|
CH HCG, QUAN
|
Facility
|
IP
|
$633.00
|
|
|
Service Code
|
HCPCS 84702
|
| Hospital Charge Code |
397073036
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$94.95 |
| Max. Negotiated Rate |
$94.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$94.95
|
|
|
CH HDL
|
Facility
|
IP
|
$92.00
|
|
|
Service Code
|
HCPCS 83718
|
| Hospital Charge Code |
397071078
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.80 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.80
|
|
|
CH HDL
|
Facility
|
OP
|
$92.00
|
|
|
Service Code
|
HCPCS 83718
|
| Hospital Charge Code |
397071078
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$22.28
|
| Rate for Payer: Aetna Medicare Advantage |
$26.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.56
|
| Rate for Payer: Cigna Commercial |
$46.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.19
|
| Rate for Payer: Clover Medicare Advantage |
$7.78
|
| Rate for Payer: EmblemHealth Commercial |
$24.57
|
| Rate for Payer: Humana Medicare Advantage |
$8.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.19
|
| 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 |
$6.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.19
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.44
|
|
|
CH HE4, OVARIAN CANCER
|
Facility
|
IP
|
$1,076.00
|
|
|
Service Code
|
HCPCS 86305
|
| Hospital Charge Code |
397071544
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$161.40 |
| Max. Negotiated Rate |
$161.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.40
|
|
|
CH HE4, OVARIAN CANCER
|
Facility
|
OP
|
$1,076.00
|
|
|
Service Code
|
HCPCS 86305
|
| Hospital Charge Code |
397071544
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$538.00 |
| 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 |
$38.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.12
|
| Rate for Payer: Cigna Commercial |
$538.00
|
| 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 |
$322.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.40
|
| 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 |
$28.51
|
|
|
CH HE4, OVARIAN CANCER
|
Facility
|
IP
|
$1,075.00
|
|
|
Service Code
|
HCPCS 86305
|
| Hospital Charge Code |
397071532
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$161.25 |
| Max. Negotiated Rate |
$161.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
|
|
CH HE4, OVARIAN CANCER
|
Facility
|
OP
|
$1,075.00
|
|
|
Service Code
|
HCPCS 86305
|
| Hospital Charge Code |
397071532
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$537.50 |
| 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 |
$38.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.12
|
| Rate for Payer: Cigna Commercial |
$537.50
|
| 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 |
$322.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$161.25
|
| 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 |
$28.49
|
|
|
CH HEAPATITIS C RNA QUAL PCR
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87521
|
| Hospital Charge Code |
397073591
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$95.44
|
| Rate for Payer: Aetna Medicare Advantage |
$113.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$126.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$126.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$35.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$73.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.66
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$35.09
|
| Rate for Payer: Clover Medicare Advantage |
$33.34
|
| Rate for Payer: EmblemHealth Commercial |
$105.27
|
| Rate for Payer: Humana Medicare Advantage |
$36.14
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$35.09
|
| 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 |
$28.07
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$35.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$35.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH HEAPATITIS C RNA QUAL PCR
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87521
|
| Hospital Charge Code |
397073591
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH HEMATOCRIT
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
HCPCS 85014
|
| Hospital Charge Code |
397021296
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$124.00 |
| 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 |
$2.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.55
|
| Rate for Payer: Cigna Commercial |
$10.00
|
| 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 |
$6.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.00
|
| 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 |
$0.53
|
|
|
CH HEMATOCRIT
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
HCPCS 85014
|
| Hospital Charge Code |
397021016
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$124.00 |
| 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 |
$2.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.55
|
| Rate for Payer: Cigna Commercial |
$10.00
|
| 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 |
$6.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.00
|
| 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 |
$0.53
|
|
|
CH HEMATOCRIT
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
HCPCS 85014
|
| Hospital Charge Code |
397021016
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.00
|
|
|
CH HEMATOCRIT
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
HCPCS 85014
|
| Hospital Charge Code |
397021296
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.00
