|
CH PLATELET ASSOC AB IGG
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
HCPCS 86023
|
| Hospital Charge Code |
397073101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$33.89
|
| Rate for Payer: Aetna Medicare Advantage |
$40.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.46
|
| 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 |
$44.98
|
| Rate for Payer: Cigna Commercial |
$75.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.46
|
| Rate for Payer: Clover Medicare Advantage |
$11.84
|
| Rate for Payer: EmblemHealth Commercial |
$37.38
|
| Rate for Payer: Humana Medicare Advantage |
$12.83
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.46
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.98
|
|
|
CH PLATELET ASSOC AB IGG
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
HCPCS 86023
|
| Hospital Charge Code |
397073101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.50 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.50
|
|
|
CH PLATELET ASSOC AB IGM
|
Facility
|
OP
|
$205.00
|
|
|
Service Code
|
HCPCS 86023
|
| Hospital Charge Code |
397073102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$33.89
|
| Rate for Payer: Aetna Medicare Advantage |
$40.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.46
|
| 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 |
$44.98
|
| Rate for Payer: Cigna Commercial |
$102.50
|
| Rate for Payer: Cigna Medicare Advantage |
$12.46
|
| Rate for Payer: Clover Medicare Advantage |
$11.84
|
| Rate for Payer: EmblemHealth Commercial |
$37.38
|
| Rate for Payer: Humana Medicare Advantage |
$12.83
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.46
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.43
|
|
|
CH PLATELET ASSOC AB IGM
|
Facility
|
IP
|
$205.00
|
|
|
Service Code
|
HCPCS 86023
|
| Hospital Charge Code |
397073102
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.75 |
| Max. Negotiated Rate |
$30.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.75
|
|
|
CH PLATELET CONCENTRATE
|
Facility
|
IP
|
$244.00
|
|
|
Service Code
|
HCPCS P9019
|
| Hospital Charge Code |
397031002
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$36.60 |
| Max. Negotiated Rate |
$36.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.60
|
|
|
CH PLATELET CONCENTRATE
|
Facility
|
OP
|
$244.00
|
|
|
Service Code
|
HCPCS P9019
|
| Hospital Charge Code |
397031002
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$5.88 |
| Max. Negotiated Rate |
$1,167.00 |
| Rate for Payer: Aetna Commercial |
$168.18
|
| Rate for Payer: Aetna Medicare Advantage |
$200.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$223.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$223.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$61.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$223.19
|
| Rate for Payer: Cigna Commercial |
$123.93
|
| Rate for Payer: Cigna Medicare Advantage |
$61.83
|
| Rate for Payer: Clover Medicare Advantage |
$58.74
|
| Rate for Payer: EmblemHealth Commercial |
$185.49
|
| Rate for Payer: Humana Medicare Advantage |
$63.68
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$61.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.20
|
| Rate for Payer: Oxford Commercial |
$666.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,167.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$61.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$61.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.47
|
|
|
CH PLATELET COUNT
|
Facility
|
OP
|
$27.00
|
|
|
Service Code
|
HCPCS 85049
|
| Hospital Charge Code |
397021052
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$12.19
|
| Rate for Payer: Aetna Medicare Advantage |
$14.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.17
|
| Rate for Payer: Cigna Commercial |
$13.50
|
| Rate for Payer: Cigna Medicare Advantage |
$4.48
|
| Rate for Payer: Clover Medicare Advantage |
$4.26
|
| Rate for Payer: EmblemHealth Commercial |
$13.44
|
| Rate for Payer: Humana Medicare Advantage |
$4.61
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.48
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.48
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.72
|
|
|
CH PLATELET COUNT
|
Facility
|
IP
|
$27.00
|
|
|
Service Code
|
HCPCS 85049
|
| Hospital Charge Code |
397021052
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$4.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.05
|
|
|
CH PLATELET FUNCTION TEST
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 85576
|
| Hospital Charge Code |
397021096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$67.76
|
| Rate for Payer: Aetna Medicare Advantage |
$80.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24.91
|
| 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 |
$89.92
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$24.91
|
| Rate for Payer: Clover Medicare Advantage |
$23.66
|
| Rate for Payer: EmblemHealth Commercial |
$74.73
|
| Rate for Payer: Humana Medicare Advantage |
$25.66
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24.91
|
| 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 |
$19.93
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$24.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH PLATELET FUNCTION TEST
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 85576
|
