|
CH ALDOSTERONE
|
Facility
|
IP
|
$251.00
|
|
|
Service Code
|
HCPCS 82088
|
| Hospital Charge Code |
397071326
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$37.65 |
| Max. Negotiated Rate |
$37.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.65
|
|
|
CH ALDOSTERONE
|
Facility
|
OP
|
$251.00
|
|
|
Service Code
|
HCPCS 82088
|
| Hospital Charge Code |
397071326
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$6.65 |
| Max. Negotiated Rate |
$147.10 |
| Rate for Payer: Aetna Commercial |
$110.84
|
| Rate for Payer: Aetna Medicare Advantage |
$132.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$147.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$147.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$40.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$77.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$147.10
|
| Rate for Payer: Cigna Commercial |
$125.50
|
| Rate for Payer: Cigna Medicare Advantage |
$40.75
|
| Rate for Payer: Clover Medicare Advantage |
$38.71
|
| Rate for Payer: EmblemHealth Commercial |
$122.25
|
| Rate for Payer: Humana Medicare Advantage |
$41.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$40.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$40.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$40.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.65
|
|
|
CH ALDOSTERONE SERUM
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
HCPCS 82088
|
| Hospital Charge Code |
397073005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$49.05 |
| Max. Negotiated Rate |
$49.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.05
|
|
|
CH ALDOSTERONE SERUM
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
HCPCS 82088
|
| Hospital Charge Code |
397073005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$8.67 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: Aetna Commercial |
$110.84
|
| Rate for Payer: Aetna Medicare Advantage |
$132.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$147.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$147.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$40.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$77.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$147.10
|
| Rate for Payer: Cigna Commercial |
$163.50
|
| Rate for Payer: Cigna Medicare Advantage |
$40.75
|
| Rate for Payer: Clover Medicare Advantage |
$38.71
|
| Rate for Payer: EmblemHealth Commercial |
$122.25
|
| Rate for Payer: Humana Medicare Advantage |
$41.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$40.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$98.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$40.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$40.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.67
|
|
|
CH ALDOSTERONE URINE
|
Facility
|
IP
|
$251.00
|
|
|
Service Code
|
HCPCS 82088
|
| Hospital Charge Code |
397073006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$37.65 |
| Max. Negotiated Rate |
$37.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.65
|
|
|
CH ALDOSTERONE URINE
|
Facility
|
OP
|
$251.00
|
|
|
Service Code
|
HCPCS 82088
|
| Hospital Charge Code |
397073006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$6.65 |
| Max. Negotiated Rate |
$147.10 |
| Rate for Payer: Aetna Commercial |
$110.84
|
| Rate for Payer: Aetna Medicare Advantage |
$132.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$147.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$147.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$40.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$77.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$147.10
|
| Rate for Payer: Cigna Commercial |
$125.50
|
| Rate for Payer: Cigna Medicare Advantage |
$40.75
|
| Rate for Payer: Clover Medicare Advantage |
$38.71
|
| Rate for Payer: EmblemHealth Commercial |
$122.25
|
| Rate for Payer: Humana Medicare Advantage |
$41.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$40.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$32.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$40.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$40.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.65
|
|
|
CH ALICIAN BLUE
|
Facility
|
OP
|
$672.00
|
|
|
Service Code
|
HCPCS 88313
|
| Hospital Charge Code |
397061079
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.81 |
| Max. Negotiated Rate |
$570.55 |
| Rate for Payer: Aetna Commercial |
$429.92
|
| Rate for Payer: Aetna Medicare Advantage |
$512.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$570.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$158.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$570.55
|
| Rate for Payer: Cigna Commercial |
$316.85
|
| Rate for Payer: Cigna Medicare Advantage |
$158.06
|
| Rate for Payer: Clover Medicare Advantage |
$150.16
|
| Rate for Payer: EmblemHealth Commercial |
$474.18
|
| Rate for Payer: Humana Medicare Advantage |
$162.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$158.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$201.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$68.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$158.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.81
|
|
|
CH ALICIAN BLUE
|
Facility
|
IP
|
$672.00
|
|
|
Service Code
|
HCPCS 88313
|
| Hospital Charge Code |
397061079
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$100.80 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.80
|
|
|
CH ALKALINE PHOS ISO
|
Facility
|
IP
|
$442.00
|
|
|
Service Code
|
HCPCS 84080
|
| Hospital Charge Code |
397073041
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.30 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.30
|
|
|
CH ALKALINE PHOS ISO
|
Facility
|
OP
|
$442.00
|
|
|
Service Code
|
HCPCS 84080
|
| Hospital Charge Code |
397073041
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.97 |
| Max. Negotiated Rate |
$221.00 |
| Rate for Payer: Aetna Commercial |
$40.20
|
| Rate for Payer: Aetna Medicare Advantage |
$47.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$53.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$53.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$53.35
|
| Rate for Payer: Cigna Commercial |
$221.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.78
|
| Rate for Payer: Clover Medicare Advantage |
$14.04
|
| Rate for Payer: EmblemHealth Commercial |
$44.34
|
| Rate for Payer: Humana Medicare Advantage |
$15.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$132.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.78
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.71
|
|
|
CH ALKALINE PHOSPHATASE
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
HCPCS 84075
|
| Hospital Charge Code |
