|
E. HISTOLYTICA AB
|
Facility
|
IP
|
$131.25
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
3006632
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.69 |
| Max. Negotiated Rate |
$19.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.69
|
|
|
E. HISTOLYTICA AB
|
Facility
|
OP
|
$131.25
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
3006632
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna Medicare Advantage |
$48.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.11
|
| Rate for Payer: Cigna Commercial |
$65.62
|
| Rate for Payer: Cigna Medicare Advantage |
$14.99
|
| Rate for Payer: Clover Medicare Advantage |
$14.24
|
| Rate for Payer: EmblemHealth Commercial |
$44.97
|
| Rate for Payer: Humana Medicare Advantage |
$15.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.38
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.48
|
|
|
E.HISTOLYTICA AB*****
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
33006632
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$7.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.05
|
|
|
E.HISTOLYTICA AB*****
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
33006632
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna Medicare Advantage |
$48.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.11
|
| Rate for Payer: Cigna Commercial |
$23.50
|
| Rate for Payer: Cigna Medicare Advantage |
$14.99
|
| Rate for Payer: Clover Medicare Advantage |
$14.24
|
| Rate for Payer: EmblemHealth Commercial |
$44.97
|
| Rate for Payer: Humana Medicare Advantage |
$15.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.10
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.25
|
|
|
E.HISTOLYTICA(AMEBIASIS), I
|
Facility
|
OP
|
$75.65
|
|
|
Service Code
|
HCPCS 87337
|
| Hospital Charge Code |
39990055A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Medicare Advantage |
$38.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.24
|
| Rate for Payer: Cigna Commercial |
$37.83
|
| Rate for Payer: Cigna Medicare Advantage |
$11.98
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.00
|
|
|
E.HISTOLYTICA(AMEBIASIS), I
|
Facility
|
IP
|
$75.65
|
|
|
Service Code
|
HCPCS 87337
|
| Hospital Charge Code |
39990055A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.35 |
| Max. Negotiated Rate |
$11.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.35
|
|
|
E.HISTOLYTICA(AMEBIASIS), II
|
Facility
|
IP
|
$75.65
|
|
|
Service Code
|
HCPCS 87449
|
| Hospital Charge Code |
39990055B
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.35 |
| Max. Negotiated Rate |
$11.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.35
|
|
|
E.HISTOLYTICA(AMEBIASIS), II
|
Facility
|
OP
|
$75.65
|
|
|
Service Code
|
HCPCS 87449
|
| Hospital Charge Code |
39990055B
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Medicare Advantage |
$38.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.24
|
| Rate for Payer: Cigna Commercial |
$37.83
|
| Rate for Payer: Cigna Medicare Advantage |
$11.98
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.00
|
|
|
E.HISTOLYTICA ANTIGEN,EIA
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87337
|
| Hospital Charge Code |
39900284
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Medicare Advantage |
$38.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.24
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.98
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.98
|
| 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 |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
E.HISTOLYTICA ANTIGEN,EIA
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87337
|
| Hospital Charge Code |
39900284
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
E.HISTOLYTICA IGG
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86753
|
| Hospital Charge Code |
39900251
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.91 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$33.70
|
| Rate for Payer: Aetna Medicare Advantage |
$40.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.72
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.39
|
| Rate for Payer: Clover Medicare Advantage |
$11.77
|
| Rate for Payer: EmblemHealth Commercial |
$37.17
|
| Rate for Payer: Humana Medicare Advantage |
$12.76
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.39
|
| 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 |
$9.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
E.HISTOLYTICA IGG
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86753
|
| Hospital Charge Code |
39900251
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
EHRLICHHIACHAFFEENSISDNARTPCR
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
4011877984
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
EHRLICHHIACHAFFEENSISDNARTPCR
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
4011877984
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$95.44
|
| Rate for Payer: Aetna Medicare Advantage |
$113.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$126.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$126.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$35.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$153.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.66
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$35.09
|
| Rate for Payer: Clover Medicare Advantage |
$33.34
|
| Rate for Payer: EmblemHealth Commercial |
$105.27
|
| Rate for Payer: Humana Medicare Advantage |
$36.14
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$35.09
|
| 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 |
$28.07
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$35.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$35.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
EKG 12 LEAD
|
Facility
|
OP
|
$809.15
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
74115007
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$697.00 |
| Rate for Payer: Aetna Commercial |
$190.62
|
| Rate for Payer: Aetna Medicare Advantage |
$227.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$70.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$118.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$252.97
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: Cigna Medicare Advantage |
$70.08
|
| Rate for Payer: Clover Medicare Advantage |
$66.58
|
| Rate for Payer: EmblemHealth Commercial |
$210.24
|
| Rate for Payer: Humana Medicare Advantage |
