|
CIRCUIT VENTILATOR BIPAP
|
Facility
|
OP
|
$33.45
|
|
| Hospital Charge Code |
270655449
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.95 |
| Max. Negotiated Rate |
$16.73 |
| Rate for Payer: Aetna Commercial |
$12.71
|
| Rate for Payer: Aetna Medicare Advantage |
$10.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.53
|
| Rate for Payer: Cigna Commercial |
$16.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.70
|
| Rate for Payer: Oxford Commercial |
$6.69
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.69
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.95
|
|
|
CIRCUIT VENTILATOR SET-UP
|
Facility
|
OP
|
$11.87
|
|
| Hospital Charge Code |
270604475
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$5.93 |
| Rate for Payer: Aetna Commercial |
$4.51
|
| Rate for Payer: Aetna Medicare Advantage |
$3.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.03
|
| Rate for Payer: Cigna Commercial |
$5.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.09
|
| Rate for Payer: Oxford Commercial |
$2.37
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.37
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.34
|
|
|
CIRCUIT VENTILATOR SET-UP
|
Facility
|
IP
|
$11.87
|
|
| Hospital Charge Code |
270604475
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.78 |
| Max. Negotiated Rate |
$1.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.78
|
|
|
CIRCULATING ANTICOAGULANT
|
Facility
|
IP
|
$268.00
|
|
|
Service Code
|
HCPCS 85300
|
| Hospital Charge Code |
38478072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$40.20 |
| Max. Negotiated Rate |
$40.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.20
|
|
|
CIRCULATING ANTICOAGULANT
|
Facility
|
OP
|
$268.00
|
|
|
Service Code
|
HCPCS 85300
|
| Hospital Charge Code |
38478072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.61 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$32.23
|
| Rate for Payer: Aetna Medicare Advantage |
$38.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.99
|
| Rate for Payer: Cigna Commercial |
$134.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.85
|
| Rate for Payer: Clover Medicare Advantage |
$11.26
|
| Rate for Payer: EmblemHealth Commercial |
$35.55
|
| Rate for Payer: Humana Medicare Advantage |
$12.21
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.68
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$40.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.61
|
|
|
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$89,374.86
|
|
|
Service Code
|
MSDRG 286
|
| Min. Negotiated Rate |
$27,213.50 |
| Max. Negotiated Rate |
$89,374.86 |
| Rate for Payer: Aetna Commercial |
$65,512.31
|
| Rate for Payer: Aetna Medicare Advantage |
$89,374.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59,842.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59,842.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$28,645.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59,842.80
|
| Rate for Payer: Cigna Commercial |
$49,329.95
|
| Rate for Payer: Cigna Medicare Advantage |
$28,645.79
|
| Rate for Payer: Clover Medicare Advantage |
$27,213.50
|
| Rate for Payer: EmblemHealth Commercial |
$85,937.37
|
| Rate for Payer: Humana Medicare Advantage |
$29,505.16
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$28,645.79
|
| Rate for Payer: Oxford Commercial |
$38,989.54
|
| Rate for Payer: UnitedHealthcare Commercial |
$52,188.89
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$28,645.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$28,645.79
|
|
|
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$53,272.94
|
|
|
Service Code
|
MSDRG 287
|
| Min. Negotiated Rate |
$16,220.93 |
| Max. Negotiated Rate |
$53,272.94 |
| Rate for Payer: Aetna Commercial |
$39,800.10
|
| Rate for Payer: Aetna Medicare Advantage |
$53,272.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29,921.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29,921.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,074.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29,921.40
|
| Rate for Payer: Cigna Commercial |
$23,855.74
|
| Rate for Payer: Cigna Medicare Advantage |
$17,074.66
|
| Rate for Payer: Clover Medicare Advantage |
$16,220.93
|
| Rate for Payer: EmblemHealth Commercial |
$51,223.98
|
| Rate for Payer: Humana Medicare Advantage |
$17,586.90
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,074.66
|
| Rate for Payer: Oxford Commercial |
$18,855.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$25,238.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,074.66
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,074.66
|
|
|
CIRCUMCISION BY CLAMP
|
Facility
|
IP
|
$5,823.00
|
|
|
Service Code
|
HCPCS 54150
|
| Hospital Charge Code |
83091010
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$873.45 |
| Max. Negotiated Rate |
$873.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$873.45
|
|
|
CIRCUMCISION BY CLAMP
|
Facility
|
OP
|
$5,823.00
|
|
|
Service Code
|
HCPCS 54150
|
| Hospital Charge Code |
83091010
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$66.00 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$66.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,513.98
|
| Rate for Payer: Oxford Commercial |
