|
CREATE AV FSTLA,NT AGENS GRFT
|
Facility
|
IP
|
$38,857.60
|
|
|
Service Code
|
HCPCS 36830
|
| Hospital Charge Code |
1600000423
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,828.64 |
| Max. Negotiated Rate |
$5,828.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,828.64
|
|
|
CREATE AV FSTLA,NT AGENS GRFT
|
Facility
|
OP
|
$38,857.60
|
|
|
Service Code
|
HCPCS 36830
|
| Hospital Charge Code |
1600000423
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$936.47 |
| Max. Negotiated Rate |
$23,862.86 |
| Rate for Payer: Aetna Commercial |
$17,981.27
|
| Rate for Payer: Aetna Medicare Advantage |
$21,418.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23,862.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6,610.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1,626.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23,862.86
|
| Rate for Payer: Cigna Commercial |
$13,251.23
|
| Rate for Payer: Cigna Medicare Advantage |
$6,610.76
|
| Rate for Payer: Clover Medicare Advantage |
$6,280.22
|
| Rate for Payer: EmblemHealth Commercial |
$19,832.28
|
| Rate for Payer: Humana Medicare Advantage |
$6,809.08
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6,610.76
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11,657.28
|
| Rate for Payer: Oxford Commercial |
$8,679.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5,828.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$14,834.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$936.47
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellcare Medicare Advantage |
$6,610.76
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1,029.73
|
|
|
CREATINE,24HR URINE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82540
|
| Hospital Charge Code |
39900066
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CREATINE,24HR URINE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82540
|
| Hospital Charge Code |
39900066
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$12.62
|
| Rate for Payer: Aetna Medicare Advantage |
$15.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.64
|
| 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 |
$16.75
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$4.64
|
| Rate for Payer: Clover Medicare Advantage |
$4.41
|
| Rate for Payer: EmblemHealth Commercial |
$13.92
|
| Rate for Payer: Humana Medicare Advantage |
$4.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.64
|
| 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 |
$3.71
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
CREATINE KINASE (CK)
|
Facility
|
IP
|
$667.31
|
|
|
Service Code
|
HCPCS 82550
|
| Hospital Charge Code |
3000916
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.10 |
| Max. Negotiated Rate |
$100.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.10
|
|
|
CREATINE KINASE (CK)
|
Facility
|
OP
|
$667.31
|
|
|
Service Code
|
HCPCS 82550
|
| Hospital Charge Code |
3000916
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.21 |
| Max. Negotiated Rate |
$333.65 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Aetna Medicare Advantage |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.50
|
| Rate for Payer: Cigna Commercial |
$333.65
|
| Rate for Payer: Cigna Medicare Advantage |
$6.51
|
| Rate for Payer: Clover Medicare Advantage |
$6.18
|
| Rate for Payer: EmblemHealth Commercial |
$19.53
|
| Rate for Payer: Humana Medicare Advantage |
$6.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6.51
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$200.19
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.21
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.51
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.68
|
|
|
CREATINE KINASE (CK/CPK)
|
Facility
|
OP
|
$291.20
|
|
|
Service Code
|
HCPCS 82550
|
| Hospital Charge Code |
38472242
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.21 |
| Max. Negotiated Rate |
$145.60 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Aetna Medicare Advantage |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.50
|
| Rate for Payer: Cigna Commercial |
$145.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6.51
|
| Rate for Payer: Clover Medicare Advantage |
$6.18
|
| Rate for Payer: EmblemHealth Commercial |
$19.53
|
| Rate for Payer: Humana Medicare Advantage |
$6.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6.51
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$87.36
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.21
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.51
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.72
|
|
|
CREATINE KINASE (CK/CPK)
|
Facility
|
IP
|
$291.20
|
|
|
Service Code
|
HCPCS 82550
|
| Hospital Charge Code |
38472242
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.68 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.68
|
|
|
CREATINE KINASE (CK) ISOFORMS
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 82554
|
| Hospital Charge Code |
3032490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
CREATINE KINASE (CK) ISOFORMS
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 82554
|
| Hospital Charge Code |
3032490
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$32.29
|
| Rate for Payer: Aetna Medicare Advantage |
$38.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.85
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$11.87
|
| Rate for Payer: Clover Medicare Advantage |
$11.28
|
| Rate for Payer: EmblemHealth Commercial |
$35.61
|
| Rate for Payer: Humana Medicare Advantage |
$12.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.87
|
| 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 |
$9.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.69
|
|
|
CREATINE KINASE (CK) REPEAT
|
Facility
|
IP
|
$385.26
|
|
|
Service Code
|
HCPCS 8255091
|
| Hospital Charge Code |
3000916R
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.79 |
| Max. Negotiated Rate |
$57.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.79
|
|
|
CREATINE KINASE (CK) REPEAT
|
Facility
|
OP
|
$385.26
|
|
|
Service Code
|
HCPCS 8255091
|
| Hospital Charge Code |
3000916R
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.28 |
| Max. Negotiated Rate |
