|
CHROMIUM
|
Facility
|
OP
|
$139.40
|
|
|
Service Code
|
HCPCS 82495
|
| Hospital Charge Code |
39900061
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.69 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$55.16
|
| Rate for Payer: Aetna Medicare Advantage |
$65.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$59.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$73.20
|
| Rate for Payer: Cigna Commercial |
$69.70
|
| Rate for Payer: Cigna Medicare Advantage |
$20.28
|
| Rate for Payer: Clover Medicare Advantage |
$19.27
|
| Rate for Payer: EmblemHealth Commercial |
$60.84
|
| Rate for Payer: Humana Medicare Advantage |
$20.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.82
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.69
|
|
|
CHROMIUM ASSAY PLASMA
|
Facility
|
OP
|
$101.40
|
|
|
Service Code
|
HCPCS 82495
|
| Hospital Charge Code |
401182495
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$55.16
|
| Rate for Payer: Aetna Medicare Advantage |
$65.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$59.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$73.20
|
| Rate for Payer: Cigna Commercial |
$50.70
|
| Rate for Payer: Cigna Medicare Advantage |
$20.28
|
| Rate for Payer: Clover Medicare Advantage |
$19.27
|
| Rate for Payer: EmblemHealth Commercial |
$60.84
|
| Rate for Payer: Humana Medicare Advantage |
$20.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.42
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.21
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.69
|
|
|
CHROMIUM ASSAY PLASMA
|
Facility
|
IP
|
$101.40
|
|
|
Service Code
|
HCPCS 82495
|
| Hospital Charge Code |
401182495
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.21 |
| Max. Negotiated Rate |
$15.21 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.21
|
|
|
CHROMIUM, SERUM
|
Facility
|
IP
|
$205.65
|
|
|
Service Code
|
HCPCS 82495
|
| Hospital Charge Code |
3007291
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.85 |
| Max. Negotiated Rate |
$30.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.85
|
|
|
CHROMIUM, SERUM
|
Facility
|
OP
|
$205.65
|
|
|
Service Code
|
HCPCS 82495
|
| Hospital Charge Code |
3007291
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.45 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$55.16
|
| Rate for Payer: Aetna Medicare Advantage |
$65.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$59.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$73.20
|
| Rate for Payer: Cigna Commercial |
$102.83
|
| Rate for Payer: Cigna Medicare Advantage |
$20.28
|
| Rate for Payer: Clover Medicare Advantage |
$19.27
|
| Rate for Payer: EmblemHealth Commercial |
$60.84
|
| Rate for Payer: Humana Medicare Advantage |
$20.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.45
|
|
|
CHROMIUM, URINE I
|
Facility
|
IP
|
$205.65
|
|
|
Service Code
|
HCPCS 82495
|
| Hospital Charge Code |
3038523A
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.85 |
| Max. Negotiated Rate |
$30.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.85
|
|
|
CHROMIUM, URINE I
|
Facility
|
OP
|
$205.65
|
|
|
Service Code
|
HCPCS 82495
|
| Hospital Charge Code |
3038523A
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.45 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$55.16
|
| Rate for Payer: Aetna Medicare Advantage |
$65.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$73.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$59.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$73.20
|
| Rate for Payer: Cigna Commercial |
$102.83
|
| Rate for Payer: Cigna Medicare Advantage |
$20.28
|
| Rate for Payer: Clover Medicare Advantage |
$19.27
|
| Rate for Payer: EmblemHealth Commercial |
$60.84
|
| Rate for Payer: Humana Medicare Advantage |
$20.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$61.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$30.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.45
|
|
|
CHROMIUM, URINE II
|
Facility
|
IP
|
$152.65
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3038523B
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$22.90 |
| Max. Negotiated Rate |
$22.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.90
|
|
|
CHROMIUM, URINE II
|
Facility
|
OP
|
$152.65
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3038523B
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$14.09
|
| Rate for Payer: Aetna Medicare Advantage |
$16.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.70
|
| Rate for Payer: Cigna Commercial |
$76.33
|
| Rate for Payer: Cigna Medicare Advantage |
$5.18
|
| Rate for Payer: Clover Medicare Advantage |
$4.92
|
| Rate for Payer: EmblemHealth Commercial |
$15.54
|
| Rate for Payer: Humana Medicare Advantage |
$5.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$45.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.05
|
|
|
CHROMOGENIC SUBST ASSAY
|
Facility
|
OP
|
$305.00
|
|
|
Service Code
|
HCPCS 85130
|
| Hospital Charge Code |
38477104
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$152.50 |
| Rate for Payer: Aetna Commercial |
$32.34
|
| Rate for Payer: Aetna Medicare Advantage |
$38.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.92
|
| Rate for Payer: Cigna Commercial |
$152.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.89
|
| Rate for Payer: Clover Medicare Advantage |
$11.30
|
| Rate for Payer: EmblemHealth Commercial |
$35.67
|
| Rate for Payer: Humana Medicare Advantage |
$12.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.89
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$91.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.89
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.89
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.08
|
|
|
CHROMOGENIC SUBST ASSAY
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
HCPCS 85130
|
| Hospital Charge Code |
38477104
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$45.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.75
|
|
|
CHROMOGRANIN A
|
Facility
|
OP
|
$218.45
|
|
|
Service Code
|
HCPCS 86316
|
| Hospital Charge Code |
3007689
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare Advantage |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.12
|
| Rate for Payer: Cigna Commercial |
$109.22
|
| Rate for Payer: Cigna Medicare Advantage |
$20.81
|
| Rate for Payer: Clover Medicare Advantage |
$19.77
|
| Rate for Payer: EmblemHealth Commercial |
$62.43
|
| Rate for Payer: Humana Medicare Advantage |
$21.43
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.53
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.79
