|
REPAIR NASAL SEPTAL PERFORAT
|
Facility
|
OP
|
$20,083.40
|
|
|
Service Code
|
HCPCS 30630
|
| Hospital Charge Code |
1600000739
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.37 |
| 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 |
$5,221.68
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,012.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$634.64
|
| 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 |
$570.37
|
|
|
REPAIR NASAL STENOSIS
|
Facility
|
IP
|
$42,339.20
|
|
|
Service Code
|
HCPCS 30465
|
| Hospital Charge Code |
1600000738
|
|
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
|
|
|
REPAIR NASAL STENOSIS
|
Facility
|
OP
|
$42,339.20
|
|
|
Service Code
|
HCPCS 30465
|
| Hospital Charge Code |
1600000738
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,202.43 |
| Max. Negotiated Rate |
$25,511.88 |
| Rate for Payer: Aetna Commercial |
$19,129.52
|
| Rate for Payer: Aetna Medicare Advantage |
$22,786.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25,511.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25,511.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,032.91
|
| 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 |
$25,511.88
|
| Rate for Payer: Cigna Commercial |
$14,097.46
|
| Rate for Payer: Cigna Medicare Advantage |
$7,032.91
|
| Rate for Payer: Clover Medicare Advantage |
$6,681.26
|
| Rate for Payer: EmblemHealth Commercial |
$21,098.73
|
| Rate for Payer: Humana Medicare Advantage |
$7,243.90
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,032.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,008.19
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,350.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,337.92
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,032.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,032.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,202.43
|
|
|
REPAIR NONUNION OF RAD OR ULNA
|
Facility
|
OP
|
$45,935.07
|
|
|
Service Code
|
HCPCS 25400
|
| Hospital Charge Code |
16000836
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,304.56 |
| Max. Negotiated Rate |
$31,271.12 |
| Rate for Payer: Aetna Commercial |
$23,447.95
|
| Rate for Payer: Aetna Medicare Advantage |
$27,930.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31,271.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31,271.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,620.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31,271.12
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: Cigna Medicare Advantage |
$8,620.57
|
| Rate for Payer: Clover Medicare Advantage |
$8,189.54
|
| Rate for Payer: EmblemHealth Commercial |
$25,861.71
|
| Rate for Payer: Humana Medicare Advantage |
$8,879.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,620.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,943.12
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,890.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,451.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,304.56
|
|
|
REPAIR NONUNION OF RAD OR ULNA
|
Facility
|
IP
|
$45,935.07
|
|
|
Service Code
|
HCPCS 25400
|
| Hospital Charge Code |
16000836
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,890.26 |
| Max. Negotiated Rate |
$6,890.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,890.26
|
|
|
REPAIR OF BLADDER WOUND
|
Facility
|
OP
|
$39,842.00
|
|
|
Service Code
|
HCPCS 51865
|
| Hospital Charge Code |
1600000324
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,131.51 |
| Max. Negotiated Rate |
$19,921.00 |
| Rate for Payer: Aetna Commercial |
$15,139.96
|
| Rate for Payer: Aetna Medicare Advantage |
$11,952.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10,159.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10,159.71
|
| 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 |
$10,159.71
|
| Rate for Payer: Cigna Commercial |
$19,921.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10,358.92
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,976.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,259.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,131.51
|
|
|
REPAIR OF BLADDER WOUND
|
Facility
|
IP
|
$39,842.00
|
|
|
Service Code
|
HCPCS 51865
|
| Hospital Charge Code |
1600000324
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,976.30 |
| Max. Negotiated Rate |
$5,976.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,976.30
|
|
|
REPAIR OF DIAPHRAGM
|
Facility
|
OP
|
$17,842.40
|
|
|
Service Code
|
HCPCS 39540
|
| Hospital Charge Code |
1600000813
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$506.72 |
| Max. Negotiated Rate |
$10,269.00 |
| Rate for Payer: Aetna Commercial |
$6,780.11
|
| Rate for Payer: Aetna Medicare Advantage |
$5,352.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$4,549.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$4,549.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$4,549.81
|
| Rate for Payer: Cigna Commercial |
$8,921.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,639.02
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,676.36
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$563.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$506.72
|
|
|
REPAIR OF DIAPHRAGM
|
Facility
|
IP
|
$17,842.40
|
|
|
Service Code
|
HCPCS 39540
|
| Hospital Charge Code |
1600000813
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,676.36 |
| Max. Negotiated Rate |
$2,676.36 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,676.36
|
|
|
REPAIR OF DIGIT NERVE 1
|
Facility
|
OP
|
$34,014.10
|
|
|
Service Code
|
HCPCS 64831
|
| Hospital Charge Code |
16000368