$72.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$70.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$242.75
|
| Rate for Payer: Oxford Commercial |
$531.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$697.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.44
|
|
|
EKG 12 LEAD
|
Facility
|
IP
|
$809.15
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
74116007
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$121.37 |
| Max. Negotiated Rate |
$121.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.37
|
|
|
EKG 12 LEAD
|
Facility
|
OP
|
$809.15
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
74116007
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$697.00 |
| Rate for Payer: Aetna Commercial |
$190.62
|
| Rate for Payer: Aetna Medicare Advantage |
$227.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$70.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$118.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$252.97
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: Cigna Medicare Advantage |
$70.08
|
| Rate for Payer: Clover Medicare Advantage |
$66.58
|
| Rate for Payer: EmblemHealth Commercial |
$210.24
|
| Rate for Payer: Humana Medicare Advantage |
$72.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$70.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$242.75
|
| Rate for Payer: Oxford Commercial |
$531.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$697.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.44
|
|
|
EKG 12 LEAD
|
Facility
|
IP
|
$809.15
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
74115007
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$121.37 |
| Max. Negotiated Rate |
$121.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.37
|
|
|
EKG 12 LEAD
|
Facility
|
IP
|
$809.15
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
74117007
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$121.37 |
| Max. Negotiated Rate |
$121.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.37
|
|
|
EKG 12 LEAD
|
Facility
|
OP
|
$809.15
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
74117007
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$697.00 |
| Rate for Payer: Aetna Commercial |
$190.62
|
| Rate for Payer: Aetna Medicare Advantage |
$227.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$70.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$118.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$252.97
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: Cigna Medicare Advantage |
$70.08
|
| Rate for Payer: Clover Medicare Advantage |
$66.58
|
| Rate for Payer: EmblemHealth Commercial |
$210.24
|
| Rate for Payer: Humana Medicare Advantage |
$72.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$70.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$242.75
|
| Rate for Payer: Oxford Commercial |
$531.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$121.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$697.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.50
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.44
|
|
|
EKG 12 LEADS
|
Facility
|
OP
|
$2,050.00
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
36540001
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$49.41 |
| Max. Negotiated Rate |
$697.00 |
| Rate for Payer: Aetna Commercial |
$190.62
|
| Rate for Payer: Aetna Medicare Advantage |
$227.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$70.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$118.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$252.97
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: Cigna Medicare Advantage |
$70.08
|
| Rate for Payer: Clover Medicare Advantage |
$66.58
|
| Rate for Payer: EmblemHealth Commercial |
$210.24
|
| Rate for Payer: Humana Medicare Advantage |
$72.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$70.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$615.00
|
| Rate for Payer: Oxford Commercial |
$531.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$307.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$697.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$49.41
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$54.33
|
|
|
EKG 12 LEADS
|
Facility
|
IP
|
$2,050.00
|
|
|
Service Code
|
HCPCS 93005
|
| Hospital Charge Code |
36540001
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$307.50 |
| Max. Negotiated Rate |
$307.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$307.50
|
|
|
EKG AHA LEADWIRES 5-SET
|
Facility
|
OP
|
$337.50
|
|
| Hospital Charge Code |
2709002961
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$168.75 |
| Rate for Payer: Aetna Commercial |
$128.25
|
| Rate for Payer: Aetna Medicare Advantage |
$101.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86.06
|
| Rate for Payer: Cigna Commercial |
$168.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.25
|
| Rate for Payer: Oxford Commercial |
$67.50
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$67.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.94
|
|
|
EKG AHA LEADWIRES 5-SET
|
Facility
|
IP
|
$337.50
|
|
| Hospital Charge Code |
2709002961
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$50.62 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.62
|
|
|
EKG RHYTHM STRIP W/O INTERPR**
|
Facility
|
OP
|
$10.80
|
|
|
Service Code
|
HCPCS 93041
|
| Hospital Charge Code |
5300018
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$697.00 |
| Rate for Payer: Aetna Commercial |
$190.62
|
| Rate for Payer: Aetna Medicare Advantage |
$227.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$252.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$70.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$63.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$252.97
|
| Rate for Payer: Cigna Commercial |
$140.48
|
| Rate for Payer: Cigna Medicare Advantage |
$70.08
|
| Rate for Payer: Clover Medicare Advantage |
$66.58
|
| Rate for Payer: EmblemHealth Commercial |
$210.24
|
| Rate for Payer: Humana Medicare Advantage |
$72.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$70.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.24
|
| Rate for Payer: Oxford Commercial |
$531.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.62
|
| Rate for Payer: UnitedHealthcare Commercial |
$697.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$70.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.29
|
|
