|
REPAIR FOREARM TENDON/MUSCLE
|
Facility
|
OP
|
$14,339.40
|
|
|
Service Code
|
HCPCS 25260
|
| Hospital Charge Code |
2705792292
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| 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 |
$279.51
|
| 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 |
$3,728.24
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,150.91
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,887.22
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$662.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$407.24
|
|
|
REPAIR/GRAFT RADIUS OR ULNA
|
Facility
|
IP
|
$26,701.01
|
|
|
Service Code
|
HCPCS 25425
|
| Hospital Charge Code |
16000689
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,005.15 |
| Max. Negotiated Rate |
$4,005.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,005.15
|
|
|
REPAIR/GRAFT RADIUS OR ULNA
|
Facility
|
OP
|
$26,701.01
|
|
|
Service Code
|
HCPCS 25425
|
| Hospital Charge Code |
16000689
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$758.31 |
| 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 |
$6,942.26
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,005.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$843.75
|
| 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 |
$758.31
|
|
|
REPAIR HALLUX GIDUS BL
|
Facility
|
IP
|
$37,325.80
|
|
|
Service Code
|
HCPCS 28289
|
| Hospital Charge Code |
16000218
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,598.87 |
| Max. Negotiated Rate |
$5,598.87 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,598.87
|
|
|
REPAIR HALLUX GIDUS BL
|
Facility
|
OP
|
$37,325.80
|
|
|
Service Code
|
HCPCS 28289
|
| Hospital Charge Code |
16000218
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,060.05 |
| 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 |
$9,704.71
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,598.87
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,179.50
|
| 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 |
$1,060.05
|
|
|
REPAIR HAND JOINT
|
Facility
|
IP
|
$10,580.92
|
|
|
Service Code
|
HCPCS 26540
|
| Hospital Charge Code |
16000412
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,587.14 |
| Max. Negotiated Rate |
$1,587.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,587.14
|
|
|
REPAIR HAND JOINT
|
Facility
|
OP
|
$10,580.92
|
|
|
Service Code
|
HCPCS 26540
|
| Hospital Charge Code |
16000412
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$300.50 |
| 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 |
$2,751.04
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,587.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$334.36
|
| 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 |
$300.50
|
|
|
REPAIR HAND JOINT W/GRAFT
|
Facility
|
IP
|
$12,406.91
|
|
|
Service Code
|
HCPCS 26541
|
| Hospital Charge Code |
16000701
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,861.04 |
| Max. Negotiated Rate |
$1,861.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,861.04
|
|
|
REPAIR HAND JOINT W/GRAFT
|
Facility
|
OP
|
$12,406.91
|
|
|
Service Code
|
HCPCS 26541
|
| Hospital Charge Code |
16000701
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$352.36 |
| 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 |
$3,225.80
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,861.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$392.06
|
| 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 |
$352.36
|
|
|
REPAIR HUMERUS MALUNION WO GRA
|
Facility
|
IP
|
$74,506.50
|
|
|
Service Code
|
HCPCS 24430
|
| Hospital Charge Code |
1600000789
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,175.98 |
| Max. Negotiated Rate |
$11,175.98 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,175.98
|
|
|
REPAIR HUMERUS MALUNION WO GRA
|
Facility
|
OP
|
$74,506.50
|
|
|
Service Code
|
HCPCS 24430
|
| Hospital Charge Code |
1600000789
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,115.98 |
| 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 |
$19,371.69
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11,175.98
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,354.41
|
| 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 |
$2,115.98
|
|
|
REPAIR INGUINAL HERNIA, SLIDING, ANY AGE
|
Facility
|
OP
|
$15,429.97
|
|
|
Service Code
|
CPT 49525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,536.00 |
| Max. Negotiated Rate |
$15,429.97 |
| Rate for Payer: Aetna Commercial |
$11,569.82
|
| Rate for Payer: Aetna Medicare Advantage |
$13,781.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,429.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,253.61
|
| 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 |
$15,429.97
|
| Rate for Payer: Cigna Commercial |
$8,526.35
|
| Rate for Payer: Cigna Medicare Advantage |
$4,253.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,040.93
|
| Rate for Payer: EmblemHealth Commercial |
$12,760.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,381.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,253.61
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
|
|
REPAIR KIT ASPIRA
|
Facility
|
IP
|
$166.00
|
|
| Hospital Charge Code |
270661651
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.90 |
| Max. Negotiated Rate |
$24.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.90
|
|
|
REPAIR KIT ASPIRA
|
Facility
|
OP
|
$166.00
|
|
| Hospital Charge Code |
270661651N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.71 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: Aetna Commercial |
$63.08
|
| Rate for Payer: Aetna Medicare Advantage |
$49.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.33
|
| Rate for Payer: Cigna Commercial |
$83.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.16
|
| Rate for Payer: Oxford Commercial |
$33.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$33.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.71
|
|
|
REPAIR KIT ASPIRA
