|
SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS
|
Facility
|
IP
|
$127,249.23
|
|
|
Service Code
|
MSDRG 029
|
| Min. Negotiated Rate |
$38,745.76 |
| Max. Negotiated Rate |
$127,249.23 |
| Rate for Payer: Aetna Medicare Advantage |
$127,249.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$95,028.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$95,028.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$40,785.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$95,028.15
|
| Rate for Payer: Cigna Commercial |
$76,054.80
|
| Rate for Payer: Cigna Medicare Advantage |
$40,785.01
|
| Rate for Payer: Clover Medicare Advantage |
$38,745.76
|
| Rate for Payer: EmblemHealth Commercial |
$122,355.03
|
| Rate for Payer: Humana Medicare Advantage |
$42,008.56
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$40,785.01
|
| Rate for Payer: Oxford Commercial |
$60,112.39
|
| Rate for Payer: UnitedHealthcare Commercial |
$80,462.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$40,785.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$40,785.01
|
|
|
SPINAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$209,288.26
|
|
|
Service Code
|
MSDRG 028
|
| Min. Negotiated Rate |
$63,725.59 |
| Max. Negotiated Rate |
$209,288.26 |
| Rate for Payer: Aetna Medicare Advantage |
$209,288.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$167,061.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$167,061.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$67,079.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$167,061.15
|
| Rate for Payer: Cigna Commercial |
$133,943.03
|
| Rate for Payer: Cigna Medicare Advantage |
$67,079.57
|
| Rate for Payer: Clover Medicare Advantage |
$63,725.59
|
| Rate for Payer: EmblemHealth Commercial |
$201,238.71
|
| Rate for Payer: Humana Medicare Advantage |
$69,091.96
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$67,079.57
|
| Rate for Payer: Oxford Commercial |
$105,866.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$141,705.76
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$67,079.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$67,079.57
|
|
|
SPINAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$88,818.82
|
|
|
Service Code
|
MSDRG 030
|
| Min. Negotiated Rate |
$27,044.19 |
| Max. Negotiated Rate |
$88,818.82 |
| Rate for Payer: Aetna Medicare Advantage |
$88,818.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$64,275.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$64,275.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$28,467.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$64,275.60
|
| Rate for Payer: Cigna Commercial |
$48,937.59
|
| Rate for Payer: Cigna Medicare Advantage |
$28,467.57
|
| Rate for Payer: Clover Medicare Advantage |
$27,044.19
|
| Rate for Payer: EmblemHealth Commercial |
$85,402.71
|
| Rate for Payer: Humana Medicare Advantage |
$29,321.60
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$28,467.57
|
| Rate for Payer: Oxford Commercial |
$38,679.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$51,773.79
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$28,467.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$28,467.57
|
|
|
SPINAL ROD
|
Facility
|
IP
|
$1,098.00
|
|
| Hospital Charge Code |
270335299
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$164.70 |
| Max. Negotiated Rate |
$265.72 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.70
|
|
|
SPINAL ROD
|
Facility
|
OP
|
$1,098.00
|
|
| Hospital Charge Code |
270335299
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.18 |
| Max. Negotiated Rate |
$549.00 |
| Rate for Payer: Aetna Commercial |
$417.24
|
| Rate for Payer: Aetna Medicare Advantage |
$329.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$279.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$279.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$219.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$279.99
|
| Rate for Payer: Cigna Commercial |
$549.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$265.72
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$164.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.70
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.18
|
|
|
SPINAL STIM BATTERY
|
Facility
|
IP
|
$120,000.00
|
|
|
Service Code
|
HCPCS C1778
|
| Hospital Charge Code |
270703698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18,000.00 |
| Max. Negotiated Rate |
$29,040.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29,040.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18,000.00
|
|
|
SPINAL STIM BATTERY
|
Facility
|
OP
|
$120,000.00
|
|
|
Service Code
|
HCPCS C1778
|
| Hospital Charge Code |
270703698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,408.00 |
| Max. Negotiated Rate |
$60,000.00 |
| Rate for Payer: Aetna Commercial |
$45,600.00
|
| Rate for Payer: Aetna Medicare Advantage |
$36,000.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30,600.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30,600.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24,000.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30,600.00
|
| Rate for Payer: Cigna Commercial |
$60,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29,040.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18,000.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3,792.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3,408.00
|
|
|
SPINAL SYSTEM DTRAX
|
Facility
|
IP
|
$14,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692492
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,100.00 |
| Max. Negotiated Rate |
$3,388.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,800.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,388.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,100.00
|
|
|
SPINAL SYSTEM DTRAX
|
Facility
|
OP
|
$14,000.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270692492
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$397.60 |
| Max. Negotiated Rate |
$7,000.00 |
| Rate for Payer: Aetna Commercial |
$5,320.00
|
| Rate for Payer: Aetna Medicare Advantage |
$4,200.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,570.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,570.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2,800.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,570.00
|
| Rate for Payer: Cigna Commercial |
$7,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,388.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,100.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$442.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$397.60
|
|
|
SPINE ACCESS KIT, DISPOSABLE
|
Facility
|
IP
|
$375.00
