|
CHANGE OF BLADDER TUBE
|
Facility
|
IP
|
$1,076.57
|
|
|
Service Code
|
HCPCS 51705
|
| Hospital Charge Code |
160000191
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$161.49 |
| Max. Negotiated Rate |
$161.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.49
|
|
|
CHANGE OF BLADDER TUBE
|
Facility
|
IP
|
$543.70
|
|
|
Service Code
|
HCPCS 51705
|
| Hospital Charge Code |
1001160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$81.56 |
| Max. Negotiated Rate |
$81.56 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.56
|
|
|
CHANGE OF BLADDER TUBE
|
Facility
|
OP
|
$1,076.57
|
|
|
Service Code
|
HCPCS 51705
|
| Hospital Charge Code |
160000191
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$25.95 |
| Max. Negotiated Rate |
$2,220.00 |
| Rate for Payer: Aetna Commercial |
$807.38
|
| Rate for Payer: Aetna Medicare Advantage |
$961.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,071.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,071.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$296.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,071.47
|
| Rate for Payer: Cigna Commercial |
$594.98
|
| Rate for Payer: Cigna Medicare Advantage |
$296.83
|
| Rate for Payer: Clover Medicare Advantage |
$281.99
|
| Rate for Payer: EmblemHealth Commercial |
$890.49
|
| Rate for Payer: Humana Medicare Advantage |
$305.73
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$296.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$322.97
|
| Rate for Payer: Oxford Commercial |
$1,487.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,220.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$25.95
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$296.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.53
|
|
|
CHANGE UTERINE STENT PERCUT
|
Facility
|
OP
|
$12,062.25
|
|
|
Service Code
|
HCPCS 50382
|
| Hospital Charge Code |
1600000704
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$290.70 |
| Max. Negotiated Rate |
$8,964.44 |
| Rate for Payer: Aetna Commercial |
$6,754.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8,046.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,964.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,483.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8,964.44
|
| Rate for Payer: Cigna Commercial |
$4,978.04
|
| Rate for Payer: Cigna Medicare Advantage |
$2,483.43
|
| Rate for Payer: Clover Medicare Advantage |
$2,359.26
|
| Rate for Payer: EmblemHealth Commercial |
$7,450.29
|
| Rate for Payer: Humana Medicare Advantage |
$2,557.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,483.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,618.68
|
| Rate for Payer: Oxford Commercial |
$4,871.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,809.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,157.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$290.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,483.43
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$319.65
|
|
|
CHANGE UTERINE STENT PERCUT
|
Facility
|
IP
|
$12,062.25
|
|
|
Service Code
|
HCPCS 50382
|
| Hospital Charge Code |
1600000704
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,809.34 |
| Max. Negotiated Rate |
$1,809.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,809.34
|
|
|
CH ANGIOTENSION/CONV EN
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
HCPCS 82164
|
| Hospital Charge Code |
397071232
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.55 |
| 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 |
$67.00
|
| 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 |
$40.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.10
|
| 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 |
$3.55
|
|
|
CH ANGIOTENSION/CONV EN
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
HCPCS 82164
|
| Hospital Charge Code |
397071232
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.10 |
| Max. Negotiated Rate |
$20.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.10
|
|
|
CHANNEL SIDE CARE EXTERNAL
|
Facility
|
OP
|
$625.00
|
|
| Hospital Charge Code |
270679449
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.06 |
| Max. Negotiated Rate |
$312.50 |
| Rate for Payer: Aetna Commercial |
$237.50
|
| Rate for Payer: Aetna Medicare Advantage |
$187.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$159.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$159.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$159.38
|
| Rate for Payer: Cigna Commercial |
$312.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$187.50
|
| Rate for Payer: Oxford Commercial |
$125.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$125.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.56
|
|
|
CHANNEL SIDE CARE EXTERNAL
|
Facility
|
IP
|
$625.00
|
|
| Hospital Charge Code |
270679449
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.75 |
| Max. Negotiated Rate |
$93.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.75
|
|
|
CH ANTIBIOTIC SENSITIVITY
|
Facility
|
IP
|
$587.57
|
|
|
Service Code
|
HCPCS 87181
|
| Hospital Charge Code |
397041335
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$88.14 |
| Max. Negotiated Rate |
$88.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$88.14
|
|
|
CH ANTIBIOTIC SENSITIVITY
|
Facility
|
OP
|
$587.57
|
|
|
Service Code
|
HCPCS 87181
|
| Hospital Charge Code |
397041335
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$293.79 |
| Rate for Payer: Aetna Commercial |
$12.92
|
| Rate for Payer: Aetna Medicare Advantage |
$15.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.15
|
| Rate for Payer: Cigna Commercial |
$293.79
|
| Rate for Payer: Cigna Medicare Advantage |
$4.75
|
| Rate for Payer: Clover Medicare Advantage |
$4.51
|
| Rate for Payer: EmblemHealth Commercial |
$14.25
|
| Rate for Payer: Humana Medicare Advantage |
$4.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$176.27
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$88.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.57
|
|
|
CH ANTIBODY ID
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
HCPCS 86870
|
| Hospital Charge Code |
397031014
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$1,537.15 |
| Rate for Payer: Aetna Commercial |
$1,158.28
|
| Rate for Payer: Aetna Medicare Advantage |
$1,379.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,537.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,537.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$425.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,537.15
|
| Rate for Payer: Cigna Commercial |
$853.60
|
| Rate for Payer: Cigna Medicare Advantage |
$425.84
|
| Rate for Payer: Clover Medicare Advantage |
$404.55
|
| Rate for Payer: EmblemHealth Commercial |
$1,277.52
|
| Rate for Payer: Humana Medicare Advantage |
$438.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$425.84
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$51.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$425.84
