|
REPR DISL PERONEAL TNDN W FIB
|
Facility
|
IP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27676
|
| Hospital Charge Code |
1600000585
|
|
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
|
|
|
REPR DISL PERONEAL TNDN W FIB
|
Facility
|
OP
|
$30,595.00
|
|
|
Service Code
|
HCPCS 27676
|
| Hospital Charge Code |
1600000585
|
|
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
|
|
|
REP&RECON FINGER VP IP JNT FA
|
Facility
|
IP
|
$26,471.80
|
|
|
Service Code
|
HCPCS 26548
|
| Hospital Charge Code |
16000855
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,970.77 |
| Max. Negotiated Rate |
$3,970.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,970.77
|
|
|
REP&RECON FINGER VP IP JNT FA
|
Facility
|
OP
|
$26,471.80
|
|
|
Service Code
|
HCPCS 26548
|
| Hospital Charge Code |
16000855
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$751.80 |
| 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 |
$6,882.67
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,970.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$836.51
|
| 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 |
$751.80
|
|
|
REP RECURRENT INC HERNIA REDC
|
Facility
|
OP
|
$30,877.00
|
|
|
Service Code
|
HCPCS 49565
|
| Hospital Charge Code |
16000990
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$876.91 |
| Max. Negotiated Rate |
$15,438.50 |
| Rate for Payer: Aetna Commercial |
$11,733.26
|
| Rate for Payer: Aetna Medicare Advantage |
$9,263.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,873.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,873.64
|
| 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 |
$7,873.64
|
| Rate for Payer: Cigna Commercial |
$15,438.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,028.02
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,631.55
|
| Rate for Payer: UnitedHealthcare Community & State |
$975.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$876.91
|
|
|
REP RECURRENT INC HERNIA REDC
|
Facility
|
IP
|
$30,877.00
|
|
|
Service Code
|
HCPCS 49565
|
| Hospital Charge Code |
16000990
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,631.55 |
| Max. Negotiated Rate |
$4,631.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,631.55
|
|
|
REP RECURR FEMORAL HERNIA; INC
|
Facility
|
IP
|
$15,383.24
|
|
|
Service Code
|
HCPCS 49557
|
| Hospital Charge Code |
1600000709
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,307.49 |
| Max. Negotiated Rate |
$2,307.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,307.49
|
|
|
REP RECURR FEMORAL HERNIA; INC
|
Facility
|
OP
|
$15,383.24
|
|
|
Service Code
|
HCPCS 49557
|
| Hospital Charge Code |
1600000709
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$436.88 |
| 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: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,999.64
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,307.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$486.11
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$436.88
|
|
|
REPR ELBOW LAT LIGMNT W/TISS
|
Facility
|
IP
|
$30,663.00
|
|
|
Service Code
|
HCPCS 24343
|
| Hospital Charge Code |
16000548
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,599.45 |
| Max. Negotiated Rate |
$4,599.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,599.45
|
|
|
REPR ELBOW LAT LIGMNT W/TISS
|
Facility
|
OP
|
$30,663.00
|
|
|
Service Code
|
HCPCS 24343
|
| Hospital Charge Code |
16000548
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$870.83 |
| 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 |
$7,972.38
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,599.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$968.95
|
| 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 |
$870.83
|
|
|
REPR FOOT EXTENSOR TENDON EA
|
Facility
|
IP
|
$19,998.60
|
|
|
Service Code
|
HCPCS 28208
|
| Hospital Charge Code |
16000451
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,999.79 |
| Max. Negotiated Rate |
$2,999.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.79
|
|
|
REPR FOOT EXTENSOR TENDON EA
|
Facility
|
OP
|
$19,998.60
|
|
|
Service Code
|
HCPCS 28208
|
| Hospital Charge Code |
16000451
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$567.96 |
| 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 |
$5,199.64
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,999.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$631.96
|
| 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 |
$567.96
|
|
|
REPR FOOT FLEXOR TENDON EA BL
|
Facility
|
IP
|
$20,537.30
|
|
|
Service Code
|
HCPCS 28200
|
| Hospital Charge Code |
16000278
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,080.59 |
| Max. Negotiated Rate |
$3,080.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,080.59
|
|
|
REPR FOOT FLEXOR TENDON EA BL
|
Facility
|
OP
|
$20,537.30
|
|
|
