|
CH ACANTHAMOEBA CULTURE
|
Facility
|
IP
|
$104.00
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
397071467
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$15.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.60
|
|
|
CH ACANTHAMOEBA CULTURE-CSF
|
Facility
|
IP
|
$436.00
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
397071531
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$65.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.40
|
|
|
CH ACANTHAMOEBA CULTURE-CSF
|
Facility
|
OP
|
$436.00
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
397071531
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$218.00 |
| Rate for Payer: Aetna Commercial |
$18.03
|
| Rate for Payer: Aetna Medicare Advantage |
$21.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.93
|
| Rate for Payer: Cigna Commercial |
$218.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6.63
|
| Rate for Payer: Clover Medicare Advantage |
$6.30
|
| Rate for Payer: EmblemHealth Commercial |
$19.89
|
| Rate for Payer: Humana Medicare Advantage |
$6.83
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.55
|
|
|
CH ACCUTYPE R WARFARIN
|
Facility
|
IP
|
$2,146.25
|
|
|
Service Code
|
HCPCS 83891
|
| Hospital Charge Code |
397071551
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$321.94 |
| Max. Negotiated Rate |
$321.94 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$321.94
|
|
|
CH ACCUTYPE R WARFARIN
|
Facility
|
OP
|
$2,146.25
|
|
|
Service Code
|
HCPCS 83891
|
| Hospital Charge Code |
397071551
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.72 |
| Max. Negotiated Rate |
$1,073.12 |
| Rate for Payer: Aetna Commercial |
$815.58
|
| Rate for Payer: Aetna Medicare Advantage |
$643.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$547.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$547.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$547.29
|
| Rate for Payer: Cigna Commercial |
$1,073.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$643.88
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$321.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$51.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$56.88
|
|
|
CH ACE CSF
|
Facility
|
OP
|
$124.00
|
|
|
Service Code
|
HCPCS 82164
|
| Hospital Charge Code |
397071026
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$39.71
|
| Rate for Payer: Aetna Medicare Advantage |
$47.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.70
|
| Rate for Payer: Cigna Commercial |
$62.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.60
|
| Rate for Payer: Clover Medicare Advantage |
$13.87
|
| Rate for Payer: EmblemHealth Commercial |
$43.80
|
| Rate for Payer: Humana Medicare Advantage |
$15.04
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.68
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.29
|
|
|
CH ACE CSF
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
HCPCS 82164
|
| Hospital Charge Code |
397071026
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.60 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.60
|
|
|
CH ACETAMINOPHEN
|
Facility
|
IP
|
$310.00
|
|
|
Service Code
|
HCPCS 80329
|
| Hospital Charge Code |
397071254
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.50 |
| Max. Negotiated Rate |
$46.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.50
|
|
|
CH ACETAMINOPHEN
|
Facility
|
OP
|
$310.00
|
|
|
Service Code
|
HCPCS 80329
|
| Hospital Charge Code |
397071254
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.21 |
| Max. Negotiated Rate |
$155.00 |
| Rate for Payer: Aetna Commercial |
$117.80
|
| Rate for Payer: Aetna Medicare Advantage |
$93.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.05
|
| Rate for Payer: Cigna Commercial |
$155.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$93.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.21
|
|
|
CH ACETONE ASSAY
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
HCPCS 82010
|
| Hospital Charge Code |
397072165
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$8.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.40
|
|
|
CH ACETONE ASSAY
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
HCPCS 82010
|
| Hospital Charge Code |
397072165
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$22.22
|
| Rate for Payer: Aetna Medicare Advantage |
$26.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.49
|
| Rate for Payer: Cigna Commercial |
$28.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.17
|
| Rate for Payer: Clover Medicare Advantage |
$7.76
|
| Rate for Payer: EmblemHealth Commercial |
$24.51
|
| Rate for Payer: Humana Medicare Advantage |
$8.42
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.54
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.48
|
|
|
CH ACETYLCHOLINE REC BLOC AB
|
Facility
|
IP
|
$515.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
397071390
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.25 |
| Max. Negotiated Rate |
$77.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.25
|
|
|
CH ACETYLCHOLINE REC BLOC AB
|
Facility
|
OP
|
$515.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
397071390
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$257.50 |
| Rate for Payer: Aetna Commercial |
$50.05
|
| Rate for Payer: Aetna Medicare Advantage |
$59.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$66.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$66.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$66.42
|
| Rate for Payer: Cigna Commercial |
$257.50
|
| Rate for Payer: Cigna Medicare Advantage |
$18.40
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$18.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$154.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$77.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.65
|
|
|
CH ACETYLCHOLINE RECEPT AB
|
Facility
|
OP
|
$435.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
397072003
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$217.50 |
| Rate for Payer: Aetna Commercial |
$32.78
|
