|
CHUCK KEY SMALL 5/32
|
Facility
|
OP
|
$104.70
|
|
| Hospital Charge Code |
270645830
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$52.35 |
| Rate for Payer: Aetna Commercial |
$39.79
|
| Rate for Payer: Aetna Medicare Advantage |
$31.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.70
|
| Rate for Payer: Cigna Commercial |
$52.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.41
|
| Rate for Payer: Oxford Commercial |
$20.94
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$20.94
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.77
|
|
|
CH UREA NITROGEN
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
HCPCS 84520
|
| Hospital Charge Code |
397071038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$10.74
|
| Rate for Payer: Aetna Medicare Advantage |
$12.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.95
|
| 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 |
$14.26
|
| Rate for Payer: Cigna Commercial |
$20.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.95
|
| Rate for Payer: Clover Medicare Advantage |
$3.75
|
| Rate for Payer: EmblemHealth Commercial |
$11.85
|
| Rate for Payer: Humana Medicare Advantage |
$4.07
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.16
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.95
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.06
|
|
|
CH UREA NITROGEN
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
HCPCS 84520
|
| Hospital Charge Code |
397071038
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.00
|
|
|
CH UREA NITROGEN (RANDOM)
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 84540
|
| Hospital Charge Code |
397073108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CH UREA NITROGEN (RANDOM)
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 84540
|
| Hospital Charge Code |
397073108
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.45 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$15.12
|
| Rate for Payer: Aetna Medicare Advantage |
$18.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.56
|
| 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 |
$20.07
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.56
|
| Rate for Payer: Clover Medicare Advantage |
$5.28
|
| Rate for Payer: EmblemHealth Commercial |
$16.68
|
| Rate for Payer: Humana Medicare Advantage |
$5.73
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.56
|
| 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 |
$4.45
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.56
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CH UREA NITROGEN UR 24 HR
|
Facility
|
OP
|
$127.00
|
|
|
Service Code
|
HCPCS 84540
|
| Hospital Charge Code |
397071012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.37 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$15.12
|
| Rate for Payer: Aetna Medicare Advantage |
$18.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.56
|
| 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 |
$20.07
|
| Rate for Payer: Cigna Commercial |
$63.50
|
| Rate for Payer: Cigna Medicare Advantage |
$5.56
|
| Rate for Payer: Clover Medicare Advantage |
$5.28
|
| Rate for Payer: EmblemHealth Commercial |
$16.68
|
| Rate for Payer: Humana Medicare Advantage |
$5.73
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.56
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$38.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.45
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.56
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.56
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.37
|
|
|
CH UREA NITROGEN UR 24 HR
|
Facility
|
IP
|
$127.00
|
|
|
Service Code
|
HCPCS 84540
|
| Hospital Charge Code |
397071012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.05 |
| Max. Negotiated Rate |
$19.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.05
|
|
|
CH URIC ACID
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
HCPCS 84550
|
| Hospital Charge Code |
397071040
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$12.29
|
| Rate for Payer: Aetna Medicare Advantage |
$14.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.52
|
| 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 |
$16.32
|
| Rate for Payer: Cigna Commercial |
$41.00
|
| Rate for Payer: Cigna Medicare Advantage |
$4.52
|
| Rate for Payer: Clover Medicare Advantage |
$4.29
|
| Rate for Payer: EmblemHealth Commercial |
$13.56
|
| Rate for Payer: Humana Medicare Advantage |
$4.66
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.17
|
|
|
CH URIC ACID
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
HCPCS 84550
|
| Hospital Charge Code |
397071040
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$12.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.30
|
|
|
CH URIC ACID FLUID
|
Facility
|
OP
|
$63.25
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
397073046
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.08
|
| 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 |
$18.34
|
| Rate for Payer: Cigna Commercial |
$31.62
|
| Rate for Payer: Cigna Medicare Advantage |
$5.08
|
| Rate for Payer: Clover Medicare Advantage |
$4.83
|
| Rate for Payer: EmblemHealth Commercial |
$15.24
|
| Rate for Payer: Humana Medicare Advantage |
$5.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.98
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.68
|
|
|
CH URIC ACID FLUID
|
Facility
|
IP
|
$63.25
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
397073046
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.49 |
| Max. Negotiated Rate |
$9.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.49
|
|
|
CH URIC ACID (RANDOM)
|
Facility
|
IP
|
$158.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
397073109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.70 |
| Max. Negotiated Rate |
$23.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.70
|
|
|
CH URIC ACID (RANDOM)
|
Facility
|
OP
|
$158.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
397073109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.08
|
| 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 |
$18.34
|
| Rate for Payer: Cigna Commercial |
$79.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.08
|
| Rate for Payer: Clover Medicare Advantage |
$4.83
|
| Rate for Payer: EmblemHealth Commercial |
$15.24
|
| Rate for Payer: Humana Medicare Advantage |
$5.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.08
|
| 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 |
$4.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.19
|
|
|
CH URIC ACID URINE 24HR