|
|
| Hospital Charge Code |
270702072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$56.25 |
| Max. Negotiated Rate |
$90.75 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$75.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.25
|
|
|
SPINE ACCESS KIT, DISPOSABLE
|
Facility
|
OP
|
$375.00
|
|
| Hospital Charge Code |
270702072
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Aetna Commercial |
$142.50
|
| Rate for Payer: Aetna Medicare Advantage |
$112.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$95.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$95.62
|
| Rate for Payer: Cigna Commercial |
$187.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.65
|
|
|
SPINE ENTIRE 1 VIEW
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72081
|
| Hospital Charge Code |
94061477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$35.43 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$281.22
|
| Rate for Payer: Aetna Medicare Advantage |
$334.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$103.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$375.05
|
| Rate for Payer: Cigna Commercial |
$207.24
|
| Rate for Payer: Cigna Medicare Advantage |
$72.37
|
| Rate for Payer: Clover Medicare Advantage |
$98.22
|
| Rate for Payer: EmblemHealth Commercial |
$310.17
|
| Rate for Payer: Humana Medicare Advantage |
$106.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$103.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$216.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
SPINE ENTIRE 1 VIEW
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72081
|
| Hospital Charge Code |
2011556
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$35.43 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$281.22
|
| Rate for Payer: Aetna Medicare Advantage |
$334.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$375.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$103.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$375.05
|
| Rate for Payer: Cigna Commercial |
$207.24
|
| Rate for Payer: Cigna Medicare Advantage |
$72.37
|
| Rate for Payer: Clover Medicare Advantage |
$98.22
|
| Rate for Payer: EmblemHealth Commercial |
$310.17
|
| Rate for Payer: Humana Medicare Advantage |
$106.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$103.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$103.39
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$216.59
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
SPINE ENTIRE 1 VIEW
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72081
|
| Hospital Charge Code |
2011556
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
SPINE ENTIRE 1 VIEW
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72081
|
| Hospital Charge Code |
94061477
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
SPINE ENTIRE 2-3 VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72082
|
| Hospital Charge Code |
94061476
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$57.21 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$57.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$407.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
SPINE ENTIRE 2-3 VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72082
|
| Hospital Charge Code |
2011557
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
SPINE ENTIRE 2-3 VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72082
|
| Hospital Charge Code |
94061476
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
SPINE ENTIRE 2-3 VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72082
|
| Hospital Charge Code |
2011557
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$57.21 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$57.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$407.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
SPINE ENTIRE 4-5 VIEWS
|
Facility
|
IP
|
$1,131.07
|
|
|
Service Code
|
HCPCS 72083
|
| Hospital Charge Code |
94061478
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$169.66 |
| Max. Negotiated Rate |
$169.66 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.66
|
|
|
SPINE ENTIRE 4-5 VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72083
|
| Hospital Charge Code |
2011558
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
|
SPINE ENTIRE 4-5 VIEWS
|
Facility
|
OP
|
$1,131.07
|
|
|
Service Code
|
HCPCS 72083
|
| Hospital Charge Code |
94061478
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.12 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$62.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$294.08
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$169.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$35.74
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$1,837.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$32.12
|
|
|
SPINE ENTIRE 4-5 VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72083
|
| Hospital Charge Code |
2011558
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$62.07 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$62.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$1,837.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
SPINE ENTIRE MIN 6 VIEWS
|
Facility
|
OP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72084
|
| Hospital Charge Code |
2011559
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$74.20 |
| Max. Negotiated Rate |
$2,231.00 |
| Rate for Payer: Aetna Commercial |
$337.82
|
| Rate for Payer: Aetna Medicare Advantage |
$402.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$450.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$124.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$74.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$450.54
|
| Rate for Payer: Cigna Commercial |
$248.96
|
| Rate for Payer: Cigna Medicare Advantage |
$86.94
|
| Rate for Payer: Clover Medicare Advantage |
$117.99
|
| Rate for Payer: EmblemHealth Commercial |
$372.60
|
| Rate for Payer: Humana Medicare Advantage |
$127.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$124.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,326.00
|
| Rate for Payer: Oxford Commercial |
$1,955.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,231.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$161.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$124.20
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$817.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$144.84
|
|
|
SPINE ENTIRE MIN 6 VIEWS
|
Facility
|
IP
|
$5,100.00
|
|
|
Service Code
|
HCPCS 72084
|
| Hospital Charge Code |
2011559
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$765.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$765.00
|
|