Service Code
|
HCPCS 28200
|
| Hospital Charge Code |
16000278
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$583.26 |
| 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 |
$5,339.70
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,080.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$648.98
|
| 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 |
$583.26
|
|
|
REPR TORN COLLATRAL KNEE LIGAM
|
Facility
|
OP
|
$44,325.10
|
|
|
Service Code
|
HCPCS 27405
|
| Hospital Charge Code |
16000562
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,258.83 |
| 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 |
$11,524.53
|
| Rate for Payer: Oxford Commercial |
$11,677.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,648.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$12,906.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,400.67
|
| 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 |
$1,258.83
|
|
|
REPR TORN COLLATRAL KNEE LIGAM
|
Facility
|
IP
|
$44,325.10
|
|
|
Service Code
|
HCPCS 27405
|
| Hospital Charge Code |
16000562
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,648.77 |
| Max. Negotiated Rate |
$6,648.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6,648.77
|
|
|
REP TENDN/MSCL - FARM.WRIST
|
Facility
|
OP
|
$12,832.72
|
|
|
Service Code
|
HCPCS 25260
|
| Hospital Charge Code |
16000833
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$405.51 |
| 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 |
$3,336.51
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$405.51
|
| 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 |
$649.28
|
|
|
REP TENDN/MSCL - FARM.WRIST
|
Facility
|
IP
|
$12,832.72
|
|
|
Service Code
|
HCPCS 25260
|
| Hospital Charge Code |
16000833
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,924.91 |
| Max. Negotiated Rate |
$1,924.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,924.91
|
|
|
REPTILASE TEST
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 85635
|
| Hospital Charge Code |
38477063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
REPTILASE TEST
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 85635
|
| Hospital Charge Code |
38477063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$26.79
|
| Rate for Payer: Aetna Medicare Advantage |
$31.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.73
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$9.85
|
| Rate for Payer: Clover Medicare Advantage |
$9.36
|
| Rate for Payer: EmblemHealth Commercial |
$29.55
|
| Rate for Payer: Humana Medicare Advantage |
$10.15
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.40
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
REP T.M EXTENSOR FA/W,1' EA
|
Facility
|
OP
|
$38,731.07
|
|
|
Service Code
|
HCPCS 25270
|
| Hospital Charge Code |
16000423
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,223.90 |
| 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 |
$10,070.08
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,809.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1,223.90
|
| 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 |
$8,822.25
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8,649.26
|
|
|
REP T.M EXTENSOR FA/W,1' EA
|
Facility
|
IP
|
$38,731.07
|
|
|
Service Code
|
HCPCS 25270
|
| Hospital Charge Code |
16000423
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,809.66 |
| Max. Negotiated Rate |
$5,809.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,809.66
|
|
|
REP TS FA/WR W FGRAFT
|
Facility
|
OP
|
$30,651.00
|
|
|
Service Code
|
HCPCS 25275
|
| Hospital Charge Code |
16000834
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$870.49 |
| 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 |
$7,969.26
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,597.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$968.57
|
| 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 |
$870.49
|
|
|
REP TS FA/WR W FGRAFT
|
Facility
|
IP
|
$30,651.00
|
|
|
Service Code
|
HCPCS 25275
|
| Hospital Charge Code |
16000834
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,597.65 |
| Max. Negotiated Rate |
$4,597.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,597.65
|
|
|
REREPAIR ING HERNIA,REDUCE-RT
|
Facility
|
OP
|
$30,877.00
|
|
|
Service Code
|
HCPCS 49520
|
| Hospital Charge Code |
160000242
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$876.91 |
| 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: MagnaCare PPO/Direct Plus/Exchange/WC |
$8,028.02
|
| Rate for Payer: Oxford Commercial |
$9,354.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4,631.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$10,269.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$975.71
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,253.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$876.91
|
|