| Rate for Payer: Aetna Medicare Advantage |
$39.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$217.50
|
| Rate for Payer: Cigna Medicare Advantage |
$12.05
|
| Rate for Payer: Clover Medicare Advantage |
$11.45
|
| Rate for Payer: EmblemHealth Commercial |
$36.15
|
| Rate for Payer: Humana Medicare Advantage |
$12.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.53
|
|
|
CH ACETYLCHOLINE RECEPT AB
|
Facility
|
IP
|
$435.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
397072003
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$65.25 |
| Max. Negotiated Rate |
$65.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.25
|
|
|
CH ACHR BINDING AUTOANTIBODY
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
397073272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
|
|
CH ACHR BINDING AUTOANTIBODY
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
397073272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$50.05
|
| Rate for Payer: Aetna Medicare Advantage |
$59.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$66.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$66.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$66.42
|
| Rate for Payer: Cigna Commercial |
$62.50
|
| Rate for Payer: Cigna Medicare Advantage |
$18.40
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$18.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.31
|
|
|
CH ACID FAST SMEAR
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87206
|
| Hospital Charge Code |
397041036
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.31 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$14.66
|
| Rate for Payer: Aetna Medicare Advantage |
$17.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.46
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.39
|
| Rate for Payer: Clover Medicare Advantage |
$5.12
|
| Rate for Payer: EmblemHealth Commercial |
$16.17
|
| Rate for Payer: Humana Medicare Advantage |
$5.55
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH ACID FAST SMEAR
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87206
|
| Hospital Charge Code |
397041036
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH ACTH
|
Facility
|
IP
|
$497.00
|
|
|
Service Code
|
HCPCS 82024
|
| Hospital Charge Code |
397071252
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$74.55 |
| Max. Negotiated Rate |
$74.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.55
|
|
|
CH ACTH
|
Facility
|
OP
|
$497.00
|
|
|
Service Code
|
HCPCS 82024
|
| Hospital Charge Code |
397071252
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$13.17 |
| Max. Negotiated Rate |
$248.50 |
| Rate for Payer: Aetna Commercial |
$105.05
|
| Rate for Payer: Aetna Medicare Advantage |
$125.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$139.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$139.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$38.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$58.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$139.41
|
| Rate for Payer: Cigna Commercial |
$248.50
|
| Rate for Payer: Cigna Medicare Advantage |
$38.62
|
| Rate for Payer: Clover Medicare Advantage |
$36.69
|
| Rate for Payer: EmblemHealth Commercial |
$115.86
|
| Rate for Payer: Humana Medicare Advantage |
$39.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$38.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$149.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$74.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$30.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$38.62
|
| Rate for Payer: Wellcare Medicare Advantage |
$38.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.17
|
|
|
CH ACTIVATED PROTEIN C RESIS
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
HCPCS 85307
|
| Hospital Charge Code |
397071364
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: Aetna Medicare Advantage |
$49.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$55.30
|
| Rate for Payer: Cigna Commercial |
$100.00
|
| Rate for Payer: Cigna Medicare Advantage |
$15.32
|
| Rate for Payer: Clover Medicare Advantage |
$14.55
|
| Rate for Payer: EmblemHealth Commercial |
$45.96
|
| Rate for Payer: Humana Medicare Advantage |
$15.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$15.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.30
|
|
|
CH ACTIVATED PROTEIN C RESIS
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
HCPCS 85307
|
| Hospital Charge Code |
397071364
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.00
|
|
|
CH ACUTE HEPATITIS PANEL
|
Facility
|
OP
|
$2,220.17
|
|
|
Service Code
|
HCPCS 80074
|
| Hospital Charge Code |
397073343
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.10 |
| Max. Negotiated Rate |
$1,110.09 |
| Rate for Payer: Aetna Commercial |
$129.55
|
| Rate for Payer: Aetna Medicare Advantage |
$154.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$171.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$171.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$47.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$171.93
|
| Rate for Payer: Cigna Commercial |
$1,110.09
|
| Rate for Payer: Cigna Medicare Advantage |
$47.63
|
| Rate for Payer: Clover Medicare Advantage |
$45.25
|
| Rate for Payer: EmblemHealth Commercial |
$142.89
|
| Rate for Payer: Humana Medicare Advantage |
$49.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$47.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$666.05
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$333.03
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$38.10
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$47.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$47.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$58.83
|
|
|
CH ACUTE HEPATITIS PANEL
|
Facility
|
IP
|
$2,220.17
|
|
|
Service Code
|
HCPCS 80074
|
| Hospital Charge Code |
397073343
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$333.03 |
| Max. Negotiated Rate |
$333.03 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$333.03
|
|