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$966.00 |
| Max. Negotiated Rate |
$10,269.00 |
| Rate for Payer: Aetna Commercial |
$6,310.10
|
| Rate for Payer: Aetna Medicare Advantage |
$7,516.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,415.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,415.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,319.89
|
| 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 |
$8,415.40
|
| Rate for Payer: Cigna Commercial |
$4,650.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2,319.89
|
| Rate for Payer: Clover Medicare Advantage |
$2,203.90
|
| Rate for Payer: EmblemHealth Commercial |
$6,959.67
|
| Rate for Payer: Humana Medicare Advantage |
$2,389.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,319.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,843.67
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,102.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,074.85
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,319.89
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,319.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$966.00
|
|
|
REPAIR OF DIGIT NERVE 1
|
Facility
|
IP
|
$34,014.10
|
|
|
Service Code
|
HCPCS 64831
|
| Hospital Charge Code |
16000368
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,102.11 |
| Max. Negotiated Rate |
$5,102.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,102.11
|
|
|
REPAIR OF FINGER/HAND TENDON
|
Facility
|
IP
|
$19,436.10
|
|
|
Service Code
|
HCPCS 26373
|
| Hospital Charge Code |
1600000885
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,915.41 |
| Max. Negotiated Rate |
$2,915.41 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,915.41
|
|
|
REPAIR OF FINGER/HAND TENDON
|
Facility
|
OP
|
$19,436.10
|
|
|
Service Code
|
HCPCS 26373
|
| Hospital Charge Code |
1600000885
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$551.99 |
| Max. Negotiated Rate |
$14,100.89 |
| Rate for Payer: Aetna Commercial |
$10,573.24
|
| Rate for Payer: Aetna Medicare Advantage |
$12,594.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,100.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,887.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14,100.89
|
| Rate for Payer: Cigna Commercial |
$7,791.93
|
| Rate for Payer: Cigna Medicare Advantage |
$3,887.22
|
| Rate for Payer: Clover Medicare Advantage |
$3,692.86
|
| Rate for Payer: EmblemHealth Commercial |
$11,661.66
|
| Rate for Payer: Humana Medicare Advantage |
$4,003.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,887.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,053.39
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,915.41
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$614.18
|
| 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 |
$551.99
|
|
|
REPAIR OF HAND OR FOOT NERVE
|
Facility
|
OP
|
$21,704.79
|
|
|
Service Code
|
HCPCS 64834
|
| Hospital Charge Code |
1600000883
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$616.42 |
| Max. Negotiated Rate |
$14,722.10 |
| Rate for Payer: Aetna Commercial |
$11,039.04
|
| Rate for Payer: Aetna Medicare Advantage |
$13,149.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14,722.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14,722.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,058.47
|
| 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 |
$14,722.10
|
| Rate for Payer: Cigna Commercial |
$8,135.20
|
| Rate for Payer: Cigna Medicare Advantage |
$4,058.47
|
| Rate for Payer: Clover Medicare Advantage |
$3,855.55
|
| Rate for Payer: EmblemHealth Commercial |
$12,175.41
|
| Rate for Payer: Humana Medicare Advantage |
$4,180.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,058.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,643.25
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,255.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$685.87
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,058.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,058.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$616.42
|
|
|
REPAIR OF HAND OR FOOT NERVE
|
Facility
|
IP
|
$21,704.79
|
|
|
Service Code
|
HCPCS 64834
|
| Hospital Charge Code |
1600000883
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,255.72 |
| Max. Negotiated Rate |
$3,255.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,255.72
|
|
|
REPAIR OF HAND TENDON
|
Facility
|
IP
|
$6,331.60
|
|
|
Service Code
|
HCPCS 26410
|
| Hospital Charge Code |
16000844
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$949.74 |
| Max. Negotiated Rate |
$949.74 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$949.74
|
|
|
REPAIR OF HAND TENDON
|
Facility
|
OP
|
$6,331.60
|
|
|
Service Code
|
HCPCS 26410
|
| Hospital Charge Code |
16000844
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$179.82 |
| Max. Negotiated Rate |
$6,929.76 |
| Rate for Payer: Aetna Commercial |
$5,196.12
|
| Rate for Payer: Aetna Medicare Advantage |
$6,189.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,929.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,910.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$6,929.76
|
| Rate for Payer: Cigna Commercial |
$3,829.26
|
| Rate for Payer: Cigna Medicare Advantage |
$1,910.34
|
| Rate for Payer: Clover Medicare Advantage |
$1,814.82
|
| Rate for Payer: EmblemHealth Commercial |
$5,731.02
|
| Rate for Payer: Humana Medicare Advantage |
$1,967.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,910.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,646.22