|
|
|
CHROMOGRANIN A
|
Facility
|
IP
|
$218.45
|
|
|
Service Code
|
HCPCS 86316
|
| Hospital Charge Code |
3007689
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.77 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$32.77
|
|
|
CHROMOGRANIN A,ECL
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 86316
|
| Hospital Charge Code |
39900210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
CHROMOGRANIN A,ECL
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 86316
|
| Hospital Charge Code |
39900210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare Advantage |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$75.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$75.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$54.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$75.12
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$20.81
|
| Rate for Payer: Clover Medicare Advantage |
$19.77
|
| Rate for Payer: EmblemHealth Commercial |
$62.43
|
| Rate for Payer: Humana Medicare Advantage |
$21.43
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.81
|
| 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 |
$16.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.69
|
|
|
CHROMOSOMAL MICROARRAY
|
Facility
|
OP
|
$1.00
|
|
| Hospital Charge Code |
39708032
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$0.38
|
| Rate for Payer: Aetna Medicare Advantage |
$0.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$0.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$0.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$0.26
|
| Rate for Payer: Cigna Commercial |
$0.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.02
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.03
|
|
|
CHROMOSOMAL MICROARRAY
|
Facility
|
IP
|
$1.00
|
|
| Hospital Charge Code |
39708032
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$0.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.15
|
|
|
CHROMOSOME, 15-20 CELLS
|
Facility
|
IP
|
$882.69
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
38474057
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$132.40 |
| Max. Negotiated Rate |
$132.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.40
|
|
|
CHROMOSOME, 15-20 CELLS
|
Facility
|
OP
|
$882.69
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
38474057
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$23.39 |
| Max. Negotiated Rate |
$452.98 |
| Rate for Payer: Aetna Commercial |
$341.33
|
| Rate for Payer: Aetna Medicare Advantage |
$406.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$452.98
|
| Rate for Payer: Cigna Commercial |
$441.35
|
| Rate for Payer: Cigna Medicare Advantage |
$125.49
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$125.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$264.81
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$100.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.39
|
|
|
CHROMOSOME AMNIOTIC/CHORIONIC
|
Facility
|
IP
|
$1,273.99
|
|
|
Service Code
|
HCPCS 88267
|
| Hospital Charge Code |
38477216
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$191.10 |
| Max. Negotiated Rate |
$191.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$191.10
|
|
|
CHROMOSOME AMNIOTIC/CHORIONIC
|
Facility
|
OP
|
$1,273.99
|
|
|
Service Code
|
HCPCS 88267
|
| Hospital Charge Code |
38477216
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.76 |
| Max. Negotiated Rate |
$680.68 |
| Rate for Payer: Aetna Commercial |
$512.91
|
| Rate for Payer: Aetna Medicare Advantage |
$610.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$680.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$680.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$188.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$680.68
|
| Rate for Payer: Cigna Commercial |
$637.00
|
| Rate for Payer: Cigna Medicare Advantage |
$188.57
|
| Rate for Payer: Clover Medicare Advantage |
$179.14
|
| Rate for Payer: EmblemHealth Commercial |
$565.71
|
| Rate for Payer: Humana Medicare Advantage |
$194.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$188.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$382.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$191.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$150.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$188.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$188.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$33.76
|
|
|
CHROMOSOME ANALYSIS (15-20)
|
Facility
|
OP
|
$2,149.65
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
3030467
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$56.97 |
| Max. Negotiated Rate |
$1,074.83 |
| Rate for Payer: Aetna Commercial |
$341.33
|
| Rate for Payer: Aetna Medicare Advantage |
$406.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$452.98
|
| Rate for Payer: Cigna Commercial |
$1,074.83
|
| Rate for Payer: Cigna Medicare Advantage |
$125.49
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$125.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$644.89
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$322.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$100.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$56.97
|
|
|
CHROMOSOME ANALYSIS (15-20)
|
Facility
|
IP
|
$2,149.65
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
3030467
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$322.45 |
| Max. Negotiated Rate |
$322.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$322.45
|
|
|
CHROMOSOME ANALYSIS,BLOOD
|
Facility
|
OP
|
$4,469.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
38474106
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$100.39 |
| Max. Negotiated Rate |
$2,234.50 |
| Rate for Payer: Aetna Commercial |
$341.33
|
| Rate for Payer: Aetna Medicare Advantage |
$406.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$452.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$452.98
|
| Rate for Payer: Cigna Commercial |
$2,234.50
|
| Rate for Payer: Cigna Medicare Advantage |
$125.49
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$125.49
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,340.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$670.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$100.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$118.43
|
|
|
CHROMOSOME ANALYSIS,BLOOD
|
Facility
|
IP
|
$4,469.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
38474106
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$670.35 |
| Max. Negotiated Rate |
$670.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$670.35
|
|
