|
CL TX PROX TIBIAL FX W SK TRCN
|
Facility
|
OP
|
$14,872.30
|
|
|
Service Code
|
HCPCS 27532
|
| Hospital Charge Code |
16000887
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$422.37 |
| 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 |
$3,866.80
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,230.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$469.96
|
| 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 |
$422.37
|
|
|
CL TX PROX TIBIAL FX W SK TRCN
|
Facility
|
IP
|
$14,872.30
|
|
|
Service Code
|
HCPCS 27532
|
| Hospital Charge Code |
16000887
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,230.84 |
| Max. Negotiated Rate |
$2,230.84 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,230.84
|
|
|
CL TX RADIAL HD/NK FX: W MANIP
|
Facility
|
IP
|
$2,063.00
|
|
|
Service Code
|
HCPCS 24655
|
| Hospital Charge Code |
16000684
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$309.45 |
| Max. Negotiated Rate |
$309.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$309.45
|
|
|
CL TX RADIAL HD/NK FX: W MANIP
|
Facility
|
OP
|
$2,063.00
|
|
|
Service Code
|
HCPCS 24655
|
| Hospital Charge Code |
16000684
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$58.59 |
| 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 |
$536.38
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$309.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$65.19
|
| 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 |
$58.59
|
|
|
CLTX RADL&ULNA FX W MANIP
|
Facility
|
IP
|
$2,244.48
|
|
|
Service Code
|
HCPCS 25565
|
| Hospital Charge Code |
1600000647
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$336.67 |
| Max. Negotiated Rate |
$336.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$336.67
|
|
|
CLTX RADL&ULNA FX W MANIP
|
Facility
|
OP
|
$2,244.48
|
|
|
Service Code
|
HCPCS 25565
|
| Hospital Charge Code |
1600000647
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$63.74 |
| 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 |
$583.56
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$336.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$70.93
|
| 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 |
$63.74
|
|
|
CL TX SCAPULA W/MANIP
|
Facility
|
IP
|
$7,914.45
|
|
|
Service Code
|
HCPCS 23575
|
| Hospital Charge Code |
5780035
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,187.17 |
| Max. Negotiated Rate |
$1,187.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,187.17
|
|
|
CL TX SCAPULA W/MANIP
|
Facility
|
OP
|
$7,914.45
|
|
|
Service Code
|
HCPCS 23575
|
| Hospital Charge Code |
5780035
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$129.78 |
| 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 |
$129.78
|
| 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 |
$2,057.76
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,187.17
|
| 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 |
$224.77
|
|
|
CL TX SC/TX HMRS SHFT FX W MNP
|
Facility
|
OP
|
$2,232.31
|
|
|
Service Code
|
HCPCS 24535
|
| Hospital Charge Code |
16000683
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$63.40 |
| 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 |
$580.40
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$334.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$70.54
|
| 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 |
$63.40
|
|
|
CL TX SC/TX HMRS SHFT FX W MNP
|
Facility
|
IP
|
$2,232.31
|
|
|
Service Code
|
HCPCS 24535
|
| Hospital Charge Code |
16000683
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$334.85 |
| Max. Negotiated Rate |
$334.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$334.85
|
|
|
CLTX SHLDR DISL W M;W ANSTH
|
Facility
|
IP
|
$14,397.50
|
|
|
Service Code
|
HCPCS 23655
|
| Hospital Charge Code |
1600000646
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,159.62 |
| Max. Negotiated Rate |
$2,159.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,159.62
|
|
|
CLTX SHLDR DISL W M;W ANSTH
|
Facility
|
OP
|
$14,397.50
|
|
|
Service Code
|
HCPCS 23655
|
| Hospital Charge Code |
1600000646
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$408.89 |
| 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 |
$3,743.35
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,159.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$454.96
|
| 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 |
$408.89
|
|
|
CL TX TARSAL BONE DISC,W ANEST
|
Facility
|
OP
|
$23,899.60
|
|
|
Service Code
|
HCPCS 28545
|
| Hospital Charge Code |
1600000697
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$678.75 |
| 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 |
$6,213.90
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,584.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$755.23
|
| 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 |
$678.75
|
|
|
CL TX TARSAL BONE DISC,W ANEST
