|
DISORDERS OF GALLBLADDER AND BILIARY TRACT
|
Facility
|
IP
|
$8,843.41
|
|
|
Service Code
|
APR-DRG 2841
|
| Min. Negotiated Rate |
$8,670.01 |
| Max. Negotiated Rate |
$8,843.41 |
| Rate for Payer: UnitedHealthcare Community & State |
$8,670.01
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$8,843.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8,670.01
|
|
|
DISORDERS OF IMPULSE CONTROL & DEVELOPMENT
|
Facility
|
IP
|
$6,180.67
|
|
|
Service Code
|
APR-DRG 7582
|
| Min. Negotiated Rate |
$6,059.48 |
| Max. Negotiated Rate |
$6,180.67 |
| Rate for Payer: UnitedHealthcare Community & State |
$6,059.48
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$6,180.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6,059.48
|
|
|
DISORDERS OF IMPULSE CONTROL & DEVELOPMENT
|
Facility
|
IP
|
$14,226.39
|
|
|
Service Code
|
APR-DRG 7584
|
| Min. Negotiated Rate |
$13,947.44 |
| Max. Negotiated Rate |
$14,226.39 |
| Rate for Payer: UnitedHealthcare Community & State |
$13,947.44
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$14,226.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13,947.44
|
|
|
DISORDERS OF IMPULSE CONTROL & DEVELOPMENT
|
Facility
|
IP
|
$4,845.08
|
|
|
Service Code
|
APR-DRG 7581
|
| Min. Negotiated Rate |
$4,750.08 |
| Max. Negotiated Rate |
$4,845.08 |
| Rate for Payer: UnitedHealthcare Community & State |
$4,750.08
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$4,845.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4,750.08
|
|
|
DISORDERS OF IMPULSE CONTROL & DEVELOPMENT
|
Facility
|
IP
|
$10,808.10
|
|
|
Service Code
|
APR-DRG 7583
|
| Min. Negotiated Rate |
$10,596.18 |
| Max. Negotiated Rate |
$10,808.10 |
| Rate for Payer: UnitedHealthcare Community & State |
$10,596.18
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$10,808.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10,596.18
|
|
|
DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$49,961.90
|
|
|
Service Code
|
MSDRG 442
|
| Min. Negotiated Rate |
$15,212.76 |
| Max. Negotiated Rate |
$49,961.90 |
| Rate for Payer: Aetna Commercial |
$37,441.93
|
| Rate for Payer: Aetna Medicare Advantage |
$49,961.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26,319.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26,319.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16,013.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26,319.75
|
| Rate for Payer: Cigna Commercial |
$21,519.43
|
| Rate for Payer: Cigna Medicare Advantage |
$16,013.43
|
| Rate for Payer: Clover Medicare Advantage |
$15,212.76
|
| Rate for Payer: EmblemHealth Commercial |
$48,040.29
|
| Rate for Payer: Humana Medicare Advantage |
$16,493.83
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16,013.43
|
| Rate for Payer: Oxford Commercial |
$17,008.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$22,766.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16,013.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$16,013.43
|
|
|
DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$76,165.63
|
|
|
Service Code
|
MSDRG 441
|
| Min. Negotiated Rate |
$23,191.46 |
| Max. Negotiated Rate |
$76,165.63 |
| Rate for Payer: Aetna Commercial |
$56,104.52
|
| Rate for Payer: Aetna Medicare Advantage |
$76,165.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50,700.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50,700.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24,412.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50,700.15
|
| Rate for Payer: Cigna Commercial |
$40,009.25
|
| Rate for Payer: Cigna Medicare Advantage |
$24,412.06
|
| Rate for Payer: Clover Medicare Advantage |
$23,191.46
|
| Rate for Payer: EmblemHealth Commercial |
$73,236.18
|
| Rate for Payer: Humana Medicare Advantage |
$25,144.42
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24,412.06
|
| Rate for Payer: Oxford Commercial |
$31,622.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$42,328.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24,412.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$24,412.06
|
|
|
DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$41,570.72
|
|
|
Service Code
|
MSDRG 443
|
| Min. Negotiated Rate |
$12,328.71 |
| Max. Negotiated Rate |
$41,570.72 |
| Rate for Payer: Aetna Commercial |
$31,465.63
|
| Rate for Payer: Aetna Medicare Advantage |
$41,570.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19,670.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19,670.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13,323.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19,670.55
|
| Rate for Payer: Cigna Commercial |
$15,598.41
|
| Rate for Payer: Cigna Medicare Advantage |
$13,323.95
|
| Rate for Payer: Clover Medicare Advantage |
$12,657.75
|
| Rate for Payer: EmblemHealth Commercial |
$39,971.85
|
| Rate for Payer: Humana Medicare Advantage |
$13,723.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13,323.95
|
| Rate for Payer: Oxford Commercial |
$12,328.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$16,502.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13,323.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$13,323.95
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$9,353.20
|
|
|
Service Code
|
APR-DRG 2822
|
| Min. Negotiated Rate |
$9,169.80 |
| Max. Negotiated Rate |
$9,353.20 |
| Rate for Payer: UnitedHealthcare Community & State |
$9,169.80
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$9,353.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9,169.80
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$7,231.20
|
|
|
Service Code
|
APR-DRG 2821
|
| Min. Negotiated Rate |
$7,089.41 |
| Max. Negotiated Rate |
$7,231.20 |
| Rate for Payer: UnitedHealthcare Community & State |
$7,089.41
