|
CH ANTITHROMBIN III ACT REFL
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
HCPCS 85300
|
| Hospital Charge Code |
397071541
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.88 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$32.23
|
| Rate for Payer: Aetna Medicare Advantage |
$38.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.77
|
| Rate for Payer: Cigna Commercial |
$35.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.85
|
| Rate for Payer: Clover Medicare Advantage |
$11.26
|
| Rate for Payer: EmblemHealth Commercial |
$35.55
|
| Rate for Payer: Humana Medicare Advantage |
$12.21
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.88
|
|
|
CH ANTITHROMBIN III ACT REFL
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
HCPCS 85301
|
| Hospital Charge Code |
397071445
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$29.40
|
| Rate for Payer: Aetna Medicare Advantage |
$35.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.02
|
| Rate for Payer: Cigna Commercial |
$32.00
|
| Rate for Payer: Cigna Medicare Advantage |
$10.81
|
| Rate for Payer: Clover Medicare Advantage |
$10.27
|
| Rate for Payer: EmblemHealth Commercial |
$32.43
|
| Rate for Payer: Humana Medicare Advantage |
$11.13
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.70
|
|
|
CH ANTITHROMBIN III ACT REFL
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
HCPCS 85301
|
| Hospital Charge Code |
397071445
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$9.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.60
|
|
|
CH ANTITHROMBIN III ANTIGEN
|
Facility
|
IP
|
$732.00
|
|
|
Service Code
|
HCPCS 85301
|
| Hospital Charge Code |
397073645
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$109.80 |
| Max. Negotiated Rate |
$109.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.80
|
|
|
CH ANTITHROMBIN III ANTIGEN
|
Facility
|
OP
|
$732.00
|
|
|
Service Code
|
HCPCS 85301
|
| Hospital Charge Code |
397073645
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$366.00 |
| Rate for Payer: Aetna Commercial |
$29.40
|
| Rate for Payer: Aetna Medicare Advantage |
$35.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.02
|
| Rate for Payer: Cigna Commercial |
$366.00
|
| Rate for Payer: Cigna Medicare Advantage |
$10.81
|
| Rate for Payer: Clover Medicare Advantage |
$10.27
|
| Rate for Payer: EmblemHealth Commercial |
$32.43
|
| Rate for Payer: Humana Medicare Advantage |
$11.13
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$219.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.40
|
|
|
CH ANTI THYROGLOBULIN
|
Facility
|
IP
|
$238.00
|
|
|
Service Code
|
HCPCS 86800
|
| Hospital Charge Code |
397071222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$35.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.70
|
|
|
CH ANTI THYROGLOBULIN
|
Facility
|
OP
|
$238.00
|
|
|
Service Code
|
HCPCS 86800
|
| Hospital Charge Code |
397071222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$43.28
|
| Rate for Payer: Aetna Medicare Advantage |
$51.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.43
|
| Rate for Payer: Cigna Commercial |
$119.00
|
| Rate for Payer: Cigna Medicare Advantage |
$15.91
|
| Rate for Payer: Clover Medicare Advantage |
$15.11
|
| Rate for Payer: EmblemHealth Commercial |
$47.73
|
| Rate for Payer: Humana Medicare Advantage |
$16.39
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$35.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.73
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$15.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.31
|
|
|
CH ANTI THYROID MICRO
|
Facility
|
IP
|
$186.00
|
|
|
Service Code
|
HCPCS 86376
|
| Hospital Charge Code |
397071220
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.90
|
|
|
CH ANTI THYROID MICRO
|
Facility
|
OP
|
$186.00
|
|
|
Service Code
|
HCPCS 86376
|
| Hospital Charge Code |
397071220
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.93 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$39.58
|
| Rate for Payer: Aetna Medicare Advantage |
$47.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.55
|
| 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 |
$52.52
|
| Rate for Payer: Cigna Commercial |
$93.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.55
|
| Rate for Payer: Clover Medicare Advantage |
$13.82
|
| Rate for Payer: EmblemHealth Commercial |
$43.65
|
| Rate for Payer: Humana Medicare Advantage |
$14.99
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.55
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.93
|
|
|
CH APC RESISTANCE
|
Facility
|
OP
|
$108.00
|
|
|
Service Code
|
HCPCS 85307
|
| Hospital Charge Code |
397073686
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.86 |
| 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 |
$54.00
|
| 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 |
$32.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.20
|
| 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 |
$2.86
|
|
|
CH APC RESISTANCE
|
Facility
|
IP
|
$108.00
|
|
|
Service Code
|
HCPCS 85307
|
| Hospital Charge Code |
397073686
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.20 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.20
|
|
|
CH A.PHAGOCYTOPHILUM,DNA,PCR
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
397071373
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.85 |
| Max. Negotiated Rate |
$50.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.85
|
|
|
CH A.PHAGOCYTOPHILUM,DNA,PCR
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
397071373
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$169.50 |
| Rate for Payer: Aetna Commercial |
$95.44
|
| Rate for Payer: Aetna Medicare Advantage |
$113.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$126.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$126.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$35.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$153.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.66
|
| Rate for Payer: Cigna Commercial |
$169.50
|
| Rate for Payer: Cigna Medicare Advantage |
$35.09
|
| Rate for Payer: Clover Medicare Advantage |
$33.34
|
| Rate for Payer: EmblemHealth Commercial |
$105.27
|
| Rate for Payer: Humana Medicare Advantage |
$36.14
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$35.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.07
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$35.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$35.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.98
|
|
|
CH APHERESIS PLASMA
|
Facility
|
OP
|
$3,550.00
|
|
|
Service Code
|
HCPCS 36514
|
| Hospital Charge Code |
93655001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$85.56 |
