| Hospital Charge Code |
412320520
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$224.45 |
| Max. Negotiated Rate |
$7,117.66 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| 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 |
$7,117.66
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,054.84
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,185.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$249.74
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$224.45
|
|
|
REMOVAL FOREIGN BODY MUSCLE,SM
|
Facility
|
IP
|
$6,322.68
|
|
|
Service Code
|
HCPCS 20520
|
| Hospital Charge Code |
16000792
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$948.40 |
| Max. Negotiated Rate |
$948.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$948.40
|
|
|
REMOVAL FOREIGN BODY MUSCLE,SM
|
Facility
|
OP
|
$6,322.68
|
|
|
Service Code
|
HCPCS 20520
|
| Hospital Charge Code |
16000792
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$179.56 |
| Max. Negotiated Rate |
$7,117.66 |
| Rate for Payer: Aetna Commercial |
$5,337.02
|
| Rate for Payer: Aetna Medicare Advantage |
$6,357.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,117.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,962.14
|
| 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 |
$7,117.66
|
| Rate for Payer: Cigna Commercial |
$3,933.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,962.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,864.03
|
| Rate for Payer: EmblemHealth Commercial |
$5,886.42
|
| Rate for Payer: Humana Medicare Advantage |
$2,021.00
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,962.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,643.90
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$948.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$199.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,962.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$179.56
|
|
|
REMOVAL FOREIGN BODY-VAGINA
|
Facility
|
IP
|
$8,455.00
|
|
|
Service Code
|
HCPCS 57415
|
| Hospital Charge Code |
5770010
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,268.25 |
| Max. Negotiated Rate |
$1,268.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,268.25
|
|
|
REMOVAL FOREIGN BODY-VAGINA
|
Facility
|
OP
|
$8,455.00
|
|
|
Service Code
|
HCPCS 57415
|
| Hospital Charge Code |
5770010
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$13,950.60 |
| Rate for Payer: Aetna Commercial |
$10,460.55
|
| Rate for Payer: Aetna Medicare Advantage |
$12,460.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,950.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,950.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,845.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,950.60
|
| Rate for Payer: Cigna Commercial |
$7,708.87
|
| Rate for Payer: Cigna Medicare Advantage |
$3,845.79
|
| Rate for Payer: Clover Medicare Advantage |
$3,653.50
|
| Rate for Payer: EmblemHealth Commercial |
$11,537.37
|
| Rate for Payer: Humana Medicare Advantage |
$3,961.16
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,845.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,198.30
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,268.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,845.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,845.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$240.12
|
|
|
REMOVAL IUD
|
Facility
|
IP
|
$669.00
|
|
|
Service Code
|
HCPCS 58301
|
| Hospital Charge Code |
5770035
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$100.35 |
| Max. Negotiated Rate |
$100.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.35
|
|
|
REMOVAL IUD
|
Facility
|
OP
|
$669.00
|
|
|
Service Code
|
HCPCS 58301
|
| Hospital Charge Code |
5770035
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$1,313.26 |
| Rate for Payer: Aetna Commercial |
$984.72
|
| Rate for Payer: Aetna Medicare Advantage |
$1,172.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,313.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,313.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$362.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,313.26
|
| Rate for Payer: Cigna Commercial |
$725.69
|
| Rate for Payer: Cigna Medicare Advantage |
$362.03
|
| Rate for Payer: Clover Medicare Advantage |
$343.93
|
| Rate for Payer: EmblemHealth Commercial |
$1,086.09
|
| Rate for Payer: Humana Medicare Advantage |
$372.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$362.03
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$173.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.35
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$362.03
|
| Rate for Payer: Wellcare Medicare Advantage |
$362.03
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.00
|
|
|
REMOVAL KIDNEY OPEN RADICAL
|
Facility
|
IP
|
$27,043.80
|
|
|
Service Code
|
HCPCS 50230
|
| Hospital Charge Code |
1600000686
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,056.57 |
| Max. Negotiated Rate |
$4,056.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,056.57
