|
REMOVE MUTI-COMP PENIS PROS
|
Facility
|
IP
|
$20,308.55
|
|
|
Service Code
|
HCPCS 54406
|
| Hospital Charge Code |
1600000725
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,046.28 |
| Max. Negotiated Rate |
$3,046.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,046.28
|
|
|
REMOVE MUTI-COMP PENIS PROS
|
Facility
|
OP
|
$20,308.55
|
|
|
Service Code
|
HCPCS 54406
|
| Hospital Charge Code |
1600000725
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$576.76 |
| 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 |
$5,280.22
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,046.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$641.75
|
| 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 |
$576.76
|
|
|
REMOVE PART OF NECK VERTEBRA
|
Facility
|
IP
|
$94,563.00
|
|
|
Service Code
|
HCPCS 22110
|
| Hospital Charge Code |
1600000449
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$14,184.45 |
| Max. Negotiated Rate |
$14,184.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14,184.45
|
|
|
REMOVE PART OF NECK VERTEBRA
|
Facility
|
OP
|
$94,563.00
|
|
|
Service Code
|
HCPCS 22110
|
| Hospital Charge Code |
1600000449
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,685.59 |
| 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 |
$24,586.38
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14,184.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,988.19
|
| 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 |
$2,685.59
|
|
|
REMOVE PROSTATE REGROWTH
|
Facility
|
OP
|
$34,504.00
|
|
|
Service Code
|
HCPCS 52630
|
| Hospital Charge Code |
1600000691
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$979.91 |
| Max. Negotiated Rate |
$23,107.03 |
| Rate for Payer: Aetna Commercial |
$17,326.29
|
| Rate for Payer: Aetna Medicare Advantage |
$20,638.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,107.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,107.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,369.96
|
| 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 |
$23,107.03
|
| Rate for Payer: Cigna Commercial |
$12,768.54
|
| Rate for Payer: Cigna Medicare Advantage |
$6,369.96
|
| Rate for Payer: Clover Medicare Advantage |
$6,051.46
|
| Rate for Payer: EmblemHealth Commercial |
$19,109.88
|
| Rate for Payer: Humana Medicare Advantage |
$6,561.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,369.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,971.04
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,175.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,090.33
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,369.96
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,369.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$979.91
|
|
|
REMOVE PROSTATE REGROWTH
|
Facility
|
IP
|
$34,504.00
|
|
|
Service Code
|
HCPCS 52630
|
| Hospital Charge Code |
1600000691
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,175.60 |
| Max. Negotiated Rate |
$5,175.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,175.60
|
|
|
REMOVE RENAL TUBE W/FLUORO
|
Facility
|
OP
|
$6,402.00
|
|
|
Service Code
|
HCPCS 50389
|
| Hospital Charge Code |
16000995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$181.82 |
| Max. Negotiated Rate |
$3,629.00 |
| Rate for Payer: Aetna Commercial |
$2,253.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,684.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,005.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,005.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$828.41
|
| 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 |
$3,005.06
|
| Rate for Payer: Cigna Commercial |
$1,660.53
|
| Rate for Payer: Cigna Medicare Advantage |
$828.41
|
| Rate for Payer: Clover Medicare Advantage |
$786.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,485.23
|
| Rate for Payer: Humana Medicare Advantage |
$853.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$828.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,664.52
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$960.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$202.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$828.41
|
| Rate for Payer: Wellcare Medicare Advantage |
$828.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$181.82
|
|
|
REMOVE RENAL TUBE W/FLUORO
|
Facility
|
IP
|
$6,402.00
|
|
|
Service Code
|
HCPCS 50389
|
| Hospital Charge Code |
16000995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$960.30 |
| Max. Negotiated Rate |
$960.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$960.30
|
|
|
REMOVE REPLACE UR SPHINCTER
|
Facility
|
IP
|
$118,523.00
|
|
|
Service Code
|
HCPCS 53447
|
| Hospital Charge Code |
1600000794