$1,164.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$873.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,164.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$184.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.37
|
|
|
CIRCUMCISION-BY CLAMP
|
Facility
|
IP
|
$5,823.00
|
|
|
Service Code
|
HCPCS 54150
|
| Hospital Charge Code |
83080015
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$873.45 |
| Max. Negotiated Rate |
$873.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$873.45
|
|
|
CIRCUMCISION-BY CLAMP
|
Facility
|
OP
|
$5,823.00
|
|
|
Service Code
|
HCPCS 54150
|
| Hospital Charge Code |
83080015
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$165.37 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| 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 |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,513.98
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$873.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$184.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.37
|
|
|
CIRCUMCISION BY SLIT
|
Facility
|
OP
|
$5,823.00
|
|
|
Service Code
|
HCPCS 54160
|
| Hospital Charge Code |
83091015
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$77.00 |
| Max. Negotiated Rate |
$3,005.06 |
| Rate for Payer: Aetna Commercial |
$2,253.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,684.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,005.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,005.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$828.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$77.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,005.06
|
| Rate for Payer: Cigna Commercial |
$1,660.53
|
| Rate for Payer: Cigna Medicare Advantage |
$828.41
|
| Rate for Payer: Clover Medicare Advantage |
$786.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,485.23
|
| Rate for Payer: Humana Medicare Advantage |
$853.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$828.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,513.98
|
| Rate for Payer: Oxford Commercial |
$1,164.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$873.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,164.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$184.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$828.41
|
| Rate for Payer: Wellcare Medicare Advantage |
$828.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$165.37
|
|
|
CIRCUMCISION BY SLIT
|
Facility
|
IP
|
$5,823.00
|
|
|
Service Code
|
HCPCS 54160
|
| Hospital Charge Code |
83091015
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$873.45 |
| Max. Negotiated Rate |
$873.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$873.45
|
|
|
CIRCUMCISION-BY SLIT
|
Facility
|
IP
|
$10,847.54
|
|
|
Service Code
|
HCPCS 54160
|
| Hospital Charge Code |
83080020
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,627.13 |
| Max. Negotiated Rate |
$1,627.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,627.13
|
|
|
CIRCUMCISION-BY SLIT
|
Facility
|
OP
|
$10,847.54
|
|
|
Service Code
|
HCPCS 54160
|
| Hospital Charge Code |
83080020
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$77.00 |
| Max. Negotiated Rate |
$3,005.06 |
| Rate for Payer: Aetna Commercial |
$2,253.28
|
| Rate for Payer: Aetna Medicare Advantage |
$2,684.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,005.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,005.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$828.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$77.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,005.06
|
| Rate for Payer: Cigna Commercial |
$1,660.53
|
| Rate for Payer: Cigna Medicare Advantage |
$828.41
|
| Rate for Payer: Clover Medicare Advantage |
$786.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,485.23
|
| Rate for Payer: Humana Medicare Advantage |
$853.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$828.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,820.36
|
| Rate for Payer: Oxford Commercial |
$2,169.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,627.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,169.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$342.78
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$828.41
|
| Rate for Payer: Wellcare Medicare Advantage |
$828.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$308.07
|
|
|
CIRCUMCISION W CLAMP AND BLOCK
|
Facility
|
OP
|
$9,705.00
|
|
|
Service Code
|
HCPCS 54150
|
| Hospital Charge Code |
87502605
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$275.62 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| 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 |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,523.30
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,455.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$306.68
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$275.62
|
|
|
CIRCUMCISION W CLAMP AND BLOCK
|
Facility
|
IP
|
$9,705.00
|
|
|
Service Code
|
HCPCS 54150
|
| Hospital Charge Code |
87502605
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,455.75 |
| Max. Negotiated Rate |
$1,455.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,455.75
|
|
|
CIRCUMCISION W/REGIONL BLOCK
|
Facility
|
IP
|
$4,952.46
|
|
|
Service Code
|
HCPCS 54150
|
| Hospital Charge Code |
1600000606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$742.87 |
| Max. Negotiated Rate |
$742.87 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$742.87