|
|
|
CH HEMATOCRIT FLUID
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
HCPCS 85014
|
| Hospital Charge Code |
397021293
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$124.00 |
| 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 |
$2.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.55
|
| Rate for Payer: Cigna Commercial |
$10.00
|
| 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 |
$6.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.00
|
| 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 |
$0.53
|
|
|
CH HEMATOCRIT FLUID
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
HCPCS 85014
|
| Hospital Charge Code |
397021293
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.00
|
|
|
CH HEMODIALYSIS
|
Facility
|
OP
|
$2,868.64
|
|
|
Service Code
|
HCPCS 90935
|
| Hospital Charge Code |
93655005
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$69.13 |
| Max. Negotiated Rate |
$2,943.20 |
| Rate for Payer: Aetna Commercial |
$2,217.78
|
| Rate for Payer: Aetna Medicare Advantage |
$2,641.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,943.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,943.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$815.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$842.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,943.20
|
| Rate for Payer: Cigna Commercial |
$1,634.39
|
| Rate for Payer: Cigna Medicare Advantage |
$815.36
|
| Rate for Payer: Clover Medicare Advantage |
$774.59
|
| Rate for Payer: EmblemHealth Commercial |
$2,446.08
|
| Rate for Payer: Humana Medicare Advantage |
$839.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$815.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$860.59
|
| Rate for Payer: Oxford Commercial |
$573.73
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$430.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$573.73
|
| Rate for Payer: UnitedHealthcare Community & State |
$69.13
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$815.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$815.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$76.02
|
|
|
CH HEMODIALYSIS
|
Facility
|
IP
|
$2,868.64
|
|
|
Service Code
|
HCPCS 90935
|
| Hospital Charge Code |
93655005
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$430.30 |
| Max. Negotiated Rate |
$430.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$430.30
|
|
|
CH HEMOGLOBIN
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
397021048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$0.56 |
| Max. Negotiated Rate |
$124.00 |
| 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 |
$10.50
|
| 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 |
$6.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
| 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 |
$0.56
|
|
|
CH HEMOGLOBIN
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
397021048
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$3.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
|
|
CH HEMOGLOBIN
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
397021295
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$0.56 |
| Max. Negotiated Rate |
$124.00 |
| 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 |
$10.50
|
| 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 |
$6.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
| 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 |
$0.56
|
|
|
CH HEMOGLOBIN
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
397021295
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$3.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.15
|
|
|
CH HEMOGLOBIN A2 & FETAL
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
HCPCS 83021
|
| Hospital Charge Code |
397023254
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
|
|
CH HEMOGLOBIN A2 & FETAL
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
HCPCS 83021
|
| Hospital Charge Code |
397023254
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$49.12
|
| Rate for Payer: Aetna Medicare Advantage |
$58.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.06
|
| 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 |
$65.19
|
| Rate for Payer: Cigna Commercial |
$50.00
|
| Rate for Payer: Cigna Medicare Advantage |
$18.06
|
| Rate for Payer: Clover Medicare Advantage |
$17.16
|
| Rate for Payer: EmblemHealth Commercial |
$54.18
|
| Rate for Payer: Humana Medicare Advantage |
$18.60
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$18.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.45
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.65
|
|
|
CH HEMOGLOBIN A2, QUANT
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
HCPCS 83020
|
| Hospital Charge Code |
397073050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.00
|
|
|
CH HEMOGLOBIN A2, QUANT
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
HCPCS 83020
|
| Hospital Charge Code |
397073050
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$35.01
|
| Rate for Payer: Aetna Medicare Advantage |
$41.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.87
|
| 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 |
$46.46
|
| Rate for Payer: Cigna Commercial |
$40.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.87
|
| Rate for Payer: Clover Medicare Advantage |
$12.23
|
| Rate for Payer: EmblemHealth Commercial |
$38.61
|
| Rate for Payer: Humana Medicare Advantage |
$13.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.12
|
|
