|
CH GENTAMYCIN RANDOM
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 80170
|
| Hospital Charge Code |
397073181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$44.55
|
| Rate for Payer: Aetna Medicare Advantage |
$53.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.38
|
| 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 |
$59.13
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.38
|
| Rate for Payer: Clover Medicare Advantage |
$15.56
|
| Rate for Payer: EmblemHealth Commercial |
$49.14
|
| Rate for Payer: Humana Medicare Advantage |
$16.87
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.38
|
| 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 |
$13.10
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH GENTAMYCIN RANDOM
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 80170
|
| Hospital Charge Code |
397073181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH GENTAMYCIN THROUGH
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 80170
|
| Hospital Charge Code |
397071316
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$44.55
|
| Rate for Payer: Aetna Medicare Advantage |
$53.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.38
|
| 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 |
$59.13
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.38
|
| Rate for Payer: Clover Medicare Advantage |
$15.56
|
| Rate for Payer: EmblemHealth Commercial |
$49.14
|
| Rate for Payer: Humana Medicare Advantage |
$16.87
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.38
|
| 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 |
$13.10
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.38
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH GENTAMYCIN THROUGH
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 80170
|
| Hospital Charge Code |
397071316
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH GGTP
|
Facility
|
OP
|
$140.00
|
|
|
Service Code
|
HCPCS 82977
|
| Hospital Charge Code |
397071128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$19.58
|
| Rate for Payer: Aetna Medicare Advantage |
$23.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$25.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$25.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$25.99
|
| Rate for Payer: Cigna Commercial |
$70.00
|
| Rate for Payer: Cigna Medicare Advantage |
$7.20
|
| Rate for Payer: Clover Medicare Advantage |
$6.84
|
| Rate for Payer: EmblemHealth Commercial |
$21.60
|
| Rate for Payer: Humana Medicare Advantage |
$7.42
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.76
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$7.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.71
|
|
|
CH GGTP
|
Facility
|
IP
|
$140.00
|
|
|
Service Code
|
HCPCS 82977
|
| Hospital Charge Code |
397071128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.00
|
|
|
CH GLIADIN AB (IGA)
|
Facility
|
OP
|
$63.00
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
397071420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$31.36
|
| Rate for Payer: Aetna Medicare Advantage |
$37.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.53
|
| 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 |
$41.62
|
| Rate for Payer: Cigna Commercial |
$31.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.53
|
| Rate for Payer: Clover Medicare Advantage |
$10.95
|
| Rate for Payer: EmblemHealth Commercial |
$34.59
|
| Rate for Payer: Humana Medicare Advantage |
$11.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.67
|
|
|
CH GLIADIN AB (IGA)
|
Facility
|
IP
|
$63.00
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
397071420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$9.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.45
|
|
|
CH GLIPIZIDE
|
Facility
|
OP
|
$353.00
|
|
|
Service Code
|
HCPCS 80299
|
| Hospital Charge Code |
397071548
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$176.50 |
| 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 |
$176.50
|
| 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 |
$105.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.95
|
| 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 |
$9.35
|
|
|
CH GLIPIZIDE
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
HCPCS 80299
|
| Hospital Charge Code |
397071548
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.95 |
| Max. Negotiated Rate |
$52.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.95
|
|
|
CH GLUCAGON
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82943
|
| Hospital Charge Code |
397073559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH GLUCAGON
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82943
|
| Hospital Charge Code |
397073559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$38.87
|
| Rate for Payer: Aetna Medicare Advantage |
$46.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.58
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.29
|
| Rate for Payer: Clover Medicare Advantage |
$13.58
|
| Rate for Payer: EmblemHealth Commercial |
$42.87
|
| Rate for Payer: Humana Medicare Advantage |
$14.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.29
|
| 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 |
$11.43
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.29
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH GLUCOMETER
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
HCPCS 82948
|
| Hospital Charge Code |
397073570
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$8.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.40
|
|
|
CH GLUCOMETER
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
HCPCS 82948
|
| Hospital Charge Code |
397073570
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$13.71
|
| Rate for Payer: Aetna Medicare Advantage |
$16.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.19
|
| Rate for Payer: Cigna Commercial |
$28.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.04
|
| Rate for Payer: Clover Medicare Advantage |
$4.79
|
| Rate for Payer: EmblemHealth Commercial |
$15.12
|
| Rate for Payer: Humana Medicare Advantage |
$5.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.04
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.04
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.04
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.48
|
|
|
CH GLUCOSE
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
397071197
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.19
|
| Rate for Payer: Cigna Commercial |
$20.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| 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 |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.06
|
|
|
CH GLUCOSE
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
397071197
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.00
|
|
|
CH GLUCOSE, 4HR SPECIMEN
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
HCPCS 8295291
|
| Hospital Charge Code |
397073261
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.00
|
|
|
CH GLUCOSE, 4HR SPECIMEN
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
HCPCS 8295291
|
| Hospital Charge Code |
397073261
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$15.20
|
| Rate for Payer: Aetna Medicare Advantage |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.20
|
| Rate for Payer: Cigna Commercial |
$20.00
|
| 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 |
$0.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.06
|
|
|
CH GLUCOSE, 5HR SPECIMEN
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
HCPCS 8295291
|
| Hospital Charge Code |
397073267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$15.20
|
| Rate for Payer: Aetna Medicare Advantage |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.20
|
| Rate for Payer: Cigna Commercial |
$20.00
|
| 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 |
$0.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.06
|
|
|
CH GLUCOSE, 5HR SPECIMEN
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
HCPCS 8295291
|
| Hospital Charge Code |
397073267
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.00
|
|
|
CH GLUCOSE, 6HR SPECIMEN
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
HCPCS 8295291
|
| Hospital Charge Code |
397073270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.00
|
|
|
CH GLUCOSE, 6HR SPECIMEN
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
HCPCS 8295291
|
| Hospital Charge Code |
397073270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$15.20
|
| Rate for Payer: Aetna Medicare Advantage |
$12.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$10.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$10.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$10.20
|
| Rate for Payer: Cigna Commercial |
$20.00
|
| 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 |
$0.96
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.06
|
|
|
CH GLUCOSE FLUID
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
397073048
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.19
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| 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 |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH GLUCOSE FLUID
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
397073048
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH GLUCOSE, GESTATIONAL
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
HCPCS 82950
|
| Hospital Charge Code |
397073174
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$12.92
|
| Rate for Payer: Aetna Medicare Advantage |
$15.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.75
|
| 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 |
$17.15
|
| Rate for Payer: Cigna Commercial |
$20.00
|
| Rate for Payer: Cigna Medicare Advantage |
$4.75
|
| Rate for Payer: Clover Medicare Advantage |
$4.51
|
| Rate for Payer: EmblemHealth Commercial |
$14.25
|
| Rate for Payer: Humana Medicare Advantage |
$4.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.75
|
| 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 |
$3.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.06
|
|
