|
ALLERGIC REACTIONS WITH MCC
|
Facility
|
IP
|
$56,486.16
|
|
|
Service Code
|
MSDRG 915
|
| Min. Negotiated Rate |
$17,199.31 |
| Max. Negotiated Rate |
$56,486.16 |
| Rate for Payer: Aetna Commercial |
$39,069.78
|
| Rate for Payer: Aetna Medicare Advantage |
$56,486.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41,171.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41,171.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18,104.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41,171.97
|
| Rate for Payer: Cigna Commercial |
$31,469.46
|
| Rate for Payer: Cigna Medicare Advantage |
$18,104.54
|
| Rate for Payer: Clover Medicare Advantage |
$17,199.31
|
| Rate for Payer: EmblemHealth Commercial |
$54,313.62
|
| Rate for Payer: Humana Medicare Advantage |
$18,647.68
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$18,104.54
|
| Rate for Payer: Oxford Commercial |
$22,617.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$39,660.54
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18,104.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$18,104.54
|
|
|
ALLERGIC REACTIONS WITHOUT MCC
|
Facility
|
IP
|
$23,669.97
|
|
|
Service Code
|
MSDRG 916
|
| Min. Negotiated Rate |
$7,207.20 |
| Max. Negotiated Rate |
$23,669.97 |
| Rate for Payer: Aetna Commercial |
$16,521.30
|
| Rate for Payer: Aetna Medicare Advantage |
$23,669.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,352.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,352.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7,586.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15,352.26
|
| Rate for Payer: Cigna Commercial |
$12,469.14
|
| Rate for Payer: Cigna Medicare Advantage |
$7,586.53
|
| Rate for Payer: Clover Medicare Advantage |
$7,207.20
|
| Rate for Payer: EmblemHealth Commercial |
$22,759.59
|
| Rate for Payer: Humana Medicare Advantage |
$7,814.13
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7,586.53
|
| Rate for Payer: Oxford Commercial |
$8,961.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$15,714.69
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7,586.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$7,586.53
|
|
|
ALLERGY,CAT DANDER
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479154
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$89.40 |
| Max. Negotiated Rate |
$89.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
|
|
ALLERGY,CAT DANDER
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479154
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$298.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$298.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$178.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.79
|
|
|
ALLERGY,CLAM
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479144
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$89.40 |
| Max. Negotiated Rate |
$89.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
|
|
ALLERGY,CLAM
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479144
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$298.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$298.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$178.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.79
|
|
|
ALLERGY,CODFISH
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479141
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$298.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$298.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$178.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.79
|
|
|
ALLERGY,CODFISH
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479141
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$89.40 |
| Max. Negotiated Rate |
$89.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
|
|
ALLERGY,CRAB
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479142
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$89.40 |
| Max. Negotiated Rate |
$89.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
|
|
ALLERGY,CRAB
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479142
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$298.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$298.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$178.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.79
|
|
|
ALLERGY,D.FARINAE
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479146
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$89.40 |
| Max. Negotiated Rate |
$89.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
|
|
ALLERGY,D.FARINAE
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479146
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$298.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$298.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$178.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.79
|
|
|
ALLERGY,D.PTERONYSSINUS
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479147
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$298.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$298.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$178.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.79
|
|
|
ALLERGY,D.PTERONYSSINUS
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479147
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$89.40 |
| Max. Negotiated Rate |
$89.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
|
|
ALLERGY,EGGWHITE
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479149
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$89.40 |
| Max. Negotiated Rate |
$89.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
|
|
ALLERGY,EGGWHITE
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479149
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$298.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$298.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$178.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.79
|
|
|
ALLERGY,EGGYOLK
|
Facility
|
IP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479150
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$89.40 |
| Max. Negotiated Rate |
$89.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
|
|
ALLERGY,EGGYOLK
|
Facility
|
OP
|
$596.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479150
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$298.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$298.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$178.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.79
|
|
|
ALLERGY,FOOD PROFILE I
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990019A
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ALLERGY,FOOD PROFILE I
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990019A
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| 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 |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
ALLERGY,FOOD PROFILE II
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990019B
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| 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 |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
ALLERGY,FOOD PROFILE II
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990019B
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ALLERGY,FOOD PROFILE III
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990019C
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| 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 |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
ALLERGY,FOOD PROFILE III
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990019C
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ALLERGY,FOOD PROFILE IV
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
39990019D
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare Advantage |
$16.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$38.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.84
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.22
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.22
|
| 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 |
$4.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