|
Facility
|
IP
|
$23,899.60
|
|
|
Service Code
|
HCPCS 28545
|
| Hospital Charge Code |
1600000697
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,584.94 |
| Max. Negotiated Rate |
$3,584.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3,584.94
|
|
|
CL TX TIB SHFT FX W MANIP RT
|
Facility
|
IP
|
$19,424.65
|
|
|
Service Code
|
HCPCS 27752
|
| Hospital Charge Code |
1600000286
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,913.70 |
| Max. Negotiated Rate |
$2,913.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,913.70
|
|
|
CL TX TIB SHFT FX W MANIP RT
|
Facility
|
OP
|
$19,424.65
|
|
|
Service Code
|
HCPCS 27752
|
| Hospital Charge Code |
1600000286
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$551.66 |
| 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 |
$5,050.41
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,913.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$613.82
|
| 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 |
$551.66
|
|
|
CL TX TMALL ANKLE FX W MANIP
|
Facility
|
IP
|
$5,332.00
|
|
|
Service Code
|
HCPCS 27818
|
| Hospital Charge Code |
1600000427
|
|
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 TMALL ANKLE FX W MANIP
|
Facility
|
OP
|
$5,332.00
|
|
|
Service Code
|
HCPCS 27818
|
| Hospital Charge Code |
1600000427
|
|
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 TRANS-SCAPHOPERILU FX W
|
Facility
|
IP
|
$1,241.80
|
|
|
Service Code
|
HCPCS 25680
|
| Hospital Charge Code |
5780065
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$186.27 |
| Max. Negotiated Rate |
$186.27 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$186.27
|
|
|
CL TX TRANS-SCAPHOPERILU FX W
|
Facility
|
OP
|
$1,241.80
|
|
|
Service Code
|
HCPCS 25680
|
| Hospital Charge Code |
5780065
|
|
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 |
$210.03
|
| 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
|
|
|
CL TX ULNAR SHFT FX W MANIP
|
Facility
|
IP
|
$2,063.00
|
|
|
Service Code
|
HCPCS 25535
|
| Hospital Charge Code |
16000692
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$309.45 |
| Max. Negotiated Rate |
$309.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$309.45
|
|
|
CL TX ULNAR SHFT FX W MANIP
|
Facility
|
OP
|
$2,063.00
|
|
|
Service Code
|
HCPCS 25535
|
| Hospital Charge Code |
16000692
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$58.59 |
| 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 |
$536.38
|
| Rate for Payer: Oxford Commercial |
$2,297.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$309.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,256.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$65.19
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$293.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$58.59
|
|
|
CL TX WB DSTL TIB FX W MANIP
|
Facility
|
OP
|
$6,728.28
|
|
|
Service Code
|
HCPCS 27828
|
| Hospital Charge Code |
1600000715
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$191.08 |
| Max. Negotiated Rate |
$55,329.13 |
| Rate for Payer: Aetna Commercial |
$41,487.32
|
| Rate for Payer: Aetna Medicare Advantage |
$49,418.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55,329.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55,329.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15,252.69
|
| 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 |
$55,329.13
|
| Rate for Payer: Cigna Commercial |
$30,573.98
|
| Rate for Payer: Cigna Medicare Advantage |
$15,252.69
|
| Rate for Payer: Clover Medicare Advantage |
$14,490.06
|
| Rate for Payer: EmblemHealth Commercial |
$45,758.07
|
| Rate for Payer: Humana Medicare Advantage |
$15,710.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15,252.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,749.35
|
| Rate for Payer: Oxford Commercial |
$13,407.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,009.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,869.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$212.61
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$15,252.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$191.08
|
|
|
CL TX WB DSTL TIB FX W MANIP
|
Facility
|
OP
|
$15,476.60
|
|
|
Service Code
|
HCPCS 27825
|
| Hospital Charge Code |
16000480
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$439.54 |
| 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 |
$4,023.92
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,321.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$489.06
|
| 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 |
$439.54
|
|
|
CL TX WB DSTL TIB FX W MANIP
|
Facility
|
IP
|
$6,728.28
|
|
|
Service Code
|
HCPCS 27828
|
| Hospital Charge Code |
1600000715
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,009.24 |
| Max. Negotiated Rate |
$1,009.24 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,009.24
|
|
