|
CHLAMYDIA AB PANEL IGG IGM I
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
HCPCS 86631
|
| Hospital Charge Code |
3000940A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.60 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.60
|
|
|
CHLAMYDIA AB PANEL IGG IGM I
|
Facility
|
OP
|
$124.00
|
|
|
Service Code
|
HCPCS 86631
|
| Hospital Charge Code |
3000940A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$32.15
|
| Rate for Payer: Aetna Medicare Advantage |
$38.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.67
|
| Rate for Payer: Cigna Commercial |
$62.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.82
|
| Rate for Payer: Clover Medicare Advantage |
$11.23
|
| Rate for Payer: EmblemHealth Commercial |
$35.46
|
| Rate for Payer: Humana Medicare Advantage |
$12.17
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.82
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.29
|
|
|
CHLAMYDIA AB PANEL IGG IGM II
|
Facility
|
OP
|
$153.65
|
|
|
Service Code
|
HCPCS 86632
|
| Hospital Charge Code |
3000940B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.07 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: Aetna Medicare Advantage |
$41.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$45.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$45.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$45.77
|
| Rate for Payer: Cigna Commercial |
$76.83
|
| Rate for Payer: Cigna Medicare Advantage |
$12.68
|
| Rate for Payer: Clover Medicare Advantage |
$12.05
|
| Rate for Payer: EmblemHealth Commercial |
$38.04
|
| Rate for Payer: Humana Medicare Advantage |
$13.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$46.09
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.68
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.07
|
|
|
CHLAMYDIA AB PANEL IGG IGM II
|
Facility
|
IP
|
$153.65
|
|
|
Service Code
|
HCPCS 86632
|
| Hospital Charge Code |
3000940B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.05 |
| Max. Negotiated Rate |
$23.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.05
|
|
|
CHLAMYDIA,AMPLIF PROB TECH
|
Facility
|
IP
|
$248.54
|
|
|
Service Code
|
HCPCS 87491
|
| Hospital Charge Code |
38478109
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.28 |
| Max. Negotiated Rate |
$37.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.28
|
|
|
CHLAMYDIA,AMPLIF PROB TECH
|
Facility
|
OP
|
$248.54
|
|
|
Service Code
|
HCPCS 87491
|
| Hospital Charge Code |
38478109
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$126.66 |
| 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 |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.66
|
| Rate for Payer: Cigna Commercial |
$124.27
|
| 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 |
$74.56
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.28
|
| 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 |
$6.59
|
|
|
CHLAMYDIA ANTIBODIES IGG
|
Facility
|
OP
|
$124.00
|
|
|
Service Code
|
HCPCS 86631
|
| Hospital Charge Code |
3000945
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.29 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$32.15
|
| Rate for Payer: Aetna Medicare Advantage |
$38.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.67
|
| Rate for Payer: Cigna Commercial |
$62.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.82
|
| Rate for Payer: Clover Medicare Advantage |
$11.23
|
| Rate for Payer: EmblemHealth Commercial |
$35.46
|
| Rate for Payer: Humana Medicare Advantage |
$12.17
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.82
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.29
|
|
|
CHLAMYDIA ANTIBODIES IGG
|
Facility
|
IP
|
$124.00
|
|
|
Service Code
|
HCPCS 86631
|
| Hospital Charge Code |
3000945
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.60 |
| Max. Negotiated Rate |
$18.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.60
|
|
|
CHLAMYDIA ANTIBODIES,IgM
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86632
|
| Hospital Charge Code |
38476075
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CHLAMYDIA ANTIBODIES,IgM
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86632
|
| Hospital Charge Code |
38476075
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.14 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: Aetna Medicare Advantage |
$41.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$45.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$45.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$45.77
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.68
|
| Rate for Payer: Clover Medicare Advantage |
$12.05
|
| Rate for Payer: EmblemHealth Commercial |
$38.04
|
| Rate for Payer: Humana Medicare Advantage |
$13.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.68
|
| 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 |
$10.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.68
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CHLAMYDIA ANTIBODIES,QUANT
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86631
|
| Hospital Charge Code |
38476078
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$32.15
|
| Rate for Payer: Aetna Medicare Advantage |
$38.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.67
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.82
|
| Rate for Payer: Clover Medicare Advantage |
$11.23
|
| Rate for Payer: EmblemHealth Commercial |
$35.46
|
| Rate for Payer: Humana Medicare Advantage |
$12.17
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.82
|
| 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 |
$9.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.82
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CHLAMYDIA ANTIBODIES,QUANT
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86631
|
| Hospital Charge Code |
38476078
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CHLAMYDIA ANTIGEN DETECTION
|
Facility
|
IP
|
$354.00
|
|
|
Service Code
|
HCPCS 87270
|
| Hospital Charge Code |
38475050