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$949.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$200.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,910.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$179.82
|
|
|
REPAIR OUTER SHEATH 26FR
|
Facility
|
IP
|
$615.00
|
|
| Hospital Charge Code |
270645669
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.25 |
| Max. Negotiated Rate |
$148.83 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$123.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$148.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.25
|
|
|
REPAIR OUTER SHEATH 26FR
|
Facility
|
OP
|
$615.00
|
|
| Hospital Charge Code |
270645669
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Aetna Commercial |
$233.70
|
| Rate for Payer: Aetna Medicare Advantage |
$184.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$156.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$156.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$123.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$156.82
|
| Rate for Payer: Cigna Commercial |
$307.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$148.83
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.47
|
|
|
REPAIR PARAVAG DEFECT VAG
|
Facility
|
OP
|
$42,389.30
|
|
|
Service Code
|
HCPCS 57285
|
| Hospital Charge Code |
1600000473
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,203.86 |
| Max. Negotiated Rate |
$31,957.30 |
| Rate for Payer: Aetna Commercial |
$23,962.47
|
| Rate for Payer: Aetna Medicare Advantage |
$28,543.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31,957.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31,957.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,809.73
|
| 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 |
$31,957.30
|
| Rate for Payer: Cigna Commercial |
$17,659.09
|
| Rate for Payer: Cigna Medicare Advantage |
$8,809.73
|
| Rate for Payer: Clover Medicare Advantage |
$8,369.24
|
| Rate for Payer: EmblemHealth Commercial |
$26,429.19
|
| Rate for Payer: Humana Medicare Advantage |
$9,074.02
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,809.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,021.22
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,358.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,339.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,809.73
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,809.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,203.86
|
|
|
REPAIR PARAVAG DEFECT VAG
|
Facility
|
IP
|
$42,389.30
|
|
|
Service Code
|
HCPCS 57285
|
| Hospital Charge Code |
1600000473
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,358.40 |
| Max. Negotiated Rate |
$6,358.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,358.40
|
|
|
REPAIR ROTATOR CUFF CHRONIC
|
Facility
|
OP
|
$44,916.00
|
|
|
Service Code
|
HCPCS 23412
|
| Hospital Charge Code |
16000815
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,275.61 |
| Max. Negotiated Rate |
$31,271.12 |
| Rate for Payer: Aetna Commercial |
$23,447.95
|
| Rate for Payer: Aetna Medicare Advantage |
$27,930.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31,271.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31,271.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8,620.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31,271.12
|
| Rate for Payer: Cigna Commercial |
$17,279.91
|
| Rate for Payer: Cigna Medicare Advantage |
$8,620.57
|
| Rate for Payer: Clover Medicare Advantage |
$8,189.54
|
| Rate for Payer: EmblemHealth Commercial |
$25,861.71
|
| Rate for Payer: Humana Medicare Advantage |
$8,879.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8,620.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,678.16
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,737.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,419.35
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$8,620.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,275.61
|
|
|
REPAIR ROTATOR CUFF CHRONIC
|
Facility
|
IP
|
$44,916.00
|
|
|
Service Code
|
HCPCS 23412
|
| Hospital Charge Code |
16000815
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,737.40 |
| Max. Negotiated Rate |
$6,737.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,737.40
|
|
|
REPAIR TUNNELED CV CATH
|
Facility
|
IP
|
$91,470.10
|
|
|
Service Code
|
HCPCS 36576
|
| Hospital Charge Code |
1600000732
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13,720.51 |
| Max. Negotiated Rate |
$13,720.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13,720.51
|
|
|
REPAIR TUNNELED CV CATH
|
Facility
|
OP
|
$91,470.10
|
|
|
Service Code
|
HCPCS 36576
|
| Hospital Charge Code |
1600000732
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,776.63 |
| Max. Negotiated Rate |
$23,782.23 |
| Rate for Payer: Aetna Commercial |
$5,086.78
|
| Rate for Payer: Aetna Medicare Advantage |
$6,059.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,783.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,870.14
|
| 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 |
$6,783.93
|
| Rate for Payer: Cigna Commercial |
$3,748.67
|
| Rate for Payer: Cigna Medicare Advantage |
$1,870.14
|
| Rate for Payer: Clover Medicare Advantage |
$1,776.63
|
| Rate for Payer: EmblemHealth Commercial |
$5,610.42
|
| Rate for Payer: Humana Medicare Advantage |
$1,926.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,870.14
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23,782.23
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13,720.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2,890.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,870.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2,597.75
|
|
