|
CH COPPER SERUM
|
Facility
|
OP
|
$111.00
|
|
|
Service Code
|
HCPCS 82525
|
| Hospital Charge Code |
397072053
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$33.76
|
| Rate for Payer: Aetna Medicare Advantage |
$40.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.41
|
| 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 |
$44.80
|
| Rate for Payer: Cigna Commercial |
$55.50
|
| Rate for Payer: Cigna Medicare Advantage |
$12.41
|
| Rate for Payer: Clover Medicare Advantage |
$11.79
|
| Rate for Payer: EmblemHealth Commercial |
$37.23
|
| Rate for Payer: Humana Medicare Advantage |
$12.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.93
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.41
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.94
|
|
|
CH COPPER URINE
|
Facility
|
IP
|
$177.00
|
|
|
Service Code
|
HCPCS 82525
|
| Hospital Charge Code |
397072052
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.55 |
| Max. Negotiated Rate |
$26.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.55
|
|
|
CH COPPER URINE
|
Facility
|
OP
|
$177.00
|
|
|
Service Code
|
HCPCS 82525
|
| Hospital Charge Code |
397072052
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$33.76
|
| Rate for Payer: Aetna Medicare Advantage |
$40.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.41
|
| 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 |
$44.80
|
| Rate for Payer: Cigna Commercial |
$88.50
|
| Rate for Payer: Cigna Medicare Advantage |
$12.41
|
| Rate for Payer: Clover Medicare Advantage |
$11.79
|
| Rate for Payer: EmblemHealth Commercial |
$37.23
|
| Rate for Payer: Humana Medicare Advantage |
$12.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$53.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.93
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.41
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.69
|
|
|
CH CORTICOSTEROID 17 OH
|
Facility
|
IP
|
$608.00
|
|
|
Service Code
|
HCPCS 83491
|
| Hospital Charge Code |
397071177
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$91.20 |
| Max. Negotiated Rate |
$91.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$91.20
|
|
|
CH CORTICOSTEROID 17 OH
|
Facility
|
OP
|
$608.00
|
|
|
Service Code
|
HCPCS 83491
|
| Hospital Charge Code |
397071177
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.32 |
| Max. Negotiated Rate |
$304.00 |
| Rate for Payer: Aetna Commercial |
$48.69
|
| Rate for Payer: Aetna Medicare Advantage |
$58.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$64.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$64.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$64.61
|
| Rate for Payer: Cigna Commercial |
$304.00
|
| Rate for Payer: Cigna Medicare Advantage |
$17.90
|
| Rate for Payer: Clover Medicare Advantage |
$17.00
|
| Rate for Payer: EmblemHealth Commercial |
$53.70
|
| Rate for Payer: Humana Medicare Advantage |
$18.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$182.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$91.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.32
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.90
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.11
|
|
|
CH CORTISOL FREE 24 HR UR
|
Facility
|
OP
|
$158.00
|
|
|
Service Code
|
HCPCS 82530
|
| Hospital Charge Code |
397073626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$45.45
|
| Rate for Payer: Aetna Medicare Advantage |
$54.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.32
|
| Rate for Payer: Cigna Commercial |
$79.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.71
|
| Rate for Payer: Clover Medicare Advantage |
$15.87
|
| Rate for Payer: EmblemHealth Commercial |
$50.13
|
| Rate for Payer: Humana Medicare Advantage |
$17.21
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$47.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.19
|
|
|
CH CORTISOL FREE 24 HR UR
|
Facility
|
IP
|
$158.00
|
|
|
Service Code
|
HCPCS 82530
|
| Hospital Charge Code |
397073626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.70 |
| Max. Negotiated Rate |
$23.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.70
|
|
|
CH CORTISOL, FREE, URINE
|
Facility
|
IP
|
$1,386.00
|
|
|
Service Code
|
HCPCS 82530
|
| Hospital Charge Code |
397073148
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$207.90 |
| Max. Negotiated Rate |
$207.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$207.90
|
|
|
CH CORTISOL, FREE, URINE
|
Facility
|
OP
|
$1,386.00
|
|
|
Service Code
|
HCPCS 82530
|
| Hospital Charge Code |
397073148
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.37 |
| Max. Negotiated Rate |
$693.00 |
| Rate for Payer: Aetna Commercial |
$45.45
|
| Rate for Payer: Aetna Medicare Advantage |
$54.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.32
|
| Rate for Payer: Cigna Commercial |
$693.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.71
|
| Rate for Payer: Clover Medicare Advantage |
$15.87
|
| Rate for Payer: EmblemHealth Commercial |
$50.13
|
| Rate for Payer: Humana Medicare Advantage |
$17.21
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$415.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$207.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$36.73
|
|
|
CH CORTISOL,TOTAL,PM
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
HCPCS 82533
|
| Hospital Charge Code |
397071264
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.50
|
|
|
CH CORTISOL,TOTAL,PM
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
HCPCS 82533
|
| Hospital Charge Code |
397071264
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$44.34
|
| Rate for Payer: Aetna Medicare Advantage |
$52.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.84
|
| Rate for Payer: Cigna Commercial |
$55.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.30
|
| Rate for Payer: Clover Medicare Advantage |
$15.48
|
| Rate for Payer: EmblemHealth Commercial |
$48.90
|
| Rate for Payer: Humana Medicare Advantage |
$16.79
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.04
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.92
|
|
|
CH CORTISO,TOTAL,AM
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
HCPCS 82533
|
| Hospital Charge Code |
397071263
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.50
|
|
|
CH CORTISO,TOTAL,AM