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$53.10 |
| Max. Negotiated Rate |
$53.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.10
|
|
|
CHLAMYDIA ANTIGEN DETECTION
|
Facility
|
OP
|
$354.00
|
|
|
Service Code
|
HCPCS 87270
|
| Hospital Charge Code |
38475050
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$177.00 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Medicare Advantage |
$38.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.24
|
| Rate for Payer: Cigna Commercial |
$177.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.98
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.38
|
|
|
CHLAMYDIA ANTIGEN - SWAB
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
HCPCS 87449
|
| Hospital Charge Code |
3001005
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Medicare Advantage |
$38.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.24
|
| Rate for Payer: Cigna Commercial |
$62.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.98
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.31
|
|
|
CHLAMYDIA ANTIGEN - SWAB
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
HCPCS 87449
|
| Hospital Charge Code |
3001005
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
|
|
CHLAMYDIA CULTURE
|
Facility
|
IP
|
$290.00
|
|
|
Service Code
|
HCPCS 87110
|
| Hospital Charge Code |
38475012
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.50
|
|
|
CHLAMYDIA CULTURE
|
Facility
|
OP
|
$290.00
|
|
|
Service Code
|
HCPCS 87110
|
| Hospital Charge Code |
38475012
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$145.00 |
| Rate for Payer: Aetna Commercial |
$53.31
|
| Rate for Payer: Aetna Medicare Advantage |
$63.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$19.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.75
|
| Rate for Payer: Cigna Commercial |
$145.00
|
| Rate for Payer: Cigna Medicare Advantage |
$19.60
|
| Rate for Payer: Clover Medicare Advantage |
$18.62
|
| Rate for Payer: EmblemHealth Commercial |
$58.80
|
| Rate for Payer: Humana Medicare Advantage |
$20.19
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$19.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$87.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.68
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$19.60
|
| Rate for Payer: Wellcare Medicare Advantage |
$19.60
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.68
|
|
|
CHLAMYDIA/GC DNA PROBE
|
Facility
|
IP
|
$354.45
|
|
|
Service Code
|
HCPCS 87490
|
| Hospital Charge Code |
3032325
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$53.17 |
| Max. Negotiated Rate |
$53.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.17
|
|
|
CHLAMYDIA/GC DNA PROBE
|
Facility
|
OP
|
$354.45
|
|
|
Service Code
|
HCPCS 87490
|
| Hospital Charge Code |
3032325
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$177.22 |
| Rate for Payer: Aetna Commercial |
$61.88
|
| Rate for Payer: Aetna Medicare Advantage |
$73.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$82.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$82.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$22.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$82.12
|
| Rate for Payer: Cigna Commercial |
$177.22
|
| Rate for Payer: Cigna Medicare Advantage |
$22.75
|
| Rate for Payer: Clover Medicare Advantage |
$21.61
|
| Rate for Payer: EmblemHealth Commercial |
$68.25
|
| Rate for Payer: Humana Medicare Advantage |
$23.43
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$22.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.33
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.17
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$18.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$22.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$22.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.39
|
|
|
CHLAMYDIA/GC,SDA
|
Facility
|
IP
|
$248.54
|
|
|
Service Code
|
HCPCS 87491
|
| Hospital Charge Code |
38479087
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$37.28 |
| Max. Negotiated Rate |
$37.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.28
|
|
|
CHLAMYDIA/GC,SDA
|
Facility
|
OP
|
$248.54
|
|
|
Service Code
|
HCPCS 87491
|
| Hospital Charge Code |
38479087
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$126.66 |
| 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 |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.66
|
| Rate for Payer: Cigna Commercial |
$124.27
|
| 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 |
$74.56
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.28
|
| 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 |
$6.59
|
|
|
CHLAMYDIA/GC, SPA I
|
Facility
|
IP
|
$241.20
|
|
|
Service Code
|
HCPCS 87491
|
| Hospital Charge Code |
39990114A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.18 |
| Max. Negotiated Rate |
$36.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.18
|
|
|
CHLAMYDIA/GC, SPA I
|
Facility
|
OP
|
$241.20
|
|
|
Service Code
|
HCPCS 87491
|
| Hospital Charge Code |
39990114A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$126.66 |
| 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 |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.66
|
| Rate for Payer: Cigna Commercial |
$120.60
|
| 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 |
$72.36
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.18
|
| 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 |
$6.39
|
|
|
CHLAMYDIA/GC, SPA II
|
Facility
|
OP
|
$241.20
|
|
|
Service Code
|
HCPCS 87591
|
| Hospital Charge Code |
39990114B
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.39 |
| Max. Negotiated Rate |
$126.66 |
| 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 |
$72.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.66
|
| Rate for Payer: Cigna Commercial |
$120.60
|
| 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 |
$72.36
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.18
|
| 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 |
$6.39
|
|
