|
CH BENZODIAZEPINE CONF GC/MS
|
Facility
|
OP
|
$233.00
|
|
|
Service Code
|
HCPCS 80346
|
| Hospital Charge Code |
397073061
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.17 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$88.54
|
| Rate for Payer: Aetna Medicare Advantage |
$69.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.41
|
| Rate for Payer: Cigna Commercial |
$116.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$69.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.17
|
|
|
CH BENZODIAZEPINES DAU
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
HCPCS 80346
|
| Hospital Charge Code |
397071279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$6.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.60
|
|
|
CH BENZODIAZEPINES DAU
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
HCPCS 80346
|
| Hospital Charge Code |
397071279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$16.72
|
| Rate for Payer: Aetna Medicare Advantage |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.22
|
| Rate for Payer: Cigna Commercial |
$22.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.17
|
|
|
CH BETA 2-GLYCOPROT I(G,A,M)
|
Facility
|
IP
|
$983.00
|
|
|
Service Code
|
HCPCS 86146
|
| Hospital Charge Code |
397071411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$147.45 |
| Max. Negotiated Rate |
$147.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.45
|
|
|
CH BETA 2-GLYCOPROT I(G,A,M)
|
Facility
|
OP
|
$983.00
|
|
|
Service Code
|
HCPCS 86146
|
| Hospital Charge Code |
397071411
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$491.50 |
| 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 |
$27.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$91.87
|
| Rate for Payer: Cigna Commercial |
$491.50
|
| 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 |
$294.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$147.45
|
| 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 |
$26.05
|
|
|
CH BETA 2 MICROGLOB CSF
|
Facility
|
IP
|
$175.00
|
|
|
Service Code
|
HCPCS 82232
|
| Hospital Charge Code |
397072034
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.25 |
| Max. Negotiated Rate |
$26.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
|
|
CH BETA 2 MICROGLOB CSF
|
Facility
|
OP
|
$175.00
|
|
|
Service Code
|
HCPCS 82232
|
| Hospital Charge Code |
397072034
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.64 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: Aetna Medicare Advantage |
$52.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.40
|
| Rate for Payer: Cigna Commercial |
$87.50
|
| Rate for Payer: Cigna Medicare Advantage |
$16.18
|
| Rate for Payer: Clover Medicare Advantage |
$15.37
|
| Rate for Payer: EmblemHealth Commercial |
$48.54
|
| Rate for Payer: Humana Medicare Advantage |
$16.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$52.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.64
|
|
|
CH BETA 2 MICROGLOB S
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
HCPCS 82232
|
| Hospital Charge Code |
397072035
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: Aetna Medicare Advantage |
$52.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.40
|
| Rate for Payer: Cigna Commercial |
$64.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.18
|
| Rate for Payer: Clover Medicare Advantage |
$15.37
|
| Rate for Payer: EmblemHealth Commercial |
$48.54
|
| Rate for Payer: Humana Medicare Advantage |
$16.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.39
|
|
|
CH BETA 2 MICROGLOB S
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
HCPCS 82232
|
| Hospital Charge Code |
397072035
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$19.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
|
|
CH BETA 2 MICROGLOB U
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
HCPCS 82232
|
| Hospital Charge Code |
397072036
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$44.01
|
| Rate for Payer: Aetna Medicare Advantage |
$52.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$47.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.40
|
| Rate for Payer: Cigna Commercial |
$64.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.18
|
| Rate for Payer: Clover Medicare Advantage |
$15.37
|
| Rate for Payer: EmblemHealth Commercial |
$48.54
|
| Rate for Payer: Humana Medicare Advantage |
$16.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.39
|
|
|
CH BETA 2 MICROGLOB U
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
HCPCS 82232
|
| Hospital Charge Code |
397072036
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$19.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.20
|
|
|
CH BETA-2 TRANSFERRIN, (BF)
|
Facility
|
IP
|
$808.00
|
|
|
Service Code
|
HCPCS 86335
|
| Hospital Charge Code |
397071407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$121.20 |
| Max. Negotiated Rate |
$121.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.20
|
|
|
CH BETA-2 TRANSFERRIN, (BF)
|
Facility
|
OP
|
$808.00
|
|
|
Service Code
|
HCPCS 86335
|
| Hospital Charge Code |
397071407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.41 |
| Max. Negotiated Rate |
$404.00 |
| Rate for Payer: Aetna Commercial |
$79.83
|
| Rate for Payer: Aetna Medicare Advantage |
$95.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$29.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.94
|
| Rate for Payer: Cigna Commercial |
$404.00
|
| Rate for Payer: Cigna Medicare Advantage |
$29.35
|
| Rate for Payer: Clover Medicare Advantage |
$27.88
|
| Rate for Payer: EmblemHealth Commercial |
$88.05
|
| Rate for Payer: Humana Medicare Advantage |
$30.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$29.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$242.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$29.35
|
| Rate for Payer: Wellcare Medicare Advantage |
$29.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.41
|
|
|
CH BETA 2, TRANSFERRIN (BF)
|
Facility
|
OP
|
$1,502.00
|
|
|
Service Code
|
HCPCS 86335
|
| Hospital Charge Code |
397073637
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.48 |
| Max. Negotiated Rate |
$751.00 |
| Rate for Payer: Aetna Commercial |
$79.83
|
| Rate for Payer: Aetna Medicare Advantage |
$95.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$105.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$105.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$29.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$105.94
