|
CH CHROMOSOME ANALYSIS
|
Facility
|
IP
|
$1,108.00
|
|
|
Service Code
|
HCPCS 88267
|
| Hospital Charge Code |
397073330
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$166.20 |
| Max. Negotiated Rate |
$166.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$166.20
|
|
|
CH CHROMOSOME ANALYSIS
|
Facility
|
OP
|
$1,593.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
397073314
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$42.21 |
| Max. Negotiated Rate |
$796.50 |
| Rate for Payer: Aetna Commercial |
$341.33
|
| Rate for Payer: Aetna Medicare Advantage |
$406.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$452.98
|
| Rate for Payer: Cigna Commercial |
$796.50
|
| Rate for Payer: Cigna Medicare Advantage |
$125.49
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$125.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$477.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$238.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$100.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.21
|
|
|
CH CHROMOSOME ANALYSIS
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS 88281
|
| Hospital Charge Code |
397073331
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$19.18 |
| Max. Negotiated Rate |
$398.00 |
| Rate for Payer: Aetna Commercial |
$302.48
|
| Rate for Payer: Aetna Medicare Advantage |
$238.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$202.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$202.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$202.98
|
| Rate for Payer: Cigna Commercial |
$398.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$238.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.09
|
|
|
CH CHROMOSOME ANALYSIS
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS 88281
|
| Hospital Charge Code |
397073331
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
|
|
CH CHROMOSOME ANALYSIS
|
Facility
|
OP
|
$1,593.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
397073335
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$42.21 |
| Max. Negotiated Rate |
$796.50 |
| Rate for Payer: Aetna Commercial |
$341.33
|
| Rate for Payer: Aetna Medicare Advantage |
$406.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$452.98
|
| Rate for Payer: Cigna Commercial |
$796.50
|
| Rate for Payer: Cigna Medicare Advantage |
$125.49
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$125.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$477.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$238.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$100.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42.21
|
|
|
CH CHROMOSOME ANALYSIS BLOOD
|
Facility
|
OP
|
$1,374.00
|
|
|
Service Code
|
HCPCS 88261
|
| Hospital Charge Code |
397073007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.11 |
| Max. Negotiated Rate |
$954.19 |
| Rate for Payer: Aetna Commercial |
$719.00
|
| Rate for Payer: Aetna Medicare Advantage |
$856.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$954.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$954.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$264.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$954.19
|
| Rate for Payer: Cigna Commercial |
$687.00
|
| Rate for Payer: Cigna Medicare Advantage |
$264.34
|
| Rate for Payer: Clover Medicare Advantage |
$251.12
|
| Rate for Payer: EmblemHealth Commercial |
$793.02
|
| Rate for Payer: Humana Medicare Advantage |
$272.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$264.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$412.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$206.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.11
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$264.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$264.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$36.41
|
|
|
CH CHROMOSOME ANALYSIS BLOOD
|
Facility
|
IP
|
$1,374.00
|
|
|
Service Code
|
HCPCS 88261
|
| Hospital Charge Code |
397073007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$206.10 |
| Max. Negotiated Rate |
$206.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$206.10
|
|
|
CH CHROMOSOME - BONE MARROW
|
Facility
|
OP
|
$2,714.00
|
|
|
Service Code
|
HCPCS 88237
|
| Hospital Charge Code |
397072152
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$71.92 |
| Max. Negotiated Rate |
$1,357.00 |
| Rate for Payer: Aetna Commercial |
$391.00
|
| Rate for Payer: Aetna Medicare Advantage |
$465.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$518.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$518.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$143.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$518.89
|
| Rate for Payer: Cigna Commercial |
$1,357.00
|
| Rate for Payer: Cigna Medicare Advantage |
$143.75
|
| Rate for Payer: Clover Medicare Advantage |
$136.56
|
| Rate for Payer: EmblemHealth Commercial |
$431.25
|
| Rate for Payer: Humana Medicare Advantage |
$148.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$143.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$814.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$407.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$115.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$143.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$143.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$71.92
|
|
|
CH CHROMOSOME - BONE MARROW
|
Facility
|
IP
|
$2,714.00
|
|
|
Service Code
|
HCPCS 88237
|
| Hospital Charge Code |
397072152
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$407.10 |
| Max. Negotiated Rate |
$407.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$407.10
|
|
|
CH CHROMOSOME - HEMATOLOGIC
|
Facility
|
IP
|
$1,263.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
397072149
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$189.45 |
| Max. Negotiated Rate |
$189.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$189.45
|
|
|
CH CHROMOSOME - HEMATOLOGIC
|
Facility
|
OP
|
$1,263.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
397072149
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.47 |
| Max. Negotiated Rate |
$631.50 |
| Rate for Payer: Aetna Commercial |
$341.33
|
| Rate for Payer: Aetna Medicare Advantage |
$406.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$452.98
|
| Rate for Payer: Cigna Commercial |
$631.50
|
| Rate for Payer: Cigna Medicare Advantage |
$125.49
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$125.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$378.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$189.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$100.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.47
|
|
|
CH CHROMOSOME HR
|
Facility
|
OP
|
$2,169.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
397073065
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,084.50 |
| Rate for Payer: Aetna Commercial |
$341.33
|
| Rate for Payer: Aetna Medicare Advantage |
$406.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$452.98
|
| Rate for Payer: Cigna Commercial |
$1,084.50
|
| Rate for Payer: Cigna Medicare Advantage |
$125.49
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$125.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$650.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$325.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$100.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$57.48