|
|
|
REMOVAL KIDNEY OPEN RADICAL
|
Facility
|
OP
|
$27,043.80
|
|
|
Service Code
|
HCPCS 50230
|
| Hospital Charge Code |
1600000686
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$768.04 |
| Max. Negotiated Rate |
$13,521.90 |
| Rate for Payer: Aetna Commercial |
$10,276.64
|
| Rate for Payer: Aetna Medicare Advantage |
$8,113.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,896.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,896.17
|
| 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 |
$6,896.17
|
| Rate for Payer: Cigna Commercial |
$13,521.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7,031.39
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,056.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$854.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$768.04
|
|
|
REMOVAL NONBIODEG RX DELIV IMP
|
Facility
|
IP
|
$2,130.55
|
|
|
Service Code
|
HCPCS 11982
|
| Hospital Charge Code |
412311982
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$319.58 |
| Max. Negotiated Rate |
$319.58 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$319.58
|
|
|
REMOVAL NONBIODEG RX DELIV IMP
|
Facility
|
OP
|
$2,130.55
|
|
|
Service Code
|
HCPCS 11982
|
| Hospital Charge Code |
412311982
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$60.51 |
| Max. Negotiated Rate |
$1,925.19 |
| Rate for Payer: Aetna Commercial |
$1,443.56
|
| Rate for Payer: Aetna Medicare Advantage |
$1,719.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,925.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,925.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$530.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$110.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,925.19
|
| Rate for Payer: Cigna Commercial |
$1,063.82
|
| Rate for Payer: Cigna Medicare Advantage |
$530.72
|
| Rate for Payer: Clover Medicare Advantage |
$504.18
|
| Rate for Payer: EmblemHealth Commercial |
$1,592.16
|
| Rate for Payer: Humana Medicare Advantage |
$546.64
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$530.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$553.94
|
| Rate for Payer: Oxford Commercial |
$426.11
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$319.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$426.11
|
| Rate for Payer: UnitedHealthcare Community & State |
$67.33
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$530.72
|
| Rate for Payer: Wellcare Medicare Advantage |
$530.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$60.51
|
|
|
REMOVAL OF ADENOIDS 1< 12YRS
|
Facility
|
IP
|
$42,339.20
|
|
|
Service Code
|
HCPCS 42830
|
| Hospital Charge Code |
1600000385
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,350.88 |
| Max. Negotiated Rate |
$6,350.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,350.88
|
|
|
REMOVAL OF ADENOIDS 1< 12YRS
|
Facility
|
OP
|
$42,339.20
|
|
|
Service Code
|
HCPCS 42830
|
| Hospital Charge Code |
1600000385
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,202.43 |
| Max. Negotiated Rate |
$14,288.18 |
| Rate for Payer: Aetna Commercial |
$10,713.67
|
| Rate for Payer: Aetna Medicare Advantage |
$12,761.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,288.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,288.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,938.85
|
| 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 |
$14,288.18
|
| Rate for Payer: Cigna Commercial |
$7,895.42
|
| Rate for Payer: Cigna Medicare Advantage |
$3,938.85
|
| Rate for Payer: Clover Medicare Advantage |
$3,741.91
|
| Rate for Payer: EmblemHealth Commercial |
$11,816.55
|
| Rate for Payer: Humana Medicare Advantage |
$4,057.02
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,938.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,008.19
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,350.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,337.92
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,938.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,938.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,202.43
|
|
|
REMOVAL OF ANAL TAGS
|
Facility
|
IP
|
$16,487.80
|
|
|
Service Code
|
HCPCS 46230
|
| Hospital Charge Code |
1600000851
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,473.17 |
| Max. Negotiated Rate |
$2,473.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,473.17
|
|
|
REMOVAL OF ANAL TAGS
|
Facility
|
OP
|
$16,487.80
|
|
|
Service Code
|
HCPCS 46230
|
| Hospital Charge Code |
1600000851
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$468.25 |
| Max. Negotiated Rate |
$11,961.90 |
| Rate for Payer: Aetna Commercial |
$8,969.36
|
| Rate for Payer: Aetna Medicare Advantage |
$10,684.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11,961.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11,961.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,297.56
|
| 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 |
$11,961.90
|
| Rate for Payer: Cigna Commercial |
$6,609.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,297.56
