|
GLUCOSE, FASTING
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
3030186
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.19
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| 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 |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.69
|
|
|
GLUCOSE FLUID
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
38479401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
|
|
GLUCOSE FLUID
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
38479401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.19
|
| Rate for Payer: Cigna Commercial |
$78.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$46.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.13
|
|
|
GLUCOSE,FLUID
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
38472308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
|
|
GLUCOSE,FLUID
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
38472308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.19
|
| Rate for Payer: Cigna Commercial |
$78.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$46.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.13
|
|
|
GLUCOSE,GESTATIONAL DIABETES
|
Facility
|
OP
|
$335.00
|
|
|
Service Code
|
HCPCS 82950
|
| Hospital Charge Code |
38472303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$167.50 |
| Rate for Payer: Aetna Commercial |
$12.92
|
| Rate for Payer: Aetna Medicare Advantage |
$15.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.75
|
| 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 |
$17.15
|
| Rate for Payer: Cigna Commercial |
$167.50
|
| Rate for Payer: Cigna Medicare Advantage |
$4.75
|
| Rate for Payer: Clover Medicare Advantage |
$4.51
|
| Rate for Payer: EmblemHealth Commercial |
$14.25
|
| Rate for Payer: Humana Medicare Advantage |
$4.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$100.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.88
|
|
|
GLUCOSE,GESTATIONAL DIABETES
|
Facility
|
IP
|
$335.00
|
|
|
Service Code
|
HCPCS 82950
|
| Hospital Charge Code |
38472303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.25 |
| Max. Negotiated Rate |
$50.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.25
|
|
|
GLUCOSE MONITORING
|
Facility
|
IP
|
$20.85
|
|
|
Service Code
|
HCPCS 82962
|
| Hospital Charge Code |
9400177
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.13 |
| Max. Negotiated Rate |
$3.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.13
|
|
|
GLUCOSE MONITORING
|
Facility
|
OP
|
$20.85
|
|
|
Service Code
|
HCPCS 82962
|
| Hospital Charge Code |
9400177
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$8.92
|
| Rate for Payer: Aetna Medicare Advantage |
$10.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$5.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.84
|
| Rate for Payer: Cigna Commercial |