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
HCPCS 82533
|
| Hospital Charge Code |
397071263
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$44.34
|
| Rate for Payer: Aetna Medicare Advantage |
$52.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.84
|
| Rate for Payer: Cigna Commercial |
$55.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.30
|
| Rate for Payer: Clover Medicare Advantage |
$15.48
|
| Rate for Payer: EmblemHealth Commercial |
$48.90
|
| Rate for Payer: Humana Medicare Advantage |
$16.79
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$33.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.04
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.92
|
|
|
CH C PEPTIDE
|
Facility
|
IP
|
$161.00
|
|
|
Service Code
|
HCPCS 84681
|
| Hospital Charge Code |
397071208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.15 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.15
|
|
|
CH C PEPTIDE
|
Facility
|
OP
|
$161.00
|
|
|
Service Code
|
HCPCS 84681
|
| Hospital Charge Code |
397071208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.27 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare Advantage |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$42.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.12
|
| Rate for Payer: Cigna Commercial |
$80.50
|
| Rate for Payer: Cigna Medicare Advantage |
$20.81
|
| Rate for Payer: Clover Medicare Advantage |
$19.77
|
| Rate for Payer: EmblemHealth Commercial |
$62.43
|
| Rate for Payer: Humana Medicare Advantage |
$21.43
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.27
|
|
|
CH CQ1B, ABS
|
Facility
|
IP
|
$203.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
397072168
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.45 |
| Max. Negotiated Rate |
$30.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.45
|
|
|
CH CQ1B, ABS
|
Facility
|
OP
|
$203.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
397072168
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.38 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: Aetna Medicare Advantage |
$55.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.34
|
| Rate for Payer: Cigna Commercial |
$101.50
|
| Rate for Payer: Cigna Medicare Advantage |
$17.27
|
| Rate for Payer: Clover Medicare Advantage |
$16.41
|
| Rate for Payer: EmblemHealth Commercial |
$51.81
|
| Rate for Payer: Humana Medicare Advantage |
$17.79
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.38
|
|
|
CH C REACTIVE PROTEIN
|
Facility
|
OP
|
$167.00
|
|
|
Service Code
|
HCPCS 86140
|
| Hospital Charge Code |
397071290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.14 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$14.09
|
| Rate for Payer: Aetna Medicare Advantage |
$16.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.70
|
| Rate for Payer: Cigna Commercial |
$83.50
|
| Rate for Payer: Cigna Medicare Advantage |
$5.18
|
| Rate for Payer: Clover Medicare Advantage |
$4.92
|
| Rate for Payer: EmblemHealth Commercial |
$15.54
|
| Rate for Payer: Humana Medicare Advantage |
$5.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.43
|
|
|
CH C REACTIVE PROTEIN
|
Facility
|
IP
|
$167.00
|
|
|
Service Code
|
HCPCS 86140
|
| Hospital Charge Code |
397071290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.05 |
| Max. Negotiated Rate |
$25.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.05
|
|
|
CH CREATIN, 24 HR URINE
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
HCPCS 82540
|
| Hospital Charge Code |
397071481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$12.62
|
| Rate for Payer: Aetna Medicare Advantage |
$15.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.75
|
| Rate for Payer: Cigna Commercial |
$22.00
|
| Rate for Payer: Cigna Medicare Advantage |
$4.64
|
| Rate for Payer: Clover Medicare Advantage |
$4.41
|
| Rate for Payer: EmblemHealth Commercial |
$13.92
|
| Rate for Payer: Humana Medicare Advantage |
$4.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.64
|
| 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 |
$3.71
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.17
|
|
|
CH CREATIN, 24 HR URINE
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
HCPCS 82540
|
| Hospital Charge Code |
397071481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$6.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.60
|
|
|
CH CREATININE
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
HCPCS 82565
|
| Hospital Charge Code |
397071098
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$13.93
|
| Rate for Payer: Aetna Medicare Advantage |
$16.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.48
|
| Rate for Payer: Cigna Commercial |
$20.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.12
|
| Rate for Payer: Clover Medicare Advantage |
$4.86
|
| Rate for Payer: EmblemHealth Commercial |
$15.36
|
| Rate for Payer: Humana Medicare Advantage |
$5.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.10
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.12
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.12
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.06
|
|
|
CH CREATININE
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
HCPCS 82565
|
| Hospital Charge Code |
397071098
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.00
|
|
|
CH CREATININE CLEARANCE
|
Facility
|
OP
|
$118.00
|
|
|
Service Code
|
HCPCS 82575
|
| Hospital Charge Code |
397071102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.13 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$25.73
|
| Rate for Payer: Aetna Medicare Advantage |
$30.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.15
|
| Rate for Payer: Cigna Commercial |
$59.00
|
| Rate for Payer: Cigna Medicare Advantage |
$9.46
|
| Rate for Payer: Clover Medicare Advantage |
$8.99
|
| Rate for Payer: EmblemHealth Commercial |
$28.38
|
| Rate for Payer: Humana Medicare Advantage |
$9.74
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.46
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.13
|
|
|
CH CREATININE CLEARANCE
|
Facility
|
IP
|
$118.00
|
|
|
Service Code
|
HCPCS 82575
|
| Hospital Charge Code |
397071102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.70 |
| Max. Negotiated Rate |
$17.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.70
|
|