| Hospital Charge Code |
397021096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH PLATELET GLYCOPROTEIN AB
|
Facility
|
OP
|
$728.00
|
|
|
Service Code
|
HCPCS 86023
|
| Hospital Charge Code |
397023256
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.97 |
| Max. Negotiated Rate |
$364.00 |
| Rate for Payer: Aetna Commercial |
$33.89
|
| Rate for Payer: Aetna Medicare Advantage |
$40.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.46
|
| 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 |
$44.98
|
| Rate for Payer: Cigna Commercial |
$364.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.46
|
| Rate for Payer: Clover Medicare Advantage |
$11.84
|
| Rate for Payer: EmblemHealth Commercial |
$37.38
|
| Rate for Payer: Humana Medicare Advantage |
$12.83
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$218.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.46
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.29
|
|
|
CH PLATELET GLYCOPROTEIN AB
|
Facility
|
IP
|
$728.00
|
|
|
Service Code
|
HCPCS 86023
|
| Hospital Charge Code |
397023256
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.20
|
|
|
CH PLATELET PHERESIS
|
Facility
|
IP
|
$2,388.66
|
|
| Hospital Charge Code |
397031037
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$358.30 |
| Max. Negotiated Rate |
$358.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$358.30
|
|
|
CH PLATELET PHERESIS
|
Facility
|
OP
|
$2,388.66
|
|
| Hospital Charge Code |
397031037
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$57.57 |
| Max. Negotiated Rate |
$1,194.33 |
| Rate for Payer: Aetna Commercial |
$907.69
|
| Rate for Payer: Aetna Medicare Advantage |
$716.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$609.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$609.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$609.11
|
| Rate for Payer: Cigna Commercial |
$1,194.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$716.60
|
| Rate for Payer: Oxford Commercial |
$666.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$358.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,167.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$57.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$63.30
|
|
|
CH PLATELET PHERESIS HLA
|
Facility
|
IP
|
$2,936.00
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
397031039
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$440.40 |
| Max. Negotiated Rate |
$440.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$440.40
|
|
|
CH PLATELET PHERESIS HLA
|
Facility
|
OP
|
$2,936.00
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
397031039
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$70.76 |
| Max. Negotiated Rate |
$2,972.08 |
| Rate for Payer: Aetna Commercial |
$2,239.54
|
| Rate for Payer: Aetna Medicare Advantage |
$2,667.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,972.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,972.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$823.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,972.08
|
| Rate for Payer: Cigna Commercial |
$1,650.43
|
| Rate for Payer: Cigna Medicare Advantage |
$823.36
|
| Rate for Payer: Clover Medicare Advantage |
$782.19
|
| Rate for Payer: EmblemHealth Commercial |
$2,470.08
|
| Rate for Payer: Humana Medicare Advantage |
$848.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$823.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$880.80
|
| Rate for Payer: Oxford Commercial |
$666.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$440.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,167.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$70.76
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$823.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$823.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$77.80
|
|
|
CH PLATELET PHERESIS REF'D
|
Facility
|
IP
|
$2,401.00
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
397031038
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$360.15 |
| Max. Negotiated Rate |
$360.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$360.15
|
|
|
CH PLATELET PHERESIS REF'D
|
Facility
|
OP
|
$2,401.00
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
397031038
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$57.86 |
| Max. Negotiated Rate |
$2,147.41 |
| Rate for Payer: Aetna Commercial |
$1,618.13
|
| Rate for Payer: Aetna Medicare Advantage |
$1,927.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,147.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,147.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$594.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,147.41
|
| Rate for Payer: Cigna Commercial |
$1,192.48
|
| Rate for Payer: Cigna Medicare Advantage |
$594.90
|
| Rate for Payer: Clover Medicare Advantage |
$565.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,784.70
|
| Rate for Payer: Humana Medicare Advantage |
$612.75
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$594.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$720.30
|
| Rate for Payer: Oxford Commercial |
$666.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$360.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,167.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$57.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$594.90