|
Facility
|
OP
|
$166.00
|
|
| Hospital Charge Code |
270661651
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.71 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: Aetna Commercial |
$63.08
|
| Rate for Payer: Aetna Medicare Advantage |
$49.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.33
|
| Rate for Payer: Cigna Commercial |
$83.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.16
|
| Rate for Payer: Oxford Commercial |
$33.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$33.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.71
|
|
|
REPAIR KIT ASPIRA
|
Facility
|
IP
|
$166.00
|
|
| Hospital Charge Code |
270661651N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.90 |
| Max. Negotiated Rate |
$24.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.90
|
|
|
REPAIR KNEECAP TENDON
|
Facility
|
OP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27380
|
| Hospital Charge Code |
16000622
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$868.90 |
| 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 |
$7,954.70
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$966.80
|
| 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 |
$868.90
|
|
|
REPAIR KNEECAP TENDON
|
Facility
|
IP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27380
|
| Hospital Charge Code |
16000622
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,589.25 |
| Max. Negotiated Rate |
$4,589.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,589.25
|
|
|
REPAIR LEAD PACE-DEFIB,ONE
|
Facility
|
IP
|
$26,605.00
|
|
|
Service Code
|
HCPCS 33218
|
| Hospital Charge Code |
5100818
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,990.75 |
| Max. Negotiated Rate |
$3,990.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,990.75
|
|
|
REPAIR LEAD PACE-DEFIB,ONE
|
Facility
|
OP
|
$26,605.00
|
|
|
Service Code
|
HCPCS 33218
|
| Hospital Charge Code |
5100818
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$755.58 |
| Max. Negotiated Rate |
$16,104.69 |
| Rate for Payer: Aetna Commercial |
$12,075.74
|
| Rate for Payer: Aetna Medicare Advantage |
$14,384.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16,104.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16,104.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,439.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4,213.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16,104.69
|
| Rate for Payer: Cigna Commercial |
$8,899.18
|
| Rate for Payer: Cigna Medicare Advantage |
$4,439.61
|
| Rate for Payer: Clover Medicare Advantage |
$4,217.63
|
| Rate for Payer: EmblemHealth Commercial |
$13,318.83
|
| Rate for Payer: Humana Medicare Advantage |
$4,572.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,439.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6,917.30
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,990.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$840.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,439.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,439.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$755.58
|
|
|
REPAIR LIVER WOUND
|
Facility
|
IP
|
$13,705.32
|
|
|
Service Code
|
HCPCS 47360
|
| Hospital Charge Code |
1600000687
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,055.80 |
| Max. Negotiated Rate |
$2,055.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,055.80
|
|
|
REPAIR LIVER WOUND
|
Facility
|
OP
|
$13,705.32
|
|
|
Service Code
|
HCPCS 47360
|
| Hospital Charge Code |
1600000687
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$389.23 |
| Max. Negotiated Rate |
$10,269.00 |
| Rate for Payer: Aetna Commercial |
$5,208.02
|
| Rate for Payer: Aetna Medicare Advantage |
$4,111.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,494.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,494.86
|
| 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 |
$3,494.86
|
| Rate for Payer: Cigna Commercial |
$6,852.66
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,563.38
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,055.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$433.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$389.23
|
|
|
REPAIR NAIL BED
|
Facility
|
OP
|
$2,482.20
|
|
|
Service Code
|
HCPCS 11760
|
| Hospital Charge Code |
1600000712
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$70.49 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$2,388.27
|
| Rate for Payer: Aetna Medicare Advantage |
$2,844.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,185.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,185.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$878.04
|
| 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 |
$3,185.09
|
| Rate for Payer: Cigna Commercial |
$1,760.02
|
| Rate for Payer: Cigna Medicare Advantage |
$878.04
|
| Rate for Payer: Clover Medicare Advantage |
$834.14
|
| Rate for Payer: EmblemHealth Commercial |
$2,634.12
|
| Rate for Payer: Humana Medicare Advantage |
$904.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$878.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$645.37
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$372.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$78.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$878.04
|
| Rate for Payer: Wellcare Medicare Advantage |
$878.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$70.49
|
|
|
REPAIR NAIL BED
|
Facility
|
IP
|
$2,482.20
|
|
|
Service Code
|
HCPCS 11760
|
| Hospital Charge Code |
1600000712
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$372.33 |
| Max. Negotiated Rate |
$372.33 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$372.33
|
|
|
REPAIR NASAL SEPTAL PERFORAT
|
Facility
|
IP
|
$20,083.40
|
|
|
Service Code
|
HCPCS 30630
|
| Hospital Charge Code |
1600000739
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,012.51 |
| Max. Negotiated Rate |
$3,012.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,012.51
|
|