|
| Rate for Payer: Wellcare Medicare Advantage |
$425.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.50
|
|
|
CH ANTIBODY ID
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
HCPCS 86870
|
| Hospital Charge Code |
397031014
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.50 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.50
|
|
|
CH ANTIBODY SCREEN
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
HCPCS 86850
|
| Hospital Charge Code |
397031155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.82 |
| Max. Negotiated Rate |
$124.10 |
| Rate for Payer: Aetna Commercial |
$26.57
|
| Rate for Payer: Aetna Medicare Advantage |
$31.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.77
|
| 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 |
$35.27
|
| Rate for Payer: Cigna Commercial |
$124.10
|
| Rate for Payer: Cigna Medicare Advantage |
$9.77
|
| Rate for Payer: Clover Medicare Advantage |
$9.28
|
| Rate for Payer: EmblemHealth Commercial |
$29.31
|
| Rate for Payer: Humana Medicare Advantage |
$10.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$97.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.61
|
|
|
CH ANTIBODY SCREEN
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
HCPCS 86850
|
| Hospital Charge Code |
397031155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.75 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.75
|
|
|
CH ANTIBODY TITER
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
HCPCS 86886
|
| Hospital Charge Code |
397031029
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$405.73 |
| 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 |
$9.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.70
|
| Rate for Payer: Cigna Commercial |
$405.73
|
| 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 |
$19.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
| 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 |
$1.72
|
|
|
CH ANTIBODY TITER
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
HCPCS 86886
|
| Hospital Charge Code |
397031029
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
|
|
CH ANTI CARDIOLIPIN IGG
|
Facility
|
OP
|
$292.00
|
|
|
Service Code
|
HCPCS 86147
|
| Hospital Charge Code |
397073163
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.74 |
| Max. Negotiated Rate |
$146.00 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: Aetna Medicare Advantage |
$82.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$25.45
|
| 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 |
$91.87
|
| Rate for Payer: Cigna Commercial |
$146.00
|
| Rate for Payer: Cigna Medicare Advantage |
$25.45
|
| Rate for Payer: Clover Medicare Advantage |
$24.18
|
| Rate for Payer: EmblemHealth Commercial |
$76.35
|
| Rate for Payer: Humana Medicare Advantage |
$26.21
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$25.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$87.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.36
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$25.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$25.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.74
|
|
|
CH ANTI CARDIOLIPIN IGG
|
Facility
|
IP
|
$292.00
|
|
|
Service Code
|
HCPCS 86147
|
| Hospital Charge Code |
397073163
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$43.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.80
|
|
|
CH ANTI CARDIOLIPIN IGG/IGA
|
Facility
|
OP
|
$417.00
|
|
|
Service Code
|
HCPCS 86147
|
| Hospital Charge Code |
397073058
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.05 |
| Max. Negotiated Rate |
$208.50 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: Aetna Medicare Advantage |
$82.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$25.45
|
| 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 |
$91.87
|
| Rate for Payer: Cigna Commercial |
$208.50
|
| Rate for Payer: Cigna Medicare Advantage |
$25.45
|
| Rate for Payer: Clover Medicare Advantage |
$24.18
|
| Rate for Payer: EmblemHealth Commercial |
$76.35
|
| Rate for Payer: Humana Medicare Advantage |
$26.21
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$25.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.36
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$25.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$25.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.05
|
|
|
CH ANTI CARDIOLIPIN IGG/IGA
|
Facility
|
IP
|
$417.00
|
|
|
Service Code
|
HCPCS 86147
|
| Hospital Charge Code |
397073058
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$62.55 |
| Max. Negotiated Rate |
$62.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.55
|
|
|
CH ANTI CARDIOLIPIN, IGM
|
Facility
|
OP
|
$235.00
|
|
|
Service Code
|
HCPCS 86147
|
| Hospital Charge Code |
397073094
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$69.22
|
| Rate for Payer: Aetna Medicare Advantage |
$82.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$91.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$91.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$25.45
|
| 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 |
$91.87
|
| Rate for Payer: Cigna Commercial |
$117.50
|
| Rate for Payer: Cigna Medicare Advantage |
$25.45
|
| Rate for Payer: Clover Medicare Advantage |
$24.18
|
| Rate for Payer: EmblemHealth Commercial |
$76.35
|
| Rate for Payer: Humana Medicare Advantage |
$26.21
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$25.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$70.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.36
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$25.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$25.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.23
|
|
|
CH ANTI CARDIOLIPIN, IGM
|
Facility
|
IP
|
$235.00
|
|
|
Service Code
|
HCPCS 86147
|
| Hospital Charge Code |
397073094
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.25 |
| Max. Negotiated Rate |
$35.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.25
|
|
|
CH ANTIGEN TYPING
|
Facility
|
IP
|
$131.00
|
|
|
Service Code
|
HCPCS 86902
|
| Hospital Charge Code |
397031012
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.65 |
| Max. Negotiated Rate |
$19.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.65
|
|
|
CH ANTIGEN TYPING
|
Facility
|
OP
|
$131.00
|
|
|
Service Code
|
HCPCS 86902
|
| Hospital Charge Code |
397031012
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$853.60 |
| Rate for Payer: Aetna Commercial |
$17.27
|
| Rate for Payer: Aetna Medicare Advantage |
$20.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.92
|
| Rate for Payer: Cigna Commercial |
$853.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6.35
|
| Rate for Payer: Clover Medicare Advantage |
$6.03
|
| Rate for Payer: EmblemHealth Commercial |
$19.05
|
| Rate for Payer: Humana Medicare Advantage |
$6.54
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.35
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.47
|
|