|
| Rate for Payer: Wellcare Medicare Advantage |
$594.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$63.63
|
|
|
CH PLATELETS PHERESIS IRRAD
|
Facility
|
IP
|
$2,606.00
|
|
|
Service Code
|
HCPCS P9036
|
| Hospital Charge Code |
397031164
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$390.90 |
| Max. Negotiated Rate |
$390.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$390.90
|
|
|
CH PLATELETS PHERESIS IRRAD
|
Facility
|
OP
|
$2,606.00
|
|
|
Service Code
|
HCPCS P9036
|
| Hospital Charge Code |
397031164
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$62.80 |
| Max. Negotiated Rate |
$3,983.99 |
| Rate for Payer: Aetna Commercial |
$3,002.04
|
| Rate for Payer: Aetna Medicare Advantage |
$3,575.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,983.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,983.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,103.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,983.99
|
| Rate for Payer: Cigna Commercial |
$2,212.32
|
| Rate for Payer: Cigna Medicare Advantage |
$1,103.69
|
| Rate for Payer: Clover Medicare Advantage |
$1,048.51
|
| Rate for Payer: EmblemHealth Commercial |
$3,311.07
|
| Rate for Payer: Humana Medicare Advantage |
$1,136.80
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,103.69
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$781.80
|
| Rate for Payer: Oxford Commercial |
$666.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$390.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,167.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$62.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,103.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,103.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$69.06
|
|
|
CH PLATELETS PHERESIS LEUKO
|
Facility
|
IP
|
$5,626.57
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
397031163
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$843.99 |
| Max. Negotiated Rate |
$843.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$843.99
|
|
|
CH PLATELETS PHERESIS LEUKO
|
Facility
|
OP
|
$5,626.57
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
397031163
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$135.60 |
| Max. Negotiated Rate |
$2,147.41 |
| Rate for Payer: Aetna Commercial |
$1,618.13
|
| Rate for Payer: Aetna Medicare Advantage |
$1,927.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,147.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,147.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$594.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,147.41
|
| Rate for Payer: Cigna Commercial |
$1,192.48
|
| Rate for Payer: Cigna Medicare Advantage |
$594.90
|
| Rate for Payer: Clover Medicare Advantage |
$565.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,784.70
|
| Rate for Payer: Humana Medicare Advantage |
$612.75
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$594.90
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,687.97
|
| Rate for Payer: Oxford Commercial |
$666.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$843.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,167.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$135.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$594.90
|
| Rate for Payer: Wellcare Medicare Advantage |
$594.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$149.10
|
|
|
CH PLATELETS PHER IRRAD LEUK
|
Facility
|
OP
|
$2,387.00
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
397031165
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$57.53 |
| Max. Negotiated Rate |
$2,856.86 |
| Rate for Payer: Aetna Commercial |
$2,152.72
|
| Rate for Payer: Aetna Medicare Advantage |
$2,564.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2,856.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2,856.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$791.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2,856.86
|
| Rate for Payer: Cigna Commercial |
$1,586.44
|
| Rate for Payer: Cigna Medicare Advantage |
$791.44
|
| Rate for Payer: Clover Medicare Advantage |
$751.87
|
| Rate for Payer: EmblemHealth Commercial |
$2,374.32
|
| Rate for Payer: Humana Medicare Advantage |
$815.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$791.44
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$716.10
|
| Rate for Payer: Oxford Commercial |
$666.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$358.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,167.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$57.53
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$791.44
|
| Rate for Payer: Wellcare Medicare Advantage |
$791.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$63.26
|
|
|
CH PLATELETS PHER IRRAD LEUK
|
Facility
|
IP
|
$2,387.00
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
397031165
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$358.05 |
| Max. Negotiated Rate |
$358.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$358.05
|
|
|
CH PLATELETS RANDOM LEUKORED
|
Facility
|
IP
|
$326.00
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
397031161
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$48.90 |
| Max. Negotiated Rate |
$48.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.90
|
|
