|
REMOVE EPIDIDYMIS
|
Facility
|
IP
|
$16,246.84
|
|
|
Service Code
|
HCPCS 54830
|
| Hospital Charge Code |
1600000261
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,437.03 |
| Max. Negotiated Rate |
$2,437.03 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,437.03
|
|
|
REMOVE EPIDIDYMIS
|
Facility
|
OP
|
$16,246.84
|
|
|
Service Code
|
HCPCS 54830
|
| Hospital Charge Code |
1600000261
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$461.41 |
| Max. Negotiated Rate |
$15,191.14 |
| Rate for Payer: Aetna Commercial |
$11,390.73
|
| Rate for Payer: Aetna Medicare Advantage |
$13,568.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,191.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,191.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,187.77
|
| 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 |
$15,191.14
|
| Rate for Payer: Cigna Commercial |
$8,394.37
|
| Rate for Payer: Cigna Medicare Advantage |
$4,187.77
|
| Rate for Payer: Clover Medicare Advantage |
$3,978.38
|
| Rate for Payer: EmblemHealth Commercial |
$12,563.31
|
| Rate for Payer: Humana Medicare Advantage |
$4,313.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,187.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,224.18
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,437.03
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$513.40
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$461.41
|
|
|
REMOVE EPIDIDYMIS LESION
|
Facility
|
OP
|
$12,062.25
|
|
|
Service Code
|
HCPCS 54840
|
| Hospital Charge Code |
1600000322
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$342.57 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| 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 |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,136.18
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,809.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$381.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$342.57
|
|
|
REMOVE EPIDIDYMIS LESION
|
Facility
|
IP
|
$12,062.25
|
|
|
Service Code
|
HCPCS 54840
|
| Hospital Charge Code |
1600000322
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,809.34 |
| Max. Negotiated Rate |
$1,809.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,809.34
|
|
|
REMOVE EPIDIDYMIS LESION
|
Facility
|
OP
|
$9,649.80
|
|
|
Service Code
|
HCPCS 54840
|
| Hospital Charge Code |
1600000260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$274.05 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| 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 |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,508.95
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.47
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$304.93
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$274.05
|
|
|
REMOVE EPIDIDYMIS LESION
|
Facility
|
IP
|
$9,649.80
|
|
|
Service Code
|
HCPCS 54840
|
| Hospital Charge Code |
1600000260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,447.47 |
| Max. Negotiated Rate |
$1,447.47 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,447.47
|
|
|
REMOVE EXT HEM GROUPS 2+
|
Facility
|
OP
|
$22,676.60
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
1600000455
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$644.02 |
| 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 |
$5,895.92
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,401.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$716.58
|
| 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 |
$644.02
|
|
|
REMOVE EXT HEM GROUPS 2+
|
Facility
|
IP
|
$22,676.60
|
|
|
Service Code
|
HCPCS 46250
|
| Hospital Charge Code |
1600000455
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,401.49 |
| Max. Negotiated Rate |
$3,401.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,401.49
|
|
|
REMOVE EXTRA SPINE SEGMENT
|
Facility
|
IP
|
$15,178.00
|
|
|
Service Code
|
HCPCS 22116
|
| Hospital Charge Code |
1600000682
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,276.70 |
| Max. Negotiated Rate |
$2,276.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,276.70
|
|
|
REMOVE EXTRA SPINE SEGMENT
|
Facility
|
OP
|
$15,178.00
|
|
|
Service Code
|
HCPCS 22116
|
| Hospital Charge Code |
1600000682
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$431.06 |
| Max. Negotiated Rate |
$7,589.00 |
| Rate for Payer: Aetna Commercial |
$5,767.64
|
| Rate for Payer: Aetna Medicare Advantage |
$4,553.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,870.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,870.39
|
| 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 |
$3,870.39
|
| Rate for Payer: Cigna Commercial |
$7,589.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,946.28
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,276.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$479.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$431.06
|
|
|
REMOVE FECAL IMPACTION OR FB
|
Facility
|
OP
|
$21,472.19
|
|
|
Service Code
|
HCPCS 45915
|
| Hospital Charge Code |
16000486
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$609.81 |
| Max. Negotiated Rate |
$5,582.77 |
| Rate for Payer: Aetna Commercial |
$3,866.86
|
| Rate for Payer: Aetna Medicare Advantage |
$4,606.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5,157.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,421.64
|
| 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 |
$5,157.00
|
| Rate for Payer: Cigna Commercial |
$2,849.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,421.64
|
| Rate for Payer: Clover Medicare Advantage |
$1,350.56
|
| Rate for Payer: EmblemHealth Commercial |
$4,264.92
|
| Rate for Payer: Humana Medicare Advantage |
$1,464.29
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,421.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,582.77
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,220.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$678.52
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,421.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$609.81
|
|
|
REMOVE FECAL IMPACTION OR FB
|
Facility
|
IP
|
$21,472.19
|
|
|
Service Code
|
HCPCS 45915
|
| Hospital Charge Code |
16000486
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,220.83 |
| Max. Negotiated Rate |
$3,220.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,220.83
|
|
|
REMOVE GROIN LYMPH NODES
|
Facility
|
IP
|
$22,569.14
|
|
|
Service Code
|
HCPCS 38760
|
| Hospital Charge Code |
16000958
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,385.37 |
| Max. Negotiated Rate |
$3,385.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,385.37
|
|
|
REMOVE GROIN LYMPH NODES