|
| Rate for Payer: Clover Medicare Advantage |
$3,132.68
|
| Rate for Payer: EmblemHealth Commercial |
$9,892.68
|
| Rate for Payer: Humana Medicare Advantage |
$3,396.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,297.56
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,286.83
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,473.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$521.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,297.56
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,297.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$468.25
|
|
|
REMOVAL OF ARM FOREIGN BODY
|
Facility
|
IP
|
$9,299.48
|
|
|
Service Code
|
HCPCS 24201
|
| Hospital Charge Code |
16000822
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,394.92 |
| Max. Negotiated Rate |
$1,394.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,394.92
|
|
|
REMOVAL OF ARM FOREIGN BODY
|
Facility
|
OP
|
$9,299.48
|
|
|
Service Code
|
HCPCS 24201
|
| Hospital Charge Code |
16000822
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$264.11 |
| Max. Negotiated Rate |
$12,518.07 |
| Rate for Payer: Aetna Commercial |
$9,386.39
|
| Rate for Payer: Aetna Medicare Advantage |
$11,180.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,518.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,450.88
|
| 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 |
$12,518.07
|
| Rate for Payer: Cigna Commercial |
$6,917.28
|
| Rate for Payer: Cigna Medicare Advantage |
$3,450.88
|
| Rate for Payer: Clover Medicare Advantage |
$3,278.34
|
| Rate for Payer: EmblemHealth Commercial |
$10,352.64
|
| Rate for Payer: Humana Medicare Advantage |
$3,554.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,450.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,417.86
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,394.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$293.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,450.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$264.11
|
|
|
REMOVAL OF BLADDER
|
Facility
|
OP
|
$31,076.20
|
|
|
Service Code
|
HCPCS 51570
|
| Hospital Charge Code |
1600000523
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$882.56 |
| Max. Negotiated Rate |
$15,538.10 |
| Rate for Payer: Aetna Commercial |
$11,808.96
|
| Rate for Payer: Aetna Medicare Advantage |
$9,322.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,924.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,924.43
|
| 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 |
$7,924.43
|
| Rate for Payer: Cigna Commercial |
$15,538.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,079.81
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,661.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$982.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$882.56
|
|
|
REMOVAL OF BLADDER
|
Facility
|
IP
|
$31,076.20
|
|
|
Service Code
|
HCPCS 51570
|
| Hospital Charge Code |
1600000523
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,661.43 |
| Max. Negotiated Rate |
$4,661.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,661.43
|
|
|
REMOVAL OF BLADDER CYST
|
Facility
|
IP
|
$24,921.08
|
|
|
Service Code
|
HCPCS 51500
|
| Hospital Charge Code |
1600000311
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,738.16 |
| Max. Negotiated Rate |
$3,738.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,738.16
|
|
|
REMOVAL OF BLADDER CYST
|
Facility
|
OP
|
$24,921.08
|
|
|
Service Code
|
HCPCS 51500
|
| Hospital Charge Code |
1600000311
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$707.76 |
| Max. Negotiated Rate |
$26,053.61 |
| Rate for Payer: Aetna Commercial |
$19,535.72
|
| Rate for Payer: Aetna Medicare Advantage |
$23,270.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26,053.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26,053.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,182.25
|
| 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 |
$26,053.61
|
| Rate for Payer: Cigna Commercial |
$14,396.79
|
| Rate for Payer: Cigna Medicare Advantage |
$7,182.25
|
| Rate for Payer: Clover Medicare Advantage |
$6,823.14
|
| Rate for Payer: EmblemHealth Commercial |
$21,546.75
|
| Rate for Payer: Humana Medicare Advantage |
$7,397.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,182.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,479.48
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,738.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$787.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,182.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$707.76
|
|
|
REMOVAL OF BONE LESION
|
Facility
|
OP
|
$19,105.25
|
|
|
Service Code
|
HCPCS 23140
|
| Hospital Charge Code |
1600000804
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$542.59 |
| 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 |
$4,967.36
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,865.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$603.73
|
| 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 |
$542.59
|
|