$192.63 |
| Rate for Payer: Aetna Commercial |
$146.40
|
| Rate for Payer: Aetna Medicare Advantage |
$115.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$98.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$98.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$98.24
|
| Rate for Payer: Cigna Commercial |
$192.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$115.58
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$57.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.21
|
|
|
CREATINE KINASE CPK PANEL***
|
Facility
|
OP
|
$7.20
|
|
|
Service Code
|
HCPCS 82550
|
| Hospital Charge Code |
3000916P
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$17.71
|
| Rate for Payer: Aetna Medicare Advantage |
$21.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.50
|
| Rate for Payer: Cigna Commercial |
$3.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6.51
|
| Rate for Payer: Clover Medicare Advantage |
$6.18
|
| Rate for Payer: EmblemHealth Commercial |
$19.53
|
| Rate for Payer: Humana Medicare Advantage |
$6.71
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6.51
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.16
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.21
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.51
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.51
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.19
|
|
|
CREATINE KINASE CPK PANEL***
|
Facility
|
IP
|
$7.20
|
|
|
Service Code
|
HCPCS 82550
|
| Hospital Charge Code |
3000916P
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$1.08 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.08
|
|
|
CREATINE KINASE-MB (CK-MB)
|
Facility
|
IP
|
$240.00
|
|
|
Service Code
|
HCPCS 82553
|
| Hospital Charge Code |
38472245
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
|
|
CREATINE KINASE-MB (CK-MB)
|
Facility
|
OP
|
$240.00
|
|
|
Service Code
|
HCPCS 82553
|
| Hospital Charge Code |
38472245
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.36 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$31.42
|
| Rate for Payer: Aetna Medicare Advantage |
$37.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.69
|
| Rate for Payer: Cigna Commercial |
$120.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.55
|
| Rate for Payer: Clover Medicare Advantage |
$10.97
|
| Rate for Payer: EmblemHealth Commercial |
$34.65
|
| Rate for Payer: Humana Medicare Advantage |
$11.90
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.55
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.36
|
|
|
CREATINE,SERUM
|
Facility
|
OP
|
$31.85
|
|
|
Service Code
|
HCPCS 82540
|
| Hospital Charge Code |
39900067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$12.62
|
| Rate for Payer: Aetna Medicare Advantage |
$15.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.64
|
| 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 |
$16.75
|
| Rate for Payer: Cigna Commercial |
$15.93
|
| Rate for Payer: Cigna Medicare Advantage |
$4.64
|
| Rate for Payer: Clover Medicare Advantage |
$4.41
|
| Rate for Payer: EmblemHealth Commercial |
$13.92
|
| Rate for Payer: Humana Medicare Advantage |
$4.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.55
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.71
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.64
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.84
|
|
|
CREATINE,SERUM
|
Facility
|
IP
|
$31.85
|
|
|
Service Code
|
HCPCS 82540
|
| Hospital Charge Code |
39900067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$4.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.78
|
|
|
CREATINE,UR RANDOM
|
Facility
|
OP
|
$107.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
38479033
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.84 |
| 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 |
$53.50
|
| 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 |
$32.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.05
|
| 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 |
$2.84
|
|
|
CREATINE,UR RANDOM
|
Facility
|
IP
|
$107.00
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
38479033
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.05 |
| Max. Negotiated Rate |
$16.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.05
|
|
|
CREATININE
|
Facility
|
IP
|
$47.25
|
|
|
Service Code
|
HCPCS 82565
|
| Hospital Charge Code |
8200308RS
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.09 |
| Max. Negotiated Rate |
$7.09 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.09
|
|
|
CREATININE
|
Facility
|
OP
|
$47.25
|
|
|
Service Code
|
HCPCS 82565
|
| Hospital Charge Code |
8200308RS
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$13.93
|
| Rate for Payer: Aetna Medicare Advantage |
$16.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.12
|
| 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 |
$18.48
|
| Rate for Payer: Cigna Commercial |
$23.62
|
| Rate for Payer: Cigna Medicare Advantage |
$5.12
|
| Rate for Payer: Clover Medicare Advantage |
$4.86
|
| Rate for Payer: EmblemHealth Commercial |
$15.36
|
| Rate for Payer: Humana Medicare Advantage |
$5.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.18
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.09
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.10
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.12
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.12
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.25
|
|
|
CREATININE (AMNIOTIC FLUID)
|
Facility
|
IP
|
$152.65
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3030376
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.90 |
| Max. Negotiated Rate |
$22.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.90
|
|
|
CREATININE (AMNIOTIC FLUID)
|
Facility
|
OP
|
$152.65
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3030376
|
|
Hospital Revenue Code
|
301
|
| 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
|
|
|
CREATININE (CADMIUM U)
|
Facility
|
IP
|
$152.65
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
3031070A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.90 |
| Max. Negotiated Rate |
$22.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.90
|
|
