|
CH IGF-1
|
Facility
|
IP
|
$649.00
|
|
|
Service Code
|
HCPCS 84305
|
| Hospital Charge Code |
397073195
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$97.35 |
| Max. Negotiated Rate |
$97.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$97.35
|
|
|
CH IGF-3
|
Facility
|
OP
|
$132.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
397071081
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$50.05
|
| Rate for Payer: Aetna Medicare Advantage |
$59.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$66.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$66.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$66.42
|
| Rate for Payer: Cigna Commercial |
$66.00
|
| Rate for Payer: Cigna Medicare Advantage |
$18.40
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$18.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.50
|
|
|
CH IGF-3
|
Facility
|
IP
|
$132.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
397071081
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$19.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.80
|
|
|
CH IGF BINDING PROTEIN-1
|
Facility
|
IP
|
$395.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
397071493
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.25 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
|
|
CH IGF BINDING PROTEIN-1
|
Facility
|
OP
|
$395.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
397071493
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.47 |
| Max. Negotiated Rate |
$197.50 |
| Rate for Payer: Aetna Commercial |
$50.05
|
| Rate for Payer: Aetna Medicare Advantage |
$59.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$66.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$66.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$66.42
|
| Rate for Payer: Cigna Commercial |
$197.50
|
| Rate for Payer: Cigna Medicare Advantage |
$18.40
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$18.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$118.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.72
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.47
|
|
|
CH IGG
|
Facility
|
IP
|
$161.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397071136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.15 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.15
|
|
|
CH IGG
|
Facility
|
OP
|
$161.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397071136
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.27 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$25.30
|
| Rate for Payer: Aetna Medicare Advantage |
$30.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.57
|
| Rate for Payer: Cigna Commercial |
$80.50
|
| Rate for Payer: Cigna Medicare Advantage |
$9.30
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.30
|
| 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 |
$7.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.27
|
|
|
CH IGG 1
|
Facility
|
OP
|
$186.00
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
397072095
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.93 |
| Max. Negotiated Rate |
$131.65 |
| Rate for Payer: Aetna Commercial |
$21.81
|
| Rate for Payer: Aetna Medicare Advantage |
$25.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$131.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.95
|
| Rate for Payer: Cigna Commercial |
$93.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.02
|
| Rate for Payer: Clover Medicare Advantage |
$7.62
|
| Rate for Payer: EmblemHealth Commercial |
$24.06
|
| Rate for Payer: Humana Medicare Advantage |
$8.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.93
|
|
|
CH IGG 1
|
Facility
|
IP
|
$186.00
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
397072095
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.90 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.90
|
|
|
CH IGG 1 - 4
|
Facility
|
IP
|
$1,008.00
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
397072099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$151.20 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.20
|
|
|
CH IGG 1 - 4
|
Facility
|
OP
|
$1,008.00
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
397072099
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$504.00 |
| Rate for Payer: Aetna Commercial |
$21.81
|
| Rate for Payer: Aetna Medicare Advantage |
$25.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$131.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.95
|
| Rate for Payer: Cigna Commercial |
$504.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.02
|
| Rate for Payer: Clover Medicare Advantage |
$7.62
|
| Rate for Payer: EmblemHealth Commercial |
$24.06
|
| Rate for Payer: Humana Medicare Advantage |
$8.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$302.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$151.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$26.71
|
|
|
CH IGG 2
|
Facility
|
OP
|
$256.00
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
397072096
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$131.65 |
| Rate for Payer: Aetna Commercial |
$21.81
|
| Rate for Payer: Aetna Medicare Advantage |
$25.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$131.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.95
|
| Rate for Payer: Cigna Commercial |
$128.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.02
|
| Rate for Payer: Clover Medicare Advantage |
$7.62
|
| Rate for Payer: EmblemHealth Commercial |
$24.06
|
| Rate for Payer: Humana Medicare Advantage |
$8.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.78
|
|
|
CH IGG 2
|
Facility
|
IP
|
$256.00
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
397072096
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$38.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.40
|
|
|
CH IGG 3
|
Facility
|
OP
|
$256.00
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
397072097
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$131.65 |
| Rate for Payer: Aetna Commercial |
$21.81
|
| Rate for Payer: Aetna Medicare Advantage |
$25.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$131.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.95
|
| Rate for Payer: Cigna Commercial |
$128.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.02
|
| Rate for Payer: Clover Medicare Advantage |
$7.62
|
| Rate for Payer: EmblemHealth Commercial |
$24.06
|
| Rate for Payer: Humana Medicare Advantage |
$8.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.02
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.78
|
|
|
CH IGG 3
|
Facility
|
IP
|
$256.00
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
397072097
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$38.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.40
|
|
|
CH IGG 4
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
397072098
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH IGG 4
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82787
|
| Hospital Charge Code |
397072098
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$21.81
|
| Rate for Payer: Aetna Medicare Advantage |
$25.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$131.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.95
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.02
|
| Rate for Payer: Clover Medicare Advantage |
$7.62
|
| Rate for Payer: EmblemHealth Commercial |
$24.06
|
| Rate for Payer: Humana Medicare Advantage |
$8.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.02
|
| 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 |
$6.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH IGG/ALBUMIN RATIO
|
Facility
|
OP
|
$188.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397071322
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.98 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$25.30
|
| Rate for Payer: Aetna Medicare Advantage |
$30.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.57
|
| Rate for Payer: Cigna Commercial |
$94.00
|
| Rate for Payer: Cigna Medicare Advantage |
$9.30
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$56.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.98
|
|
|
CH IGG/ALBUMIN RATIO
|
Facility
|
IP
|
$188.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397071322
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.20 |
| Max. Negotiated Rate |
$28.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.20
|
|
|
CH IGG CSF
|
Facility
|
OP
|
$129.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397073227
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.42 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$25.30
|
| Rate for Payer: Aetna Medicare Advantage |
$30.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.57
|
| Rate for Payer: Cigna Commercial |
$64.50
|
| Rate for Payer: Cigna Medicare Advantage |
$9.30
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.42
|
|
|
CH IGG CSF
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397073185
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH IGG CSF
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397073185
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.44 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$25.30
|
| Rate for Payer: Aetna Medicare Advantage |
$30.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.57
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$9.30
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.30
|
| 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 |
$7.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH IGG CSF
|
Facility
|
IP
|
$129.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397073227
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.35 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.35
|
|
|
CH IGG INDEX
|
Facility
|
IP
|
$362.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397072094
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.30 |
| Max. Negotiated Rate |
$54.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.30
|
|
|
CH IGG INDEX
|
Facility
|
OP
|
$362.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397072094
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.44 |
| Max. Negotiated Rate |
$181.00 |
| Rate for Payer: Aetna Commercial |
$25.30
|
| Rate for Payer: Aetna Medicare Advantage |
$30.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$33.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$33.57
|
| Rate for Payer: Cigna Commercial |
$181.00
|
| Rate for Payer: Cigna Medicare Advantage |
$9.30
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$108.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$54.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.59
|
|