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$17,778.45 |
| Max. Negotiated Rate |
$17,778.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17,778.45
|
|
|
REMOVE REPLACE UR SPHINCTER
|
Facility
|
OP
|
$118,523.00
|
|
|
Service Code
|
HCPCS 53447
|
| Hospital Charge Code |
1600000794
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,366.05 |
| Max. Negotiated Rate |
$89,320.59 |
| Rate for Payer: Aetna Commercial |
$66,975.05
|
| Rate for Payer: Aetna Medicare Advantage |
$79,779.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89,320.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89,320.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24,623.18
|
| 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 |
$89,320.59
|
| Rate for Payer: Cigna Commercial |
$49,357.08
|
| Rate for Payer: Cigna Medicare Advantage |
$24,623.18
|
| Rate for Payer: Clover Medicare Advantage |
$23,392.02
|
| Rate for Payer: EmblemHealth Commercial |
$73,869.54
|
| Rate for Payer: Humana Medicare Advantage |
$25,361.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24,623.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30,815.98
|
| Rate for Payer: Oxford Commercial |
$15,591.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17,778.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$17,348.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3,745.33
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24,623.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$24,623.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3,366.05
|
|
|
REMOVE REPL PENIS PROSTH
|
Facility
|
OP
|
$94,816.00
|
|
|
Service Code
|
HCPCS 54410
|
| Hospital Charge Code |
1600000673
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,692.77 |
| Max. Negotiated Rate |
$89,320.59 |
| Rate for Payer: Aetna Commercial |
$66,975.05
|
| Rate for Payer: Aetna Medicare Advantage |
$79,779.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89,320.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89,320.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24,623.18
|
| 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 |
$89,320.59
|
| Rate for Payer: Cigna Commercial |
$49,357.08
|
| Rate for Payer: Cigna Medicare Advantage |
$24,623.18
|
| Rate for Payer: Clover Medicare Advantage |
$23,392.02
|
| Rate for Payer: EmblemHealth Commercial |
$73,869.54
|
| Rate for Payer: Humana Medicare Advantage |
$25,361.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24,623.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24,652.16
|
| Rate for Payer: Oxford Commercial |
$15,591.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14,222.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$17,348.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,996.19
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24,623.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$24,623.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,692.77
|
|
|
REMOVE REPL PENIS PROSTH
|
Facility
|
IP
|
$94,816.00
|
|
|
Service Code
|
HCPCS 54410
|
| Hospital Charge Code |
1600000673
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$14,222.40 |
| Max. Negotiated Rate |
$14,222.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14,222.40
|
|
|
REMOVE SELF-CONTD PENIS PROS
|
Facility
|
IP
|
$29,904.60
|
|
|
Service Code
|
HCPCS 54415
|
| Hospital Charge Code |
1600000314
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,485.69 |
| Max. Negotiated Rate |
$4,485.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,485.69
|
|
|
REMOVE SELF-CONTD PENIS PROS
|
Facility
|
OP
|
$29,904.60
|
|
|
Service Code
|
HCPCS 54415
|
| Hospital Charge Code |
1600000314
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$849.29 |
| 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 |
$7,775.20
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,485.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$944.99
|
| 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 |
$849.29
|
|
|
REMOVE SPINAL LAMINA ADD-ON
|
Facility
|
IP
|
$47,548.90
|
|
|
Service Code
|
HCPCS 63048
|
| Hospital Charge Code |
16000319
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,132.34 |
| Max. Negotiated Rate |
$7,132.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,132.34
|
|
|
REMOVE SPINAL LAMINA ADD-ON
|
Facility
|
OP
|
$47,548.90
|
|
|
Service Code
|
HCPCS 63048
|
| Hospital Charge Code |
16000319
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,350.39 |
| Max. Negotiated Rate |
$23,774.45 |
| Rate for Payer: Aetna Commercial |
$18,068.58
|
| Rate for Payer: Aetna Medicare Advantage |
$14,264.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$12,124.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$12,124.97
|