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
397071314
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$129.50 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.08
|
| 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 |
$18.34
|
| Rate for Payer: Cigna Commercial |
$129.50
|
| Rate for Payer: Cigna Medicare Advantage |
$5.08
|
| Rate for Payer: Clover Medicare Advantage |
$4.83
|
| Rate for Payer: EmblemHealth Commercial |
$15.24
|
| Rate for Payer: Humana Medicare Advantage |
$5.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$77.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.86
|
|
|
CH URIC ACID URINE 24HR
|
Facility
|
IP
|
$259.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
397071314
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.85 |
| Max. Negotiated Rate |
$38.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.85
|
|
|
CH URINALYSIS ROUTINE
|
Facility
|
OP
|
$790.84
|
|
|
Service Code
|
HCPCS 81001
|
| Hospital Charge Code |
397071008
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$395.42 |
| Rate for Payer: Aetna Commercial |
$8.62
|
| Rate for Payer: Aetna Medicare Advantage |
$10.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.44
|
| Rate for Payer: Cigna Commercial |
$395.42
|
| Rate for Payer: Cigna Medicare Advantage |
$3.17
|
| Rate for Payer: Clover Medicare Advantage |
$3.01
|
| Rate for Payer: EmblemHealth Commercial |
$9.51
|
| Rate for Payer: Humana Medicare Advantage |
$3.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.17
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$237.25
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.63
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.54
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.96
|
|
|
CH URINALYSIS ROUTINE
|
Facility
|
IP
|
$790.84
|
|
|
Service Code
|
HCPCS 81001
|
| Hospital Charge Code |
397071008
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$118.63 |
| Max. Negotiated Rate |
$118.63 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$118.63
|
|
|
CH URINE MICROSCOPIC
|
Facility
|
OP
|
$20.75
|
|
|
Service Code
|
HCPCS 81015
|
| Hospital Charge Code |
397073025
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$8.30
|
| Rate for Payer: Aetna Medicare Advantage |
$9.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$0.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.01
|
| Rate for Payer: Cigna Commercial |
$10.38
|
| Rate for Payer: Cigna Medicare Advantage |
$3.05
|
| Rate for Payer: Clover Medicare Advantage |
$2.90
|
| Rate for Payer: EmblemHealth Commercial |
$9.15
|
| Rate for Payer: Humana Medicare Advantage |
$3.14
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.22
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.55
|
|
|
CH URINE MICROSCOPIC
|
Facility
|
IP
|
$20.75
|
|
|
Service Code
|
HCPCS 81015
|
| Hospital Charge Code |
397073025
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$3.11 |
| Max. Negotiated Rate |
$3.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.11
|
|
|
CH UROBILINOGEN
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
HCPCS 84578
|
| Hospital Charge Code |
397071189
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$12.16
|
| Rate for Payer: Aetna Medicare Advantage |
$14.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$0.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.14
|
| Rate for Payer: Cigna Commercial |
$21.00
|
| Rate for Payer: Cigna Medicare Advantage |
$4.47
|
| Rate for Payer: Clover Medicare Advantage |
$4.25
|
| Rate for Payer: EmblemHealth Commercial |
$13.41
|
| Rate for Payer: Humana Medicare Advantage |
$4.60
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.11
|
|
|
CH UROBILINOGEN
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
HCPCS 84578
|
| Hospital Charge Code |
397071189
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$6.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$6.30
|
|
|
CH UROBILINOGEN FECES
|
Facility
|
IP
|
$340.00
|
|
|
Service Code
|
HCPCS 84577
|
| Hospital Charge Code |
397072133
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
|
|
CH UROBILINOGEN FECES
|
Facility
|
OP
|
$340.00
|
|
|
Service Code
|
HCPCS 84577
|
| Hospital Charge Code |
397072133
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.01 |
| Max. Negotiated Rate |
$170.00 |
| Rate for Payer: Aetna Commercial |
$45.70
|
| Rate for Payer: Aetna Medicare Advantage |
$54.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$60.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$60.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$60.64
|
| Rate for Payer: Cigna Commercial |
$170.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.80
|
| Rate for Payer: Clover Medicare Advantage |
$15.96
|
| Rate for Payer: EmblemHealth Commercial |
$50.40
|
| Rate for Payer: Humana Medicare Advantage |
$17.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$102.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$51.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.80
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.01
|
|
|
CH VAGINITIS PANEL
|
Facility
|
IP
|
$1,058.00
|
|
|
Service Code
|
HCPCS 87800
|
| Hospital Charge Code |
397040090
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$158.70 |
| Max. Negotiated Rate |
$158.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$158.70
|
|
|
CH VAGINITIS PANEL
|
Facility
|
OP
|
$1,058.00
|
|
|
Service Code
|
HCPCS 87800
|
| Hospital Charge Code |
397040090
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.04 |
| Max. Negotiated Rate |
$529.00 |
| Rate for Payer: Aetna Commercial |
$118.78
|
| Rate for Payer: Aetna Medicare Advantage |
$141.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$157.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$157.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$43.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$43.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$157.64
|
| Rate for Payer: Cigna Commercial |
$529.00
|
| Rate for Payer: Cigna Medicare Advantage |
$43.67
|
| Rate for Payer: Clover Medicare Advantage |
$41.49
|
| Rate for Payer: EmblemHealth Commercial |
$131.01
|
| Rate for Payer: Humana Medicare Advantage |
$44.98
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$43.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$317.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$158.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$34.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$43.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$43.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.04
|
|