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$7,231.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7,089.41
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$31,588.75
|
|
|
Service Code
|
APR-DRG 2824
|
| Min. Negotiated Rate |
$30,969.36 |
| Max. Negotiated Rate |
$31,588.75 |
| Rate for Payer: UnitedHealthcare Community & State |
$30,969.36
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$31,588.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$30,969.36
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY
|
Facility
|
IP
|
$14,451.10
|
|
|
Service Code
|
APR-DRG 2823
|
| Min. Negotiated Rate |
$14,167.75 |
| Max. Negotiated Rate |
$14,451.10 |
| Rate for Payer: UnitedHealthcare Community & State |
$14,167.75
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$14,451.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14,167.75
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC
|
Facility
|
IP
|
$46,041.12
|
|
|
Service Code
|
MSDRG 439
|
| Min. Negotiated Rate |
$14,018.93 |
| Max. Negotiated Rate |
$46,041.12 |
| Rate for Payer: Aetna Commercial |
$34,649.52
|
| Rate for Payer: Aetna Medicare Advantage |
$46,041.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,826.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,826.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14,756.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,826.30
|
| Rate for Payer: Cigna Commercial |
$18,752.87
|
| Rate for Payer: Cigna Medicare Advantage |
$14,756.77
|
| Rate for Payer: Clover Medicare Advantage |
$14,018.93
|
| Rate for Payer: EmblemHealth Commercial |
$44,270.31
|
| Rate for Payer: Humana Medicare Advantage |
$15,199.47
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14,756.77
|
| Rate for Payer: Oxford Commercial |
$14,821.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$19,839.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14,756.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$14,756.77
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC
|
Facility
|
IP
|
$70,968.46
|
|
|
Service Code
|
MSDRG 438
|
| Min. Negotiated Rate |
$21,608.99 |
| Max. Negotiated Rate |
$70,968.46 |
| Rate for Payer: Aetna Commercial |
$52,403.07
|
| Rate for Payer: Aetna Medicare Advantage |
$70,968.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46,267.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46,267.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$22,746.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46,267.35
|
| Rate for Payer: Cigna Commercial |
$36,342.05
|
| Rate for Payer: Cigna Medicare Advantage |
$22,746.30
|
| Rate for Payer: Clover Medicare Advantage |
$21,608.99
|
| Rate for Payer: EmblemHealth Commercial |
$68,238.90
|
| Rate for Payer: Humana Medicare Advantage |
$23,428.69
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$22,746.30
|
| Rate for Payer: Oxford Commercial |
$28,724.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$38,448.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$22,746.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$22,746.30
|
|
|
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$39,096.88
|
|
|
Service Code
|
MSDRG 440
|
| Min. Negotiated Rate |
$10,949.07 |
| Max. Negotiated Rate |
$39,096.88 |
| Rate for Payer: Aetna Commercial |
$29,703.74
|
| Rate for Payer: Aetna Medicare Advantage |
$39,096.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17,177.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17,177.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12,531.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17,177.10
|
| Rate for Payer: Cigna Commercial |
$13,852.87
|
| Rate for Payer: Cigna Medicare Advantage |
$12,531.05
|
| Rate for Payer: Clover Medicare Advantage |
$11,904.50
|
| Rate for Payer: EmblemHealth Commercial |
$37,593.15
|
| Rate for Payer: Humana Medicare Advantage |
$12,906.98
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12,531.05
|
| Rate for Payer: Oxford Commercial |
$10,949.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,655.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12,531.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$12,531.05
|
|
|
DISORDERS OF PERSONALITY AND IMPULSE CONTROL
|
Facility
|
IP
|
$81,587.03
|
|
|
Service Code
|
MSDRG 883
|
| Min. Negotiated Rate |
$7,161.00 |
| Max. Negotiated Rate |
$81,587.03 |
| Rate for Payer: Aetna Commercial |
$59,965.74
|
| Rate for Payer: Aetna Medicare Advantage |
$81,587.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52,085.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7,756.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52,085.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7,161.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$26,149.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52,085.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7,756.00
|
| Rate for Payer: Cigna Commercial |
$43,834.73
|
| Rate for Payer: Cigna Medicare Advantage |
$26,149.69
|
| Rate for Payer: Clover Medicare Advantage |
$24,842.21
|
| Rate for Payer: EmblemHealth Commercial |
$78,449.07
|
| Rate for Payer: Humana Medicare Advantage |
$26,934.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$26,149.69
|
| Rate for Payer: Oxford Commercial |
$34,646.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$46,375.19
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$26,149.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$26,149.69
|
|
|
DISORDERS OF THE BILIARY TRACT WITH CC
|
Facility
|
IP
|
$54,040.62
|
|
|
Service Code
|
MSDRG 445
|
| Min. Negotiated Rate |
$16,454.67 |
| Max. Negotiated Rate |
$54,040.62 |
| Rate for Payer: Aetna Commercial |
$40,346.84
|
| Rate for Payer: Aetna Medicare Advantage |
