Toms River, NJ, 08754-
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vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | vs nat'l | Neg max |
|---|---|---|---|---|---|---|---|---|---|
| behavioral | |||||||||
| Psychoses | MS-DRG | 885 | 2 | — | — | $1,894 | $1,894 | 0.15× | $6,021 |
| Psychiatric diagnostic evaluation | CPT | 90791 | 8 | $689 | $249 | $119.19 | $250 | 1.4× | $656 |
| Psychotherapy 30 minutes | CPT | 90832 | 8 | $328 | $118.53 | $56.74 | $126.16 | 0.85× | $196.8 |
| Psychotherapy 45 minutes | CPT | 90834 | 8 | $405 | $146.36 | $70.06 | $167.39 | 1.0× | $243 |
| Psychotherapy 60 minutes | CPT | 90837 | 8 | $450 | $162.63 | $77.85 | $175.59 | 0.92× | $270 |
| imaging | |||||||||
| EKG tracing only | CPT | 93005 | 4 | $277 | $100.1 | $47.92 | $166.2 | 1.4× | $243.76 |
| lab | |||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 4 | $172 | $62.16 | $29.75 | $103.2 | 3.2× | $151.36 |
| Electrolyte panel | CPT | 80051 | 4 | $118 | $42.64 | $20.41 | $70.8 | 3.0× | $103.84 |
| Comprehensive metabolic panel | CPT | 80053 | 4 | $320 | $115.64 | $55.36 | $192 | 4.3× | $281.6 |
| Lipid panel | CPT | 80061 | 4 | $234 | $84.56 | $40.48 | $140.4 | 3.7× | $205.92 |
| Renal function panel | CPT | 80069 | 4 | $184 | $66.49 | $31.83 | $110.4 | 4.0× | $161.92 |
| Hepatic function panel | CPT | 80076 | 4 | $168 | $60.71 | $29.06 | $100.8 | 3.8× | $147.84 |
| Urinalysis automated | CPT | 81003 | 4 | $79 | $28.55 | $13.66 | $47.4 | 3.4× | $69.52 |
| Glucose quantitative | CPT | 82947 | 4 | $45 | $16.26 | $7.78 | $27 | 1.5× | $39.6 |
| Hemoglobin A1c | CPT | 83036 | 4 | $158 | $57.1 | $27.33 | $94.8 | 3.5× | $139.04 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 4 | $249 | $89.98 | $43.07 | $149.4 | 3.2× | $219.12 |
| Complete blood count with automated differential | CPT | 85025 | 4 | $138 | $49.87 | $23.87 | $82.8 | 3.1× | $121.44 |
| Complete blood count without differential | CPT | 85027 | 4 | $94 | $33.97 | $16.26 | $56.4 | 2.6× | $82.72 |
| Urine culture bacterial | CPT | 87086 | 4 | $91 | $32.88 | $15.74 | $54.6 | 2.3× | $80.08 |
| Urine culture identification | CPT | 87088 | 4 | $82 | $29.63 | $14.18 | $49.2 | 2.2× | $72.16 |
| Tissue exam by pathologist level IV | CPT | 88305 | 4 | $476 | $172.02 | $82.34 | $285.6 | 2.8× | $418.88 |
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 21 | $103.52 |
| wellpoint | 20 | $137.66 |
| fidelis care | 20 | $30.79 |
| First Health | 20 | $106.8 |
| Blue Cross Blue Shield | 5 | $175.59 |
| Humana | 4 | $175.59 |
| amerihealth | 4 | $117.43 |
| clover health | 4 | $175.59 |