|
Facility
|
OP
|
$22,569.14
|
|
|
Service Code
|
HCPCS 38760
|
| Hospital Charge Code |
16000958
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$640.96 |
| Max. Negotiated Rate |
$28,616.22 |
| Rate for Payer: Aetna Commercial |
$21,457.24
|
| Rate for Payer: Aetna Medicare Advantage |
$25,559.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28,616.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28,616.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,888.69
|
| 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 |
$28,616.22
|
| Rate for Payer: Cigna Commercial |
$15,812.86
|
| Rate for Payer: Cigna Medicare Advantage |
$7,888.69
|
| Rate for Payer: Clover Medicare Advantage |
$7,494.26
|
| Rate for Payer: EmblemHealth Commercial |
$23,666.07
|
| Rate for Payer: Humana Medicare Advantage |
$8,125.35
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,888.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,867.98
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,385.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$713.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,888.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,888.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$640.96
|
|
|
REMOVE IMPACTED EAR WAX UNI
|
Facility
|
IP
|
$229.14
|
|
|
Service Code
|
HCPCS 69210
|
| Hospital Charge Code |
1600000283
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$34.37 |
| Max. Negotiated Rate |
$34.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.37
|
|
|
REMOVE IMPACTED EAR WAX UNI
|
Facility
|
OP
|
$229.14
|
|
|
Service Code
|
HCPCS 69210
|
| Hospital Charge Code |
1600000283
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7.24 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$190.62
|
| Rate for Payer: Aetna Medicare Advantage |
$227.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$254.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$254.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$70.08
|
| 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 |
$254.22
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: Cigna Medicare Advantage |
$70.08
|
| Rate for Payer: Clover Medicare Advantage |
$66.58
|
| Rate for Payer: EmblemHealth Commercial |
$210.24
|
| Rate for Payer: Humana Medicare Advantage |
$72.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$70.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.58
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$197.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$193.50
|
|
|
REMOVE IN/EX HEM GROUPS 2+
|
Facility
|
OP
|
$32,333.10
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
16000172
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$918.26 |
| 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 |
$8,406.61
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,849.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,021.73
|
| 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 |
$918.26
|
|
|
REMOVE IN/EX HEM GROUPS 2+
|
Facility
|
IP
|
$32,333.10
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
16000172
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,849.97 |
| Max. Negotiated Rate |
$4,849.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,849.97
|
|
|
REMOVE IN/EX HEM GRP & FISS
|
Facility
|
OP
|
$22,676.60
|
|
|
Service Code
|
HCPCS 46257
|
| Hospital Charge Code |
1600000628
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$644.02 |
| 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 |
$5,895.92
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,401.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$716.58
|
| 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 |
$644.02
|
|
|
REMOVE IN/EX HEM GRP & FISS
|
Facility
|
IP
|
$22,676.60
|
|
|
Service Code
|
HCPCS 46257
|
| Hospital Charge Code |
1600000628
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,401.49 |
| Max. Negotiated Rate |
$3,401.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,401.49
|
|
|
REMOVE INT/EXT HEM 1 GROUP
|
Facility
|
IP
|
$22,676.60
|
|
|
Service Code
|
HCPCS 46255
|
| Hospital Charge Code |
1600000384
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,401.49 |
| Max. Negotiated Rate |
$3,401.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,401.49
|
|
|
REMOVE INT/EXT HEM 1 GROUP
|
Facility
|
OP
|
$22,676.60
|
|
|
Service Code
|
HCPCS 46255
|
| Hospital Charge Code |
1600000384
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$644.02 |
| 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 |
$5,895.92
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,401.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$716.58
|
| 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 |
$644.02
|
|
|
REMOVE INT/EXT HEM 2+GRPS & F
|
Facility
|
IP
|
$22,676.60
|
|
|
Service Code
|
HCPCS 46261
|
| Hospital Charge Code |
1600000438
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,401.49 |
| Max. Negotiated Rate |
$3,401.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,401.49
|
|
|
REMOVE INT/EXT HEM 2+GRPS & F
|
Facility
|
OP
|
$22,676.60
|
|
|
Service Code
|
HCPCS 46261
|
| Hospital Charge Code |
1600000438
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$644.02 |
| 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 |
$5,895.92
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,401.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$716.58
|
| 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 |
$644.02
|
|
|
REMOVE INTRVAS FOREIGN BODY
|
Facility
|
OP
|
$13,125.82
|
|
|
Service Code
|
HCPCS 37197
|
| Hospital Charge Code |
411037197
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$372.77 |
| Max. Negotiated Rate |
$13,607.37 |
| Rate for Payer: Aetna Commercial |
$10,203.18
|
| Rate for Payer: Aetna Medicare Advantage |
$12,153.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,607.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,751.17
|
| 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 |
$13,607.37
|
| Rate for Payer: Cigna Commercial |
$7,519.21
|
| Rate for Payer: Cigna Medicare Advantage |
$3,751.17
|
| Rate for Payer: Clover Medicare Advantage |
$3,563.61
|
| Rate for Payer: EmblemHealth Commercial |
$11,253.51
|
| Rate for Payer: Humana Medicare Advantage |
$3,863.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,751.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,412.71
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,968.87
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$414.78
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,751.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$372.77
|
|