$54,040.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30,198.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30,198.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,320.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30,198.45
|
| Rate for Payer: Cigna Commercial |
$24,397.46
|
| Rate for Payer: Cigna Medicare Advantage |
$17,320.71
|
| Rate for Payer: Clover Medicare Advantage |
$16,454.67
|
| Rate for Payer: EmblemHealth Commercial |
$51,962.13
|
| Rate for Payer: Humana Medicare Advantage |
$17,840.33
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,320.71
|
| Rate for Payer: Oxford Commercial |
$19,283.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$25,811.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,320.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,320.71
|
|
|
DISORDERS OF THE BILIARY TRACT WITH MCC
|
Facility
|
IP
|
$72,254.36
|
|
|
Service Code
|
MSDRG 444
|
| Min. Negotiated Rate |
$22,000.53 |
| Max. Negotiated Rate |
$72,254.36 |
| Rate for Payer: Aetna Commercial |
$53,318.89
|
| Rate for Payer: Aetna Medicare Advantage |
$72,254.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$45,159.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$45,159.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$23,158.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$45,159.15
|
| Rate for Payer: Cigna Commercial |
$37,249.37
|
| Rate for Payer: Cigna Medicare Advantage |
$23,158.45
|
| Rate for Payer: Clover Medicare Advantage |
$22,000.53
|
| Rate for Payer: EmblemHealth Commercial |
$69,475.35
|
| Rate for Payer: Humana Medicare Advantage |
$23,853.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$23,158.45
|
| Rate for Payer: Oxford Commercial |
$29,441.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$39,408.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$23,158.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$23,158.45
|
|
|
DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC
|
Facility
|
IP
|
$45,602.01
|
|
|
Service Code
|
MSDRG 446
|
| Min. Negotiated Rate |
$13,885.23 |
| Max. Negotiated Rate |
$45,602.01 |
| Rate for Payer: Aetna Commercial |
$34,336.79
|
| Rate for Payer: Aetna Medicare Advantage |
$45,602.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22,164.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22,164.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14,616.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22,164.00
|
| Rate for Payer: Cigna Commercial |
$18,443.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14,616.03
|
| Rate for Payer: Clover Medicare Advantage |
$13,885.23
|
| Rate for Payer: EmblemHealth Commercial |
$43,848.09
|
| Rate for Payer: Humana Medicare Advantage |
$15,054.51
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14,616.03
|
| Rate for Payer: Oxford Commercial |
$14,577.03
|
| Rate for Payer: UnitedHealthcare Commercial |
$19,511.87
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14,616.03
|
| Rate for Payer: Wellcare Medicare Advantage |
$14,616.03
|
|
|
DISOSABLE I&A HAND PIECE
|
Facility
|
OP
|
$311.00
|
|
| Hospital Charge Code |
270331531
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.83 |
| Max. Negotiated Rate |
$155.50 |
| Rate for Payer: Aetna Commercial |
$118.18
|
| Rate for Payer: Aetna Medicare Advantage |
$93.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.31
|
| Rate for Payer: Cigna Commercial |
$155.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$80.86
|
| Rate for Payer: Oxford Commercial |
$62.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.83
|
|
|
DISOSABLE I&A HAND PIECE
|
Facility
|
IP
|
$311.00
|
|
| Hospital Charge Code |
270331531
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.65 |
| Max. Negotiated Rate |
$46.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
IP
|
$1,519.25
|
|
| Hospital Charge Code |
270704864
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$227.89 |
| Max. Negotiated Rate |
$227.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
OP
|
$1,519.25
|
|
| Hospital Charge Code |
270704864
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$43.15 |
| Max. Negotiated Rate |
$759.62 |
| Rate for Payer: Aetna Commercial |
$577.32
|
| Rate for Payer: Aetna Medicare Advantage |
$455.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$387.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$387.41
|
| Rate for Payer: Cigna Commercial |
$759.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$395.00
|
| Rate for Payer: Oxford Commercial |
$303.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$227.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$303.85
|
| Rate for Payer: UnitedHealthcare Community & State |
$48.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$43.15
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
IP
|
$1,416.25
|
|
| Hospital Charge Code |
270704865
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$212.44 |
| Max. Negotiated Rate |
$212.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$212.44
|
|
|
DISP KIT-HIP FIBERTAK SUTURE A
|
Facility
|
OP
|
$1,416.25
|
|
| Hospital Charge Code |
270704865
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$40.22 |
| Max. Negotiated Rate |
$708.12 |
| Rate for Payer: Aetna Commercial |
$538.17
|
| Rate for Payer: Aetna Medicare Advantage |
$424.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$361.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$361.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$361.14
|
| Rate for Payer: Cigna Commercial |
$708.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$368.23
|
| Rate for Payer: Oxford Commercial |
$283.25
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$212.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$283.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$44.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$40.22
|
|