|
| Rate for Payer: Cigna Commercial |
$751.00
|
| Rate for Payer: Cigna Medicare Advantage |
$29.35
|
| Rate for Payer: Clover Medicare Advantage |
$27.88
|
| Rate for Payer: EmblemHealth Commercial |
$88.05
|
| Rate for Payer: Humana Medicare Advantage |
$30.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$29.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$450.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$29.35
|
| Rate for Payer: Wellcare Medicare Advantage |
$29.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$39.80
|
|
|
CH BETA 2, TRANSFERRIN (BF)
|
Facility
|
IP
|
$1,502.00
|
|
|
Service Code
|
HCPCS 86335
|
| Hospital Charge Code |
397073637
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$225.30 |
| Max. Negotiated Rate |
$225.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.30
|
|
|
CH BICARBONATE, URINE RANDOM
|
Facility
|
IP
|
$29.00
|
|
|
Service Code
|
HCPCS 82374
|
| Hospital Charge Code |
397071473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$4.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.35
|
|
|
CH BICARBONATE, URINE RANDOM
|
Facility
|
OP
|
$29.00
|
|
|
Service Code
|
HCPCS 82374
|
| Hospital Charge Code |
397071473
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare Advantage |
$15.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.62
|
| Rate for Payer: Cigna Commercial |
$14.50
|
| Rate for Payer: Cigna Medicare Advantage |
$4.88
|
| Rate for Payer: Clover Medicare Advantage |
$4.64
|
| Rate for Payer: EmblemHealth Commercial |
$14.64
|
| Rate for Payer: Humana Medicare Advantage |
$5.03
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.77
|
|
|
CH BILE ACIDS
|
Facility
|
IP
|
$216.00
|
|
|
Service Code
|
HCPCS 82240
|
| Hospital Charge Code |
397071349
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$32.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.40
|
|
|
CH BILE ACIDS
|
Facility
|
OP
|
$216.00
|
|
|
Service Code
|
HCPCS 82240
|
| Hospital Charge Code |
397071349
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.72 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$72.30
|
| Rate for Payer: Aetna Medicare Advantage |
$86.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$95.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$95.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$26.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$95.95
|
| Rate for Payer: Cigna Commercial |
$108.00
|
| Rate for Payer: Cigna Medicare Advantage |
$26.58
|
| Rate for Payer: Clover Medicare Advantage |
$25.25
|
| Rate for Payer: EmblemHealth Commercial |
$79.74
|
| Rate for Payer: Humana Medicare Advantage |
$27.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$26.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$64.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$26.58
|
| Rate for Payer: Wellcare Medicare Advantage |
$26.58
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.72
|
|
|
CH BILE ACIDS,FRACT-TOT,PREG
|
Facility
|
IP
|
$549.00
|
|
|
Service Code
|
HCPCS 83789
|
| Hospital Charge Code |
397071397
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.35 |
| Max. Negotiated Rate |
$82.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.35
|
|
|
CH BILE ACIDS,FRACT-TOT,PREG
|
Facility
|
OP
|
$549.00
|
|
|
Service Code
|
HCPCS 83789
|
| Hospital Charge Code |
397071397
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.55 |
| Max. Negotiated Rate |
$274.50 |
| Rate for Payer: Aetna Commercial |
$65.58
|
| Rate for Payer: Aetna Medicare Advantage |
$78.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$87.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$87.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$87.03
|
| Rate for Payer: Cigna Commercial |
$274.50
|
| Rate for Payer: Cigna Medicare Advantage |
$24.11
|
| Rate for Payer: Clover Medicare Advantage |
$22.90
|
| Rate for Payer: EmblemHealth Commercial |
$72.33
|
| Rate for Payer: Humana Medicare Advantage |
$24.83
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$164.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24.11
|
| Rate for Payer: Wellcare Medicare Advantage |
$24.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.55
|
|
|
CH BILE URINE
|
Facility
|
OP
|
$22.45
|
|
|
Service Code
|
HCPCS 81005
|
| Hospital Charge Code |
397073024
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$0.59 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$5.90
|
| Rate for Payer: Aetna Medicare Advantage |
$7.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$7.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$7.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$7.83
|
| Rate for Payer: Cigna Commercial |
$11.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.17
|
| Rate for Payer: Clover Medicare Advantage |
$2.06
|
| Rate for Payer: EmblemHealth Commercial |
$6.51
|
| Rate for Payer: Humana Medicare Advantage |
$2.24
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.74
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.74
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$2.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.59
|
|
|
CH BILE URINE
|
Facility
|
IP
|
$22.45
|
|
|
Service Code
|
HCPCS 81005
|
| Hospital Charge Code |
397073024
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$3.37 |
| Max. Negotiated Rate |
$3.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.37
|
|
|
CH BILIRUBIN DIRECT
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS 82248
|
| Hospital Charge Code |
397071076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
|
|
CH BILIRUBIN DIRECT
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS 82248
|
| Hospital Charge Code |
397071076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.59 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$13.65
|
| Rate for Payer: Aetna Medicare Advantage |
$16.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.02
|
| 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 |
$18.12
|
| Rate for Payer: Cigna Commercial |
$30.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.02
|
| Rate for Payer: Clover Medicare Advantage |
$4.77
|
| Rate for Payer: EmblemHealth Commercial |
$15.06
|
| Rate for Payer: Humana Medicare Advantage |
$5.17
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.02
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.59
|
|
