|
CLTX DSTL RDL FX/EPIPHYSL SEP
|
Facility
|
OP
|
$5,332.00
|
|
|
Service Code
|
HCPCS 25605
|
| Hospital Charge Code |
1600000561
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$151.43 |
| 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 |
$1,386.32
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$799.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$168.49
|
| 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 |
$151.43
|
|
|
CL TX FX GT PHALANX(S),W MANIP
|
Facility
|
OP
|
$2,060.30
|
|
|
Service Code
|
HCPCS 28495
|
| Hospital Charge Code |
16000636
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$58.51 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| 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 |
$1,063.04
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$535.68
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$309.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$65.11
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$58.51
|
|
|
CL TX FX GT PHALANX(S),W MANIP
|
Facility
|
IP
|
$2,060.30
|
|
|
Service Code
|
HCPCS 28495
|
| Hospital Charge Code |
16000636
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$309.05 |
| Max. Negotiated Rate |
$309.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$309.05
|
|
|
CL TX HUMERUS FX W MANIP
|
Facility
|
IP
|
$2,060.30
|
|
|
Service Code
|
HCPCS 24505
|
| Hospital Charge Code |
16000824
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$309.05 |
| Max. Negotiated Rate |
$309.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$309.05
|
|
|
CL TX HUMERUS FX W MANIP
|
Facility
|
OP
|
$2,060.30
|
|
|
Service Code
|
HCPCS 24505
|
| Hospital Charge Code |
16000824
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$58.51 |
| 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 |
$535.68
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$309.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$65.11
|
| 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 |
$58.51
|
|
|
CLTX MED ANKLE FX W/MNPJ
|
Facility
|
OP
|
$10,964.50
|
|
|
Service Code
|
HCPCS 27762
|
| Hospital Charge Code |
1600000481
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$311.39 |
| 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 |
$2,850.77
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,644.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$346.48
|
| 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 |
$311.39
|
|
|
CLTX MED ANKLE FX W/MNPJ
|
Facility
|
IP
|
$10,964.50
|
|
|
Service Code
|
HCPCS 27762
|
| Hospital Charge Code |
1600000481
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,644.67 |
| Max. Negotiated Rate |
$1,644.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,644.67
|
|
|
CL TX METATARSAL FX; W MANIP
|
Facility
|
IP
|
$2,519.70
|
|
|
Service Code
|
HCPCS 28475
|
| Hospital Charge Code |
16000429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$377.95 |
| Max. Negotiated Rate |
$377.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$377.95
|
|
|
CL TX METATARSAL FX; W MANIP
|
Facility
|
OP
|
$2,519.70
|
|
|
Service Code
|
HCPCS 28475
|
| Hospital Charge Code |
16000429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$71.56 |
| Max. Negotiated Rate |
$3,536.00 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| 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 |
$1,063.04
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$655.12
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$377.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$79.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$71.56
|
|
|
CL TX NASAL SEPTAL FX
|
Facility
|
OP
|
$14,464.70
|
|
|
Service Code
|
HCPCS 21337
|
| Hospital Charge Code |
16000604
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$410.80 |
| 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 |
$3,760.82
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,169.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$457.08
|
| 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 |
$410.80
|
|
|
CL TX NASAL SEPTAL FX
|
Facility
|
IP
|
$14,464.70
|
|
|
Service Code
|
HCPCS 21337
|
| Hospital Charge Code |
16000604
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,169.70 |
| Max. Negotiated Rate |
$2,169.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,169.70
|
|
|
CL TX NAVICULAR FX W/MANIP
|
Facility
|
OP
|
$6,087.10
|
|
|
Service Code
|
HCPCS 25624
|
| Hospital Charge Code |
5780060
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$131.67 |
| 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 |
$131.67
|
| 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 |
$1,582.65
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$913.07
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| 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 |
$172.87
|
|
|
CL TX NAVICULAR FX W/MANIP
|
Facility
|
IP
|
$6,087.10
|
|
|
Service Code
|
HCPCS 25624
|
| Hospital Charge Code |
5780060
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$913.07 |
| Max. Negotiated Rate |
$913.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$913.07
|
|
|
CL TX OF NASAL BNE FX,W STILZ
|
Facility
|
IP
|
$19,264.86
|
|
|
Service Code
|
HCPCS 21320
|
| Hospital Charge Code |
1600000710
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,889.73 |
| Max. Negotiated Rate |
$2,889.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,889.73
|
|
|
CL TX OF NASAL BNE FX,W STILZ
|
Facility
|
OP
|
$19,264.86
|
|
|
Service Code
|
HCPCS 21320
|
| Hospital Charge Code |
