|
CH CEA ANTIGEN FLUID
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82378
|
| Hospital Charge Code |
397071075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$51.57
|
| Rate for Payer: Aetna Medicare Advantage |
$61.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$68.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$68.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$43.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$68.44
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$18.96
|
| Rate for Payer: Clover Medicare Advantage |
$18.01
|
| Rate for Payer: EmblemHealth Commercial |
$56.88
|
| Rate for Payer: Humana Medicare Advantage |
$19.53
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$18.96
|
| 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 |
$15.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.96
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH CEA ANTIGEN FLUID
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82378
|
| Hospital Charge Code |
397071075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH CELL BLOCK
|
Facility
|
IP
|
$970.00
|
|
|
Service Code
|
HCPCS 88305
|
| Hospital Charge Code |
397061075
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$145.50 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.50
|
|
|
CH CELL BLOCK
|
Facility
|
OP
|
$970.00
|
|
|
Service Code
|
HCPCS 88305
|
| Hospital Charge Code |
397061075
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$25.70 |
| Max. Negotiated Rate |
$291.00 |
| Rate for Payer: Aetna Commercial |
$168.40
|
| Rate for Payer: Aetna Medicare Advantage |
$200.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$223.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$223.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$61.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$223.48
|
| Rate for Payer: Cigna Commercial |
$124.10
|
| Rate for Payer: Cigna Medicare Advantage |
$61.91
|
| Rate for Payer: Clover Medicare Advantage |
$58.81
|
| Rate for Payer: EmblemHealth Commercial |
$185.73
|
| Rate for Payer: Humana Medicare Advantage |
$63.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$61.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$291.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$57.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$61.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$61.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$25.70
|
|
|
CH CELL COUNT BRONCHIAL WASH
|
Facility
|
IP
|
$91.25
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021291
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.69 |
| Max. Negotiated Rate |
$13.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.69
|
|
|
CH CELL COUNT BRONCHIAL WASH
|
Facility
|
OP
|
$91.25
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021291
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$15.23
|
| Rate for Payer: Aetna Medicare Advantage |
$18.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.21
|
| Rate for Payer: Cigna Commercial |
$45.62
|
| Rate for Payer: Cigna Medicare Advantage |
$5.60
|
| Rate for Payer: Clover Medicare Advantage |
$5.32
|
| Rate for Payer: EmblemHealth Commercial |
$16.80
|
| Rate for Payer: Humana Medicare Advantage |
$5.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.38
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.42
|
|
|
CH CELL COUNT CSF
|
Facility
|
IP
|
$137.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021024
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.55 |
| Max. Negotiated Rate |
$20.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.55
|
|
|
CH CELL COUNT CSF
|
Facility
|
OP
|
$137.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021024
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$15.23
|
| Rate for Payer: Aetna Medicare Advantage |
$18.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.21
|
| Rate for Payer: Cigna Commercial |
$68.50
|
| Rate for Payer: Cigna Medicare Advantage |
$5.60
|
| Rate for Payer: Clover Medicare Advantage |
$5.32
|
| Rate for Payer: EmblemHealth Commercial |
$16.80
|
| Rate for Payer: Humana Medicare Advantage |
$5.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.63
|
|
|
CH CELL COUNT MISC FLUID
|
Facility
|
IP
|
$120.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021070
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.00
|
|
|
CH CELL COUNT MISC FLUID
|
Facility
|
OP
|
$120.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021070
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$15.23
|
| Rate for Payer: Aetna Medicare Advantage |
$18.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.21
|
| Rate for Payer: Cigna Commercial |
$60.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.60
|
| Rate for Payer: Clover Medicare Advantage |
$5.32
|
| Rate for Payer: EmblemHealth Commercial |
$16.80
|
| Rate for Payer: Humana Medicare Advantage |
$5.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.60
|
| 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 |
$4.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.18
|
|
|
CH CELL COUNT PERICARDIAL FL
|
Facility
|
IP
|
$132.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021093
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$19.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.80
|
|
|
CH CELL COUNT PERICARDIAL FL
|
Facility
|
OP
|
$132.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021093
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$15.23
|
| Rate for Payer: Aetna Medicare Advantage |
$18.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.21
|
| Rate for Payer: Cigna Commercial |
$66.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.60
|
| Rate for Payer: Clover Medicare Advantage |
$5.32
|
| Rate for Payer: EmblemHealth Commercial |
$16.80
|
| Rate for Payer: Humana Medicare Advantage |
$5.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.50
|
|
|
CH CELL COUNT PERITONEAL FL
|
Facility
|
IP
|
$145.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021091
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.75 |
