|
CH CMV IGG AB CSF
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
HCPCS 86644
|
| Hospital Charge Code |
397071091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$13.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.20
|
|
|
CH CMV IGM
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86645
|
| Hospital Charge Code |
397043225
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$45.83
|
| Rate for Payer: Aetna Medicare Advantage |
$54.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.82
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.85
|
| Rate for Payer: Clover Medicare Advantage |
$16.01
|
| Rate for Payer: EmblemHealth Commercial |
$50.55
|
| Rate for Payer: Humana Medicare Advantage |
$17.36
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.85
|
| 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 |
$13.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH CMV IGM
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86645
|
| Hospital Charge Code |
397043225
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH CMV IGM AB CSF
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
HCPCS 86645
|
| Hospital Charge Code |
397071089
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$13.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.20
|
|
|
CH CMV IGM AB CSF
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
HCPCS 86645
|
| Hospital Charge Code |
397071089
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$45.83
|
| Rate for Payer: Aetna Medicare Advantage |
$54.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.82
|
| Rate for Payer: Cigna Commercial |
$44.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.85
|
| Rate for Payer: Clover Medicare Advantage |
$16.01
|
| Rate for Payer: EmblemHealth Commercial |
$50.55
|
| Rate for Payer: Humana Medicare Advantage |
$17.36
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.33
|
|
|
CH CMV NEG COMPONENT
|
Facility
|
IP
|
$715.00
|
|
|
Service Code
|
HCPCS P9051
|
| Hospital Charge Code |
397031045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$107.25 |
| Max. Negotiated Rate |
$107.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.25
|
|
|
CH CMV NEG COMPONENT
|
Facility
|
OP
|
$715.00
|
|
|
Service Code
|
HCPCS P9051
|
| Hospital Charge Code |
397031045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$17.23 |
| Max. Negotiated Rate |
$1,167.00 |
| Rate for Payer: Aetna Commercial |
$479.43
|
| Rate for Payer: Aetna Medicare Advantage |
$571.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$636.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$636.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$176.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$636.25
|
| Rate for Payer: Cigna Commercial |
$353.31
|
| Rate for Payer: Cigna Medicare Advantage |
$176.26
|
| Rate for Payer: Clover Medicare Advantage |
$167.45
|
| Rate for Payer: EmblemHealth Commercial |
$528.78
|
| Rate for Payer: Humana Medicare Advantage |
$181.55
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$176.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$214.50
|
| Rate for Payer: Oxford Commercial |
$666.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,167.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$176.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$176.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.95
|
|
|
CH CO 2
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
HCPCS 82374
|
| Hospital Charge Code |
397071148
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.50 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.50
|
|
|
CH CO 2
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
HCPCS 82374
|
| Hospital Charge Code |
397071148
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.32 |
| 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 |
$25.00
|
| 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 |
$15.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.50
|
| 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 |
$1.32
|
|
|
CH COBALT
|
Facility
|
OP
|
$315.00
|
|
|
Service Code
|
HCPCS 83018
|
| Hospital Charge Code |
397071512
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$59.73
|
| Rate for Payer: Aetna Medicare Advantage |
$71.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.27
|
| Rate for Payer: Cigna Commercial |
$157.50
|
| Rate for Payer: Cigna Medicare Advantage |
$21.96
|
| Rate for Payer: Clover Medicare Advantage |
$20.86
|
| Rate for Payer: EmblemHealth Commercial |
$65.88
|
| Rate for Payer: Humana Medicare Advantage |
$22.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$94.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21.96
|
| Rate for Payer: Wellcare Medicare Advantage |
$21.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.35
|
|
|
CH COBALT
|
Facility
|
IP
|
$315.00
|
|
|
Service Code
|
HCPCS 83018
|
| Hospital Charge Code |
397071482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.25 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.25
|
|
|
CH COBALT
|
Facility
|
OP
|
$315.00
|
|
|
Service Code
|
HCPCS 83018
|
| Hospital Charge Code |
397071482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial |
$59.73
|
| Rate for Payer: Aetna Medicare Advantage |
$71.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$79.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$79.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$21.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$79.27
|
| Rate for Payer: Cigna Commercial |
$157.50
|
| Rate for Payer: Cigna Medicare Advantage |
$21.96
|
| Rate for Payer: Clover Medicare Advantage |
$20.86
|
| Rate for Payer: EmblemHealth Commercial |
$65.88
|
| Rate for Payer: Humana Medicare Advantage |
$22.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$21.96
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$94.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$21.96