|
|
|
CIRCUMCISION W/REGIONL BLOCK
|
Facility
|
OP
|
$4,952.46
|
|
|
Service Code
|
HCPCS 54150
|
| Hospital Charge Code |
1600000606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$140.65 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| 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 |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,287.64
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$742.87
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$156.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$140.65
|
|
|
CIRCUMSICISON-ADULT
|
Facility
|
IP
|
$20,610.70
|
|
|
Service Code
|
HCPCS 54161
|
| Hospital Charge Code |
16000167
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,091.61 |
| Max. Negotiated Rate |
$3,091.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,091.61
|
|
|
CIRCUMSICISON-ADULT
|
Facility
|
OP
|
$20,610.70
|
|
|
Service Code
|
HCPCS 54161
|
| Hospital Charge Code |
16000167
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$585.34 |
| Max. Negotiated Rate |
$9,008.64 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9,008.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| 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 |
$9,008.64
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5,358.78
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,091.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$651.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$585.34
|
|
|
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$52,833.74
|
|
|
Service Code
|
MSDRG 433
|
| Min. Negotiated Rate |
$16,087.20 |
| Max. Negotiated Rate |
$52,833.74 |
| Rate for Payer: Aetna Commercial |
$39,487.29
|
| Rate for Payer: Aetna Medicare Advantage |
$52,833.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28,536.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28,536.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16,933.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28,536.15
|
| Rate for Payer: Cigna Commercial |
$23,545.87
|
| Rate for Payer: Cigna Medicare Advantage |
$16,933.89
|
| Rate for Payer: Clover Medicare Advantage |
$16,087.20
|
| Rate for Payer: EmblemHealth Commercial |
$50,801.67
|
| Rate for Payer: Humana Medicare Advantage |
$17,441.91
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16,933.89
|
| Rate for Payer: Oxford Commercial |
$18,610.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$24,910.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16,933.89
|
| Rate for Payer: Wellcare Medicare Advantage |
$16,933.89
|
|
|
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$81,647.09
|
|
|
Service Code
|
MSDRG 432
|
| Min. Negotiated Rate |
$24,860.49 |
| Max. Negotiated Rate |
$81,647.09 |
| Rate for Payer: Aetna Commercial |
$60,008.51
|
| Rate for Payer: Aetna Medicare Advantage |
$81,647.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$53,193.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$53,193.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$26,168.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$53,193.60
|
| Rate for Payer: Cigna Commercial |
$43,877.08
|
| Rate for Payer: Cigna Medicare Advantage |
$26,168.94
|
| Rate for Payer: Clover Medicare Advantage |
$24,860.49
|
| Rate for Payer: EmblemHealth Commercial |
$78,506.82
|
| Rate for Payer: Humana Medicare Advantage |
$26,954.01
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$26,168.94
|
| Rate for Payer: Oxford Commercial |
$34,679.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$46,420.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$26,168.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$26,168.94
|
|
|
CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$41,975.04
|
|
|
Service Code
|
MSDRG 434
|
| Min. Negotiated Rate |
$12,554.25 |
| Max. Negotiated Rate |
$41,975.04 |
| Rate for Payer: Aetna Commercial |
$31,753.61
|
| Rate for Payer: Aetna Medicare Advantage |
$41,975.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18,562.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18,562.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,453.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18,562.35
|
| Rate for Payer: Cigna Commercial |
$15,883.76
|
| Rate for Payer: Cigna Medicare Advantage |
$13,453.54
|
| Rate for Payer: Clover Medicare Advantage |
$12,780.86
|
| Rate for Payer: EmblemHealth Commercial |
$40,360.62
|
| Rate for Payer: Humana Medicare Advantage |
$13,857.15
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,453.54
|
| Rate for Payer: Oxford Commercial |
$12,554.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,804.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,453.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,453.54
|
|
|
CISATRACURIUM 10MG/5ML
|
Facility
|
OP
|
$126.03
|
|
|
Service Code
|
NDC 74437805
|
| Hospital Charge Code |
60635765
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$63.02 |
| Rate for Payer: Aetna Commercial |
$47.89
|
| Rate for Payer: Aetna Medicare Advantage |
$37.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.14
|
| Rate for Payer: Cigna Commercial |
$63.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.77
|
| Rate for Payer: Oxford Commercial |
$25.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$25.21
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.58
|
|