| Max. Negotiated Rate |
$6,678.88 |
| Rate for Payer: Aetna Commercial |
$5,032.71
|
| Rate for Payer: Aetna Medicare Advantage |
$5,994.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$6,678.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$6,678.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,850.26
|
| 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 |
$6,678.88
|
| Rate for Payer: Cigna Commercial |
$3,708.85
|
| Rate for Payer: Cigna Medicare Advantage |
$1,850.26
|
| Rate for Payer: Clover Medicare Advantage |
$1,757.75
|
| Rate for Payer: EmblemHealth Commercial |
$5,550.78
|
| Rate for Payer: Humana Medicare Advantage |
$1,905.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,850.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,065.00
|
| Rate for Payer: Oxford Commercial |
$3,248.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$532.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,311.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$85.56
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,850.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,850.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$94.08
|
|
|
CH APHERESIS PLASMA
|
Facility
|
IP
|
$3,550.00
|
|
|
Service Code
|
HCPCS 36514
|
| Hospital Charge Code |
93655001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$532.50 |
| Max. Negotiated Rate |
$532.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$532.50
|
|
|
CH APOLIPOPROTEIN A
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
HCPCS 82172
|
| Hospital Charge Code |
397073095
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$57.36
|
| Rate for Payer: Aetna Medicare Advantage |
$68.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21.09
|
| 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 |
$76.13
|
| Rate for Payer: Cigna Commercial |
$90.00
|
| Rate for Payer: Cigna Medicare Advantage |
$21.09
|
| Rate for Payer: Clover Medicare Advantage |
$20.04
|
| Rate for Payer: EmblemHealth Commercial |
$63.27
|
| Rate for Payer: Humana Medicare Advantage |
$21.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.87
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$21.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.77
|
|
|
CH APOLIPOPROTEIN A
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
HCPCS 82172
|
| Hospital Charge Code |
397073095
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.00
|
|
|
CH APOLIPOPROTEIN A1
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
HCPCS 82172
|
| Hospital Charge Code |
397073580
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$57.36
|
| Rate for Payer: Aetna Medicare Advantage |
$68.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21.09
|
| 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 |
$76.13
|
| Rate for Payer: Cigna Commercial |
$90.00
|
| Rate for Payer: Cigna Medicare Advantage |
$21.09
|
| Rate for Payer: Clover Medicare Advantage |
$20.04
|
| Rate for Payer: EmblemHealth Commercial |
$63.27
|
| Rate for Payer: Humana Medicare Advantage |
$21.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.87
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$21.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.77
|
|
|
CH APOLIPOPROTEIN A1
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
HCPCS 82172
|
| Hospital Charge Code |
397073580
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.00
|
|
|
CH APOLIPOPROTEIN B
|
Facility
|
OP
|
$226.00
|
|
|
Service Code
|
HCPCS 82172
|
| Hospital Charge Code |
397073581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$57.36
|
| Rate for Payer: Aetna Medicare Advantage |
$68.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21.09
|
| 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 |
$76.13
|
| Rate for Payer: Cigna Commercial |
$113.00
|
| Rate for Payer: Cigna Medicare Advantage |
$21.09
|
| Rate for Payer: Clover Medicare Advantage |
$20.04
|
| Rate for Payer: EmblemHealth Commercial |
$63.27
|
| Rate for Payer: Humana Medicare Advantage |
$21.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.87
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$21.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.99
|
|
|
CH APOLIPOPROTEIN B
|
Facility
|
IP
|
$226.00
|
|
|
Service Code
|
HCPCS 82172
|
| Hospital Charge Code |
397073096
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.90 |
| Max. Negotiated Rate |
$33.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.90
|
|
|
CH APOLIPOPROTEIN B
|
Facility
|
IP
|
$226.00
|
|
|
Service Code
|
HCPCS 82172
|
| Hospital Charge Code |
397073581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.90 |
| Max. Negotiated Rate |
$33.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.90
|
|
|
CH APOLIPOPROTEIN B
|
Facility
|
OP
|
$226.00
|
|
|
Service Code
|
HCPCS 82172
|
| Hospital Charge Code |
397073096
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$57.36
|
| Rate for Payer: Aetna Medicare Advantage |
$68.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21.09
|
| 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 |
$76.13
|
| Rate for Payer: Cigna Commercial |
$113.00
|
| Rate for Payer: Cigna Medicare Advantage |
$21.09
|
| Rate for Payer: Clover Medicare Advantage |
$20.04
|
| Rate for Payer: EmblemHealth Commercial |
$63.27
|
| Rate for Payer: Humana Medicare Advantage |
$21.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.87
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$21.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.99
|
|
|
CH APOLIPOPROTEINS A/B
|
Facility
|
OP
|
$264.00
|
|
|
Service Code
|
HCPCS 82172
|
| Hospital Charge Code |
397073059
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$132.00 |
| Rate for Payer: Aetna Commercial |
$57.36
|
| Rate for Payer: Aetna Medicare Advantage |
$68.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21.09
|
| 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 |
$76.13
|
| Rate for Payer: Cigna Commercial |
$132.00
|
| Rate for Payer: Cigna Medicare Advantage |
$21.09
|
| Rate for Payer: Clover Medicare Advantage |
$20.04
|
| Rate for Payer: EmblemHealth Commercial |
$63.27
|
| Rate for Payer: Humana Medicare Advantage |
$21.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$79.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.87
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$21.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.00
|
|
|
CH APOLIPOPROTEINS A/B
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
HCPCS 82172
|
| Hospital Charge Code |
397073059
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.60 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.60
|
|
