|
CH IGG SERUM
|
Facility
|
IP
|
$129.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397073228
|
|
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 SERUM
|
Facility
|
OP
|
$129.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397073228
|
|
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 IGM
|
Facility
|
IP
|
$161.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397071084
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.15 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.15
|
|
|
CH IGM
|
Facility
|
OP
|
$161.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397071084
|
|
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 IGM CSF
|
Facility
|
IP
|
$158.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397073184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.70 |
| Max. Negotiated Rate |
$23.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.70
|
|
|
CH IGM CSF
|
Facility
|
OP
|
$158.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397073184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.19 |
| 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 |
$79.00
|
| 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 |
$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 |
$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 |
$4.19
|
|
|
CH IGM SERUM
|
Facility
|
IP
|
$129.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397073230
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.35 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.35
|
|
|
CH IGM SERUM
|
Facility
|
OP
|
$129.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
397073230
|
|
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
|
|
|
CHIKUNGUNYA AB IGG IGM W REFLX
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86790
|
| Hospital Charge Code |
38479744
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$459.20 |
| Rate for Payer: Aetna Commercial |
$35.03
|
| Rate for Payer: Aetna Medicare Advantage |
$41.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$459.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.49
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.88
|
| Rate for Payer: Clover Medicare Advantage |
$12.24
|
| Rate for Payer: EmblemHealth Commercial |
$38.64
|
| Rate for Payer: Humana Medicare Advantage |
$13.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.88
|
| 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 |
$10.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CHIKUNGUNYA AB IGG IGM W REFLX
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86790
|
| Hospital Charge Code |
38479744
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CHILDREN'S MOTRIN/100MG
|
Facility
|
OP
|
$3.00
|
|
| Hospital Charge Code |
60634765
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Aetna Commercial |
$1.14
|
| Rate for Payer: Aetna Medicare Advantage |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.77
|
| Rate for Payer: Cigna Commercial |
$1.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.90
|
| Rate for Payer: Oxford Commercial |
$0.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.08
|
|
|
CHILDREN'S MOTRIN/100MG
|
Facility
|
IP
|
$3.00
|
|
| Hospital Charge Code |
60634765
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$0.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.45
|
|
|
CHILDREN'S TYLENOL/80MG
|
Facility
|
IP
|
$3.00
|
|
| Hospital Charge Code |
60632678
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$0.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.45
|
|
|
CHILDREN'S TYLENOL/80MG
|
Facility
|
OP
|
$3.00
|
|
| Hospital Charge Code |
60632678
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Aetna Commercial |
$1.14
|
| Rate for Payer: Aetna Medicare Advantage |
$0.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.77
|
| Rate for Payer: Cigna Commercial |
$1.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.90
|
| Rate for Payer: Oxford Commercial |
$0.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.08
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$88,061.05
|
|
|
Service Code
|
APR-DRG 0112
|
| Min. Negotiated Rate |
$86,334.36 |
| Max. Negotiated Rate |
$88,061.05 |
| Rate for Payer: UnitedHealthcare Community & State |
$86,334.36
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$88,061.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$86,334.36
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$44,010.74
|
|
|
Service Code
|
APR-DRG 0111
|
| Min. Negotiated Rate |
$43,147.78 |
| Max. Negotiated Rate |
$44,010.74 |
| Rate for Payer: UnitedHealthcare Community & State |
$43,147.78
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$44,010.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$43,147.78
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$123,282.86
|
|
|
Service Code
|
APR-DRG 0113
|
| Min. Negotiated Rate |
$120,865.55 |
| Max. Negotiated Rate |