1600000710
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$547.12 |
| 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 |
$5,008.86
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,889.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$608.77
|
| 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 |
$547.12
|
|
|
CL TX OF NSL BNE FX,WO STABILZ
|
Facility
|
OP
|
$15,651.38
|
|
|
Service Code
|
HCPCS 21315
|
| Hospital Charge Code |
16000672
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$444.50 |
| Max. Negotiated Rate |
$6,686.64 |
| Rate for Payer: Aetna Commercial |
$5,013.83
|
| Rate for Payer: Aetna Medicare Advantage |
$5,972.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,686.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,686.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,843.32
|
| 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 |
$6,686.64
|
| Rate for Payer: Cigna Commercial |
$3,694.94
|
| Rate for Payer: Cigna Medicare Advantage |
$1,843.32
|
| Rate for Payer: Clover Medicare Advantage |
$1,751.15
|
| Rate for Payer: EmblemHealth Commercial |
$5,529.96
|
| Rate for Payer: Humana Medicare Advantage |
$1,898.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,843.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,069.36
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,347.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$494.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,843.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,843.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$444.50
|
|
|
CL TX OF NSL BNE FX,WO STABILZ
|
Facility
|
IP
|
$15,651.38
|
|
|
Service Code
|
HCPCS 21315
|
| Hospital Charge Code |
16000672
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,347.71 |
| Max. Negotiated Rate |
$2,347.71 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,347.71
|
|
|
CL TX OLECRN-COROND PROC FX W/
|
Facility
|
IP
|
$6,749.20
|
|
|
Service Code
|
HCPCS 24675
|
| Hospital Charge Code |
5780055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,012.38 |
| Max. Negotiated Rate |
$1,012.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,012.38
|
|
|
CL TX OLECRN-COROND PROC FX W/
|
Facility
|
OP
|
$6,749.20
|
|
|
Service Code
|
HCPCS 24675
|
| Hospital Charge Code |
5780055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.00 |
| 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 |
$210.61
|
| 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 |
$1,754.79
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,012.38
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| 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 |
$191.68
|
|
|
CL TX POSTOP HIP DISLC W ANSTH
|
Facility
|
IP
|
$13,711.90
|
|
|
Service Code
|
HCPCS 27266
|
| Hospital Charge Code |
16000707
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,056.78 |
| Max. Negotiated Rate |
$2,056.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,056.78
|
|
|
CL TX POSTOP HIP DISLC W ANSTH
|
Facility
|
OP
|
$13,711.90
|
|
|
Service Code
|
HCPCS 27266
|
| Hospital Charge Code |
16000707
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$389.42 |
| 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 |
$3,565.09
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,056.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$433.30
|
| 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 |
$389.42
|
|
|
CL TX PROX FIB/SHAFT FX WMANIP
|
Facility
|
IP
|
$5,332.00
|
|
|
Service Code
|
HCPCS 27781
|
| Hospital Charge Code |
16000627
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$799.80 |
| Max. Negotiated Rate |
$799.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$799.80
|
|
|
CL TX PROX FIB/SHAFT FX WMANIP
|
Facility
|
OP
|
$5,332.00
|
|
|
Service Code
|
HCPCS 27781
|
| Hospital Charge Code |
16000627
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$151.43 |
| 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 |
$1,386.32
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$799.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$168.49
|
| 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 |
$151.43
|
|
|
CLTXPROXTIBFIB JTDISLC WO ANES
|
Facility
|
IP
|
$1,241.80
|
|
|
Service Code
|
HCPCS 27830
|
| Hospital Charge Code |
323027830
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$186.27 |
| Max. Negotiated Rate |
$186.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$186.27
|
|
|
CLTXPROXTIBFIB JTDISLC WO ANES
|
Facility
|
OP
|
$1,241.80
|
|
|
Service Code
|
HCPCS 27830
|
| Hospital Charge Code |
323027830
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$35.27 |
| Max. Negotiated Rate |
$1,063.04 |
| Rate for Payer: Aetna Commercial |
$797.10
|
| Rate for Payer: Aetna Medicare Advantage |
$949.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,063.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$293.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,063.04
|
| Rate for Payer: Cigna Commercial |
$587.42
|
| Rate for Payer: Cigna Medicare Advantage |
$293.05
|
| Rate for Payer: Clover Medicare Advantage |
$278.40
|
| Rate for Payer: EmblemHealth Commercial |
$879.15
|
| Rate for Payer: Humana Medicare Advantage |
$301.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$293.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$322.87
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$186.27
|
| Rate for Payer: UnitedHealthcare Community & State |
$140.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.27
|
|