397071203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.60
|
|
|
CH ALKALINE PHOSPHATASE
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
HCPCS 84075
|
| Hospital Charge Code |
397071203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$14.09
|
| Rate for Payer: Aetna Medicare Advantage |
$16.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.70
|
| Rate for Payer: Cigna Commercial |
$42.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.18
|
| Rate for Payer: Clover Medicare Advantage |
$4.92
|
| Rate for Payer: EmblemHealth Commercial |
$15.54
|
| Rate for Payer: Humana Medicare Advantage |
$5.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.23
|
|
|
CH ALK PHOS HEAT STABILE
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
HCPCS 84078
|
| Hospital Charge Code |
397071100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$22.47
|
| Rate for Payer: Aetna Medicare Advantage |
$26.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.82
|
| Rate for Payer: Cigna Commercial |
$60.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.26
|
| Rate for Payer: Clover Medicare Advantage |
$7.85
|
| Rate for Payer: EmblemHealth Commercial |
$24.78
|
| Rate for Payer: Humana Medicare Advantage |
$8.51
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.61
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.18
|
|
|
CH ALK PHOS HEAT STABILE
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
HCPCS 84078
|
| Hospital Charge Code |
397071100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.00
|
|
|
CH ALLERGEN SPECIFIC X10
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
397073321
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
|
|
CH ALLERGEN SPECIFIC X10
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
397073321
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| 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 |
$18.84
|
| Rate for Payer: Cigna Commercial |
$49.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.60
|
|
|
CH ALLERGY TEST SCREENING
|
Facility
|
OP
|
$315.00
|
|
|
Service Code
|
HCPCS 86005
|
| Hospital Charge Code |
397073644
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare Advantage |
$25.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.77
|
| Rate for Payer: Cigna Commercial |
$157.50
|
| Rate for Payer: Cigna Medicare Advantage |
$7.97
|
| Rate for Payer: Clover Medicare Advantage |
$7.57
|
| Rate for Payer: EmblemHealth Commercial |
$23.91
|
| Rate for Payer: Humana Medicare Advantage |
$8.21
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7.97
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$94.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.38
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7.97
|
| Rate for Payer: Wellcare Medicare Advantage |
$7.97
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.35
|
|
|
CH ALLERGY TEST SCREENING
|
Facility
|
IP
|
$315.00
|
|
|
Service Code
|
HCPCS 86005
|
| Hospital Charge Code |
397073644
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$47.25 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.25
|
|
|
CH ALPHA 1 ACID GLYCOPROTEIN
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
HCPCS 82985
|
| Hospital Charge Code |
397072102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.89 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$45.59
|
| Rate for Payer: Aetna Medicare Advantage |
$54.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.50
|
| Rate for Payer: Cigna Commercial |
$54.50
|
| Rate for Payer: Cigna Medicare Advantage |
$16.76
|
| Rate for Payer: Clover Medicare Advantage |
$15.92
|
| Rate for Payer: EmblemHealth Commercial |
$50.28
|
| Rate for Payer: Humana Medicare Advantage |
$17.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.41
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.89
|
|
|
CH ALPHA 1 ACID GLYCOPROTEIN
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
HCPCS 82985
|
| Hospital Charge Code |
397072102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.35 |
| Max. Negotiated Rate |
$16.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.35
|
|
|
CH ALPHA 1 ANTIT, PHENOT
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82104
|
| Hospital Charge Code |
397073056
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH ALPHA 1 ANTIT, PHENOT
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82104
|
| Hospital Charge Code |
397073056
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$39.33
|
| Rate for Payer: Aetna Medicare Advantage |
$46.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.20
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.46
|
| Rate for Payer: Clover Medicare Advantage |
$13.74
|
| Rate for Payer: EmblemHealth Commercial |
$43.38
|
| Rate for Payer: Humana Medicare Advantage |
$14.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.46
|
| 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 |
$11.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.46
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH ALPHA 1 ANTITRYPSIN
|
Facility
|
IP
|
$119.00
|
|
|
Service Code
|
HCPCS 82103
|
| Hospital Charge Code |
397071262
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.85 |
| Max. Negotiated Rate |
$17.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.85
|
|
|
CH ALPHA 1 ANTITRYPSIN
|
Facility
|
OP
|
$119.00
|
|
|
Service Code
|
HCPCS 82103
|
| Hospital Charge Code |
397071262
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$36.56
|
| Rate for Payer: Aetna Medicare Advantage |
$43.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.51
|
| Rate for Payer: Cigna Commercial |
$59.50
|
| Rate for Payer: Cigna Medicare Advantage |
$13.44
|
| Rate for Payer: Clover Medicare Advantage |
$12.77
|
| Rate for Payer: EmblemHealth Commercial |
$40.32
|
| Rate for Payer: Humana Medicare Advantage |
$13.84
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.44
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.75
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.44
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.15
|
|
|
CH ALPHA 2 MACROGLOBIN
|
Facility
|
OP
|
$144.00
|
|
|
Service Code
|
HCPCS 83883
|
| Hospital Charge Code |
397072055
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$171.49 |
| Rate for Payer: Aetna Commercial |
$36.99
|
| Rate for Payer: Aetna Medicare Advantage |
$44.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$171.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.09
|
| Rate for Payer: Cigna Commercial |
$72.00
|
| Rate for Payer: Cigna Medicare Advantage |
$13.60
|
| Rate for Payer: Clover Medicare Advantage |
$12.92
|
| Rate for Payer: EmblemHealth Commercial |
$40.80
|
| Rate for Payer: Humana Medicare Advantage |
$14.01
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.82
|
|