| Max. Negotiated Rate |
$21.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.75
|
|
|
CH CELL COUNT PERITONEAL FL
|
Facility
|
OP
|
$145.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021091
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$15.23
|
| Rate for Payer: Aetna Medicare Advantage |
$18.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.21
|
| Rate for Payer: Cigna Commercial |
$72.50
|
| Rate for Payer: Cigna Medicare Advantage |
$5.60
|
| Rate for Payer: Clover Medicare Advantage |
$5.32
|
| Rate for Payer: EmblemHealth Commercial |
$16.80
|
| Rate for Payer: Humana Medicare Advantage |
$5.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.84
|
|
|
CH CELL COUNT PLEURAL FLUID
|
Facility
|
OP
|
$132.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021090
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$15.23
|
| Rate for Payer: Aetna Medicare Advantage |
$18.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.21
|
| Rate for Payer: Cigna Commercial |
$66.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.60
|
| Rate for Payer: Clover Medicare Advantage |
$5.32
|
| Rate for Payer: EmblemHealth Commercial |
$16.80
|
| Rate for Payer: Humana Medicare Advantage |
$5.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.50
|
|
|
CH CELL COUNT PLEURAL FLUID
|
Facility
|
IP
|
$132.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021090
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$19.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.80
|
|
|
CH CELL COUNT SYNOVIAL FLUID
|
Facility
|
OP
|
$145.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021092
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$15.23
|
| Rate for Payer: Aetna Medicare Advantage |
$18.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.21
|
| Rate for Payer: Cigna Commercial |
$72.50
|
| Rate for Payer: Cigna Medicare Advantage |
$5.60
|
| Rate for Payer: Clover Medicare Advantage |
$5.32
|
| Rate for Payer: EmblemHealth Commercial |
$16.80
|
| Rate for Payer: Humana Medicare Advantage |
$5.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.84
|
|
|
CH CELL COUNT SYNOVIAL FLUID
|
Facility
|
IP
|
$145.00
|
|
|
Service Code
|
HCPCS 89051
|
| Hospital Charge Code |
397021092
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.75 |
| Max. Negotiated Rate |
$21.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.75
|
|
|
CH CELL SURFACE MARKER CD20
|
Facility
|
OP
|
$257.00
|
|
|
Service Code
|
HCPCS 86356
|
| Hospital Charge Code |
397071502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.81 |
| Max. Negotiated Rate |
$128.50 |
| Rate for Payer: Aetna Commercial |
$72.84
|
| Rate for Payer: Aetna Medicare Advantage |
$86.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$96.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$96.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$26.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$96.67
|
| Rate for Payer: Cigna Commercial |
$128.50
|
| Rate for Payer: Cigna Medicare Advantage |
$26.78
|
| Rate for Payer: Clover Medicare Advantage |
$25.44
|
| Rate for Payer: EmblemHealth Commercial |
$80.34
|
| Rate for Payer: Humana Medicare Advantage |
$27.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$26.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$77.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$21.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$26.78
|
| Rate for Payer: Wellcare Medicare Advantage |
$26.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.81
|
|
|
CH CELL SURFACE MARKER CD20
|
Facility
|
IP
|
$257.00
|
|
|
Service Code
|
HCPCS 86356
|
| Hospital Charge Code |
397071502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$38.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.55
|
|
|
CH CEREBYX
|
Facility
|
OP
|
$670.00
|
|
|
Service Code
|
HCPCS 80299
|
| Hospital Charge Code |
397073665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.64 |
| Max. Negotiated Rate |
$335.00 |
| Rate for Payer: Aetna Commercial |
$50.70
|
| Rate for Payer: Aetna Medicare Advantage |
$60.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.28
|
| Rate for Payer: Cigna Commercial |
$335.00
|
| Rate for Payer: Cigna Medicare Advantage |
$18.64
|
| Rate for Payer: Clover Medicare Advantage |
$17.71
|
| Rate for Payer: EmblemHealth Commercial |
$55.92
|
| Rate for Payer: Humana Medicare Advantage |
$19.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$18.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$201.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.75
|
|
|
CH CEREBYX
|
Facility
|
IP
|
$670.00
|
|
|
Service Code
|
HCPCS 80299
|
| Hospital Charge Code |
397073665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.50 |
| Max. Negotiated Rate |
$100.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.50
|
|
|
CH CERULOPLASMIN
|
Facility
|
IP
|
$92.00
|
|
|
Service Code
|
HCPCS 82390
|
| Hospital Charge Code |
397071050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.80
|
|
|
CH CERULOPLASMIN
|
Facility
|
OP
|
$92.00
|
|
|
Service Code
|
HCPCS 82390
|
| Hospital Charge Code |
397071050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$29.21
|
| Rate for Payer: Aetna Medicare Advantage |
$34.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.77
|
| Rate for Payer: Cigna Commercial |
$46.00
|
| Rate for Payer: Cigna Medicare Advantage |
$10.74
|
| Rate for Payer: Clover Medicare Advantage |
$10.20
|
| Rate for Payer: EmblemHealth Commercial |
$32.22
|
| Rate for Payer: Humana Medicare Advantage |
$11.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.74
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.74
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.44
|
|
|
CH CHICKEN FEATH IGE SERUM
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
397072159
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.05 |
| 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 |
$76.50
|
| 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 |
$45.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.95
|
| 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 |
$4.05
|
|