|
|
|
CH CHROMOSOME HR
|
Facility
|
IP
|
$2,169.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
397073065
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$325.35 |
| Max. Negotiated Rate |
$325.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$325.35
|
|
|
CH CHROMOSOME, POC
|
Facility
|
OP
|
$2,169.00
|
|
|
Service Code
|
HCPCS 88233
|
| Hospital Charge Code |
397073073
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$1,084.50 |
| Rate for Payer: Aetna Commercial |
$382.79
|
| Rate for Payer: Aetna Medicare Advantage |
$455.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$507.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$507.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$140.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$507.99
|
| Rate for Payer: Cigna Commercial |
$1,084.50
|
| Rate for Payer: Cigna Medicare Advantage |
$140.73
|
| Rate for Payer: Clover Medicare Advantage |
$133.69
|
| Rate for Payer: EmblemHealth Commercial |
$422.19
|
| Rate for Payer: Humana Medicare Advantage |
$144.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$140.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$650.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$325.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$112.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$140.73
|
| Rate for Payer: Wellcare Medicare Advantage |
$140.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$57.48
|
|
|
CH CHROMOSOME, POC
|
Facility
|
IP
|
$2,169.00
|
|
|
Service Code
|
HCPCS 88233
|
| Hospital Charge Code |
397073073
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$325.35 |
| Max. Negotiated Rate |
$325.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$325.35
|
|
|
CH CHROMOSOME-ROUTINE G BAND
|
Facility
|
OP
|
$1,914.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
397072150
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$50.72 |
| Max. Negotiated Rate |
$957.00 |
| Rate for Payer: Aetna Commercial |
$341.33
|
| Rate for Payer: Aetna Medicare Advantage |
$406.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$452.98
|
| Rate for Payer: Cigna Commercial |
$957.00
|
| Rate for Payer: Cigna Medicare Advantage |
$125.49
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$125.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$574.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$287.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$100.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$50.72
|
|
|
CH CHROMOSOME-ROUTINE G BAND
|
Facility
|
IP
|
$1,914.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
397072150
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$287.10 |
| Max. Negotiated Rate |
$287.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$287.10
|
|
|
CH CHROMOSOMES LEUK/LYMPH
|
Facility
|
IP
|
$728.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
397073066
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.20
|
|
|
CH CHROMOSOMES LEUK/LYMPH
|
Facility
|
OP
|
$728.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
397073066
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$364.00 |
| Rate for Payer: Aetna Commercial |
$6.45
|
| Rate for Payer: Aetna Medicare Advantage |
$7.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.55
|
| Rate for Payer: Cigna Commercial |
$364.00
|
| Rate for Payer: Cigna Medicare Advantage |
$2.37
|
| Rate for Payer: Clover Medicare Advantage |
$2.25
|
| Rate for Payer: EmblemHealth Commercial |
$7.11
|
| Rate for Payer: Humana Medicare Advantage |
$2.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$218.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2.37
|
| Rate for Payer: Wellcare Medicare Advantage |
$2.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.29
|
|
|
CH CHROMOSOME - TISSUE
|
Facility
|
OP
|
$2,933.00
|
|
|
Service Code
|
HCPCS 88233
|
| Hospital Charge Code |
397072151
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$77.72 |
| Max. Negotiated Rate |
$1,466.50 |
| Rate for Payer: Aetna Commercial |
$382.79
|
| Rate for Payer: Aetna Medicare Advantage |
$455.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$507.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$507.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$140.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$507.99
|
| Rate for Payer: Cigna Commercial |
$1,466.50
|
| Rate for Payer: Cigna Medicare Advantage |
$140.73
|
| Rate for Payer: Clover Medicare Advantage |
$133.69
|
| Rate for Payer: EmblemHealth Commercial |
$422.19
|
| Rate for Payer: Humana Medicare Advantage |
$144.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$140.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$879.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$439.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$112.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$140.73
|
| Rate for Payer: Wellcare Medicare Advantage |
$140.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$77.72
|
|
|
CH CHROMOSOME - TISSUE
|
Facility
|
IP
|
$2,933.00
|
|
|
Service Code
|
HCPCS 88233
|
| Hospital Charge Code |
397072151
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$439.95 |
| Max. Negotiated Rate |
$439.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$439.95
|
|
|
CH CITALOPRAM
|
Facility
|
OP
|
$550.00
|
|
| Hospital Charge Code |
3970727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.26 |
| Max. Negotiated Rate |
$275.00 |
| Rate for Payer: Aetna Commercial |
$209.00
|
| Rate for Payer: Aetna Medicare Advantage |
$165.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$140.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$140.25
|
| Rate for Payer: Cigna Commercial |
$275.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$165.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.57
|
|
|
CH CITALOPRAM
|
Facility
|
IP
|
$550.00
|
|
| Hospital Charge Code |
3970727
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.50
|
|
|
CH CITRATE
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
HCPCS 82507
|
| Hospital Charge Code |
397071169
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.56 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$75.62
|
| Rate for Payer: Aetna Medicare Advantage |
$90.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$100.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$100.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$27.80
|
| 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 |
$100.35
|
| Rate for Payer: Cigna Commercial |
$86.00
|
| Rate for Payer: Cigna Medicare Advantage |
$27.80
|
| Rate for Payer: Clover Medicare Advantage |
$26.41
|
| Rate for Payer: EmblemHealth Commercial |
$83.40
|
| Rate for Payer: Humana Medicare Advantage |
$28.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$27.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$51.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$22.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$27.80
|
| Rate for Payer: Wellcare Medicare Advantage |
$27.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.56
|
|
|
CH CITRATE
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
HCPCS 82507
|
| Hospital Charge Code |
397071169
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.80 |
| Max. Negotiated Rate |
$25.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.80
|
|