|
| Rate for Payer: Wellcare Medicare Advantage |
$21.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.35
|
|
|
CH COBALT
|
Facility
|
IP
|
$315.00
|
|
|
Service Code
|
HCPCS 83018
|
| Hospital Charge Code |
397071512
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.25 |
| Max. Negotiated Rate |
$47.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.25
|
|
|
CH COCAINE CONF
|
Facility
|
IP
|
$284.00
|
|
|
Service Code
|
HCPCS 80300
|
| Hospital Charge Code |
397073067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$42.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.60
|
|
|
CH COCAINE CONF
|
Facility
|
OP
|
$284.00
|
|
|
Service Code
|
HCPCS 80300
|
| Hospital Charge Code |
397073067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$142.00 |
| Rate for Payer: Aetna Commercial |
$107.92
|
| Rate for Payer: Aetna Medicare Advantage |
$85.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$72.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$72.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$72.42
|
| Rate for Payer: Cigna Commercial |
$142.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$85.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.53
|
|
|
CH COCAINE DAU
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
HCPCS 80300
|
| Hospital Charge Code |
397071286
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.06 |
| 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 |
$1.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.17
|
|
|
CH COCAINE DAU
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
HCPCS 80300
|
| Hospital Charge Code |
397071286
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$6.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.60
|
|
|
CH COCCIDIOIDES AB, ID
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
HCPCS 86635
|
| Hospital Charge Code |
397071391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$15.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.15
|
|
|
CH COCCIDIOIDES AB, ID
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
HCPCS 86635
|
| Hospital Charge Code |
397071391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.68 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$31.20
|
| Rate for Payer: Aetna Medicare Advantage |
$37.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.40
|
| Rate for Payer: Cigna Commercial |
$50.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.47
|
| Rate for Payer: Clover Medicare Advantage |
$10.90
|
| Rate for Payer: EmblemHealth Commercial |
$34.41
|
| Rate for Payer: Humana Medicare Advantage |
$11.81
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.68
|
|
|
CH COENZYME Q10
|
Facility
|
IP
|
$467.00
|
|
|
Service Code
|
HCPCS 82542
|
| Hospital Charge Code |
397071515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.05 |
| Max. Negotiated Rate |
$70.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.05
|
|
|
CH COENZYME Q10
|
Facility
|
OP
|
$467.00
|
|
|
Service Code
|
HCPCS 82542
|
| Hospital Charge Code |
397071515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.38 |
| Max. Negotiated Rate |
$233.50 |
| Rate for Payer: Aetna Commercial |
$65.52
|
| Rate for Payer: Aetna Medicare Advantage |
$78.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24.09
|
| 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 |
$86.96
|
| Rate for Payer: Cigna Commercial |
$233.50
|
| Rate for Payer: Cigna Medicare Advantage |
$24.09
|
| Rate for Payer: Clover Medicare Advantage |
$22.89
|
| Rate for Payer: EmblemHealth Commercial |
$72.27
|
| Rate for Payer: Humana Medicare Advantage |
$24.81
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$140.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$24.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.38
|
|
|
CH COLD AGGLUTININ
|
Facility
|
IP
|
$86.00
|
|
|
Service Code
|
HCPCS 86157
|
| Hospital Charge Code |
397031024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.90 |
| Max. Negotiated Rate |
$12.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.90
|
|
|
CH COLD AGGLUTININ
|
Facility
|
OP
|
$86.00
|
|
|
Service Code
|
HCPCS 86157
|
| Hospital Charge Code |
397031024
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$21.92
|
| Rate for Payer: Aetna Medicare Advantage |
$26.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.06
|
| 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 |
$29.09
|
| Rate for Payer: Cigna Commercial |
$43.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.06
|
| Rate for Payer: Clover Medicare Advantage |
$7.66
|
| Rate for Payer: EmblemHealth Commercial |
$24.18
|
| Rate for Payer: Humana Medicare Advantage |
$8.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.45
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.28
|
|
|
CH COMPL C1 ESTERASE INIT
|
Facility
|
OP
|
$173.00
|
|
|
Service Code
|
HCPCS 86160
|
| Hospital Charge Code |
397072049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.58 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$32.64
|
| Rate for Payer: Aetna Medicare Advantage |
$38.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.00
|
| 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 |
$43.32
|
| Rate for Payer: Cigna Commercial |
$86.50
|
| Rate for Payer: Cigna Medicare Advantage |
$12.00
|
| Rate for Payer: Clover Medicare Advantage |
$11.40
|
| Rate for Payer: EmblemHealth Commercial |
$36.00
|
| Rate for Payer: Humana Medicare Advantage |
$12.36
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$51.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.00
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.58
|
|
|
CH COMPL C1 ESTERASE INIT
|
Facility
|
IP
|
$173.00
|
|
|
Service Code
|
HCPCS 86160
|
| Hospital Charge Code |
397072049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.95 |
| Max. Negotiated Rate |
$25.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.95
|
|
