|
CH MEPITENYTOIN
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
HCPCS 80299
|
| Hospital Charge Code |
397072107
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$12.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.75
|
|
|
CH MEPITENYTOIN
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
HCPCS 80299
|
| Hospital Charge Code |
397072107
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$124.00 |
| 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 |
$42.50
|
| 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 |
$25.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.75
|
| 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 |
$2.25
|
|
|
CH MERCAPTOPURINE
|
Facility
|
OP
|
$780.00
|
|
|
Service Code
|
HCPCS 80299
|
| Hospital Charge Code |
397073667
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.64 |
| Max. Negotiated Rate |
$390.00 |
| 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 |
$390.00
|
| 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 |
$234.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$117.00
|
| 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 |
$20.67
|
|
|
CH MERCAPTOPURINE
|
Facility
|
IP
|
$780.00
|
|
|
Service Code
|
HCPCS 80299
|
| Hospital Charge Code |
397073667
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$117.00 |
| Max. Negotiated Rate |
$117.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$117.00
|
|
|
CH MERCURY, BLOOD
|
Facility
|
OP
|
$201.00
|
|
|
Service Code
|
HCPCS 83825
|
| Hospital Charge Code |
397072108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$44.23
|
| Rate for Payer: Aetna Medicare Advantage |
$52.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.69
|
| Rate for Payer: Cigna Commercial |
$100.50
|
| Rate for Payer: Cigna Medicare Advantage |
$16.26
|
| Rate for Payer: Clover Medicare Advantage |
$15.45
|
| Rate for Payer: EmblemHealth Commercial |
$48.78
|
| Rate for Payer: Humana Medicare Advantage |
$16.75
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.33
|
|
|
CH MERCURY, BLOOD
|
Facility
|
IP
|
$201.00
|
|
|
Service Code
|
HCPCS 83825
|
| Hospital Charge Code |
397072108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.15 |
| Max. Negotiated Rate |
$30.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.15
|
|
|
CH MERCURY URINE
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
HCPCS 83825
|
| Hospital Charge Code |
397073245
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$15.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.15
|
|
|
CH MERCURY URINE
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
HCPCS 83825
|
| Hospital Charge Code |
397073245
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.68 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$44.23
|
| Rate for Payer: Aetna Medicare Advantage |
$52.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.69
|
| Rate for Payer: Cigna Commercial |
$50.50
|
| Rate for Payer: Cigna Medicare Advantage |
$16.26
|
| Rate for Payer: Clover Medicare Advantage |
$15.45
|
| Rate for Payer: EmblemHealth Commercial |
$48.78
|
| Rate for Payer: Humana Medicare Advantage |
$16.75
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.68
|
|
|
CH MERCURY WHOLE BLOOD
|
Facility
|
OP
|
$154.00
|
|
|
Service Code
|
HCPCS 83825
|
| Hospital Charge Code |
397073249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$44.23
|
| Rate for Payer: Aetna Medicare Advantage |
$52.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.69
|
| Rate for Payer: Cigna Commercial |
$77.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.26
|
| Rate for Payer: Clover Medicare Advantage |
$15.45
|
| Rate for Payer: EmblemHealth Commercial |
$48.78
|
| Rate for Payer: Humana Medicare Advantage |
$16.75
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.26
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$46.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.26
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.26
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.08
|
|
|
CH MERCURY WHOLE BLOOD
|
Facility
|
IP
|
$154.00
|
|
|
Service Code
|
HCPCS 83825
|
| Hospital Charge Code |
397073249
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.10 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.10
|
|
|
CH METABOLIC PANEL BASIC
|
Facility
|
IP
|
$304.55
|
|
|
Service Code
|
HCPCS 80048
|
| Hospital Charge Code |
397071308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.68 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.68
|
|
|
CH METABOLIC PANEL BASIC
|
Facility
|
OP
|
$304.55
|
|
|
Service Code
|
HCPCS 80048
|
| Hospital Charge Code |
397071308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.77 |
| Max. Negotiated Rate |
$152.28 |
| Rate for Payer: Aetna Commercial |
$23.01
|
| Rate for Payer: Aetna Medicare Advantage |
$27.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30.54
|
| Rate for Payer: Cigna Commercial |
$152.28
|
| Rate for Payer: Cigna Medicare Advantage |
$8.46
|
| Rate for Payer: Clover Medicare Advantage |
$8.04
|
| Rate for Payer: EmblemHealth Commercial |
$25.38
|
| Rate for Payer: Humana Medicare Advantage |
$8.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$91.36
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.77
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.46
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.07
|
|
|
CH METABOLIC PANEL COMPREHEN
|
Facility
|
OP
|
$836.10
|
|
|
Service Code
|
HCPCS 80053
|
| Hospital Charge Code |
397071356
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$418.05 |
| Rate for Payer: Aetna Commercial |
$28.72
|
| Rate for Payer: Aetna Medicare Advantage |
$34.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$27.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.12
|
| Rate for Payer: Cigna Commercial |
$418.05
|
| Rate for Payer: Cigna Medicare Advantage |
$10.56
|
| Rate for Payer: Clover Medicare Advantage |
$10.03
|
| Rate for Payer: EmblemHealth Commercial |
$31.68
|
| Rate for Payer: Humana Medicare Advantage |