| 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 |
$12,124.97
|
| Rate for Payer: Cigna Commercial |
$23,774.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12,362.71
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,132.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,502.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,350.39
|
|
|
REMOVE SPINE ELTRD PLATE
|
Facility
|
IP
|
$11,517.52
|
|
|
Service Code
|
HCPCS 63662
|
| Hospital Charge Code |
1600000877
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,727.63 |
| Max. Negotiated Rate |
$1,727.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,727.63
|
|
|
REMOVE SPINE ELTRD PLATE
|
Facility
|
OP
|
$11,517.52
|
|
|
Service Code
|
HCPCS 63662
|
| Hospital Charge Code |
1600000877
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$327.10 |
| Max. Negotiated Rate |
$15,066.71 |
| Rate for Payer: Aetna Commercial |
$11,297.44
|
| Rate for Payer: Aetna Medicare Advantage |
$13,457.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,066.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,066.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,153.47
|
| 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 |
$15,066.71
|
| Rate for Payer: Cigna Commercial |
$8,325.61
|
| Rate for Payer: Cigna Medicare Advantage |
$4,153.47
|
| Rate for Payer: Clover Medicare Advantage |
$3,945.80
|
| Rate for Payer: EmblemHealth Commercial |
$12,460.41
|
| Rate for Payer: Humana Medicare Advantage |
$4,278.07
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,153.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,994.56
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,727.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$363.95
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,153.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,153.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$327.10
|
|
|
REMOVE SPINE FIXATION DEVICE
|
Facility
|
OP
|
$11,542.64
|
|
|
Service Code
|
HCPCS 22850
|
| Hospital Charge Code |
1600000479
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$327.81 |
| 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 |
$3,001.09
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,731.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$364.75
|
| 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 |
$327.81
|
|
|
REMOVE SPINE FIXATION DEVICE
|
Facility
|
OP
|
$13,677.00
|
|
|
Service Code
|
HCPCS 61783
|
| Hospital Charge Code |
1600000622
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$388.43 |
| Max. Negotiated Rate |
$6,838.50 |
| Rate for Payer: Aetna Commercial |
$5,197.26
|
| Rate for Payer: Aetna Medicare Advantage |
$4,103.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,487.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,487.64
|
| 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 |
$3,487.64
|
| Rate for Payer: Cigna Commercial |
$6,838.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,556.02
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,051.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$432.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$388.43
|
|
|
REMOVE SPINE FIXATION DEVICE
|
Facility
|
IP
|
$13,677.00
|
|
|
Service Code
|
HCPCS 61783
|
| Hospital Charge Code |
1600000622
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,051.55 |
| Max. Negotiated Rate |
$2,051.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,051.55
|
|
|
REMOVE SPINE FIXATION DEVICE
|
Facility
|
IP
|
$11,542.64
|
|
|
Service Code
|
HCPCS 22850
|
| Hospital Charge Code |
1600000479
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,731.40 |
| Max. Negotiated Rate |
$1,731.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,731.40
|
|
|
REMOVE SPINE LAMINA 1/2 THRC
|
Facility
|
IP
|
$26,295.79
|
|
|
Service Code
|
HCPCS 63003
|
| Hospital Charge Code |
16001019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,944.37 |
| Max. Negotiated Rate |
$3,944.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,944.37
|
|
|
REMOVE SPINE LAMINA 1/2 THRC
|
Facility
|
OP
|
$26,295.79
|
|
|
Service Code
|
HCPCS 63003
|
| Hospital Charge Code |
16001019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$746.80 |
| 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 |
$6,836.91
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,944.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$830.95
|
| 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 |
$746.80
|
|
|
REMOVE THYROID LESION
|
Facility
|
IP
|
$49,367.70
|
|
|
Service Code
|
HCPCS 60200
|
| Hospital Charge Code |
1600000749
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,405.15 |
| Max. Negotiated Rate |
$7,405.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7,405.15
|
|