$123,282.86 |
| Rate for Payer: UnitedHealthcare Community & State |
$120,865.55
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$123,282.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$120,865.55
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$1,397,873.54
|
|
|
Service Code
|
MSDRG 018
|
| Min. Negotiated Rate |
$425,634.57 |
| Max. Negotiated Rate |
$1,397,873.54 |
| Rate for Payer: Aetna Medicare Advantage |
$1,397,873.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$856,935.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$856,935.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$448,036.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$856,935.24
|
| Rate for Payer: Cigna Commercial |
$808,122.92
|
| Rate for Payer: Cigna Medicare Advantage |
$448,036.39
|
| Rate for Payer: Clover Medicare Advantage |
$425,634.57
|
| Rate for Payer: EmblemHealth Commercial |
$1,344,109.17
|
| Rate for Payer: Humana Medicare Advantage |
$461,477.48
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$448,036.39
|
| Rate for Payer: Oxford Commercial |
$580,808.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,018,466.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$448,036.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$448,036.39
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$229,436.16
|
|
|
Service Code
|
APR-DRG 0114
|
| Min. Negotiated Rate |
$224,937.41 |
| Max. Negotiated Rate |
$229,436.16 |
| Rate for Payer: UnitedHealthcare Community & State |
$224,937.41
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$229,436.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$224,937.41
|
|
|
CH IMIPRAMINE
|
Facility
|
IP
|
$107.00
|
|
|
Service Code
|
HCPCS 80335
|
| Hospital Charge Code |
397071167
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.05 |
| Max. Negotiated Rate |
$16.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.05
|
|
|
CH IMIPRAMINE
|
Facility
|
OP
|
$107.00
|
|
|
Service Code
|
HCPCS 80335
|
| Hospital Charge Code |
397071167
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$40.66
|
| Rate for Payer: Aetna Medicare Advantage |
$32.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$27.29
|
| Rate for Payer: Cigna Commercial |
$53.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.66
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.84
|
|
|
CH IMMUNE COMPLEX PANEL
|
Facility
|
IP
|
$531.00
|
|
|
Service Code
|
HCPCS 86332
|
| Hospital Charge Code |
397072092
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$79.65 |
| Max. Negotiated Rate |
$79.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.65
|
|
|
CH IMMUNE COMPLEX PANEL
|
Facility
|
OP
|
$531.00
|
|
|
Service Code
|
HCPCS 86332
|
| Hospital Charge Code |
397072092
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.07 |
| Max. Negotiated Rate |
$265.50 |
| Rate for Payer: Aetna Commercial |
$66.29
|
| Rate for Payer: Aetna Medicare Advantage |
$78.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$87.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$87.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$87.97
|
| Rate for Payer: Cigna Commercial |
$265.50
|
| Rate for Payer: Cigna Medicare Advantage |
$24.37
|
| Rate for Payer: Clover Medicare Advantage |
$23.15
|
| Rate for Payer: EmblemHealth Commercial |
$73.11
|
| Rate for Payer: Humana Medicare Advantage |
$25.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$159.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$79.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24.37
|
| Rate for Payer: Wellcare Medicare Advantage |
$24.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.07
|
|
|
CH IMMUNE COMPLEX RAJI CELL
|
Facility
|
IP
|
$392.00
|
|
|
Service Code
|
HCPCS 86332
|
| Hospital Charge Code |
397072093
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$58.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.80
|
|
|
CH IMMUNE COMPLEX RAJI CELL
|
Facility
|
OP
|
$392.00
|
|
|
Service Code
|
HCPCS 86332
|
| Hospital Charge Code |
397072093
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.39 |
| Max. Negotiated Rate |
$196.00 |
| Rate for Payer: Aetna Commercial |
$66.29
|
| Rate for Payer: Aetna Medicare Advantage |
$78.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$87.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$87.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$87.97
|
| Rate for Payer: Cigna Commercial |
$196.00
|
| Rate for Payer: Cigna Medicare Advantage |
$24.37
|
| Rate for Payer: Clover Medicare Advantage |
$23.15
|
| Rate for Payer: EmblemHealth Commercial |
$73.11
|
| Rate for Payer: Humana Medicare Advantage |
$25.10
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$117.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24.37
|
| Rate for Payer: Wellcare Medicare Advantage |
$24.37
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.39
|
|