$10.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.56
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$250.83
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.42
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.45
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.56
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.16
|
|
|
CH METABOLIC PANEL COMPREHEN
|
Facility
|
IP
|
$836.10
|
|
|
Service Code
|
HCPCS 80053
|
| Hospital Charge Code |
397071356
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$125.42 |
| Max. Negotiated Rate |
$125.42 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.42
|
|
|
CH METANEPHRINES FRAC BLOOD
|
Facility
|
OP
|
$441.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
397070011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$220.50 |
| Rate for Payer: Aetna Commercial |
$46.08
|
| Rate for Payer: Aetna Medicare Advantage |
$54.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.15
|
| Rate for Payer: Cigna Commercial |
$220.50
|
| Rate for Payer: Cigna Medicare Advantage |
$16.94
|
| Rate for Payer: Clover Medicare Advantage |
$16.09
|
| Rate for Payer: EmblemHealth Commercial |
$50.82
|
| Rate for Payer: Humana Medicare Advantage |
$17.45
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$132.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.69
|
|
|
CH METANEPHRINES FRAC BLOOD
|
Facility
|
IP
|
$441.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
397070011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.15 |
| Max. Negotiated Rate |
$66.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$66.15
|
|
|
CH METANEPHRINES,QUANT,URINE
|
Facility
|
IP
|
$478.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
397072110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.70 |
| Max. Negotiated Rate |
$71.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.70
|
|
|
CH METANEPHRINES,QUANT,URINE
|
Facility
|
OP
|
$478.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
397072110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$239.00 |
| Rate for Payer: Aetna Commercial |
$46.08
|
| Rate for Payer: Aetna Medicare Advantage |
$54.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.15
|
| Rate for Payer: Cigna Commercial |
$239.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.94
|
| Rate for Payer: Clover Medicare Advantage |
$16.09
|
| Rate for Payer: EmblemHealth Commercial |
$50.82
|
| Rate for Payer: Humana Medicare Advantage |
$17.45
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.67
|
|
|
CH METANEPHRINES, RANDOM
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
397072111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: Aetna Commercial |
$46.08
|
| Rate for Payer: Aetna Medicare Advantage |
$54.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.15
|
| Rate for Payer: Cigna Commercial |
$175.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.94
|
| Rate for Payer: Clover Medicare Advantage |
$16.09
|
| Rate for Payer: EmblemHealth Commercial |
$50.82
|
| Rate for Payer: Humana Medicare Advantage |
$17.45
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.94
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$105.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.94
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.94
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.28
|
|
|
CH METANEPHRINES, RANDOM
|
Facility
|
IP
|
$350.00
|
|
|
Service Code
|
HCPCS 83835
|
| Hospital Charge Code |
397072111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.50 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$52.50
|
|
|
CH METHADONE CONF
|
Facility
|
OP
|
$695.00
|
|
|
Service Code
|
HCPCS 80300
|
| Hospital Charge Code |
397073157
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$347.50 |
| Rate for Payer: Aetna Commercial |
$264.10
|
| Rate for Payer: Aetna Medicare Advantage |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$177.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$177.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$177.22
|
| Rate for Payer: Cigna Commercial |
$347.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$208.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.42
|
|
|
CH METHADONE CONF
|
Facility
|
IP
|
$695.00
|
|
|
Service Code
|
HCPCS 80300
|
| Hospital Charge Code |
397073157
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$104.25 |
| Max. Negotiated Rate |
$104.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$104.25
|
|
|
CH METHADONE DAU
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
HCPCS 80300
|
| Hospital Charge Code |
397071288
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$6.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.60
|
|
|
CH METHADONE DAU
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
HCPCS 80300
|
| Hospital Charge Code |
397071288
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$16.72
|
| Rate for Payer: Aetna Medicare Advantage |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.22
|
| Rate for Payer: Cigna Commercial |
$22.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.17
|
|
|
CH METHANOL, BLOOD
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 84600
|
| Hospital Charge Code |
397072157
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.69 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$46.54
|
| Rate for Payer: Aetna Medicare Advantage |
$55.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.76
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$17.11
|
| Rate for Payer: Clover Medicare Advantage |
$16.25
|
| Rate for Payer: EmblemHealth Commercial |
$51.33
|
| Rate for Payer: Humana Medicare Advantage |
$17.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.11
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$200.28
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.69
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.11
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.11
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.69
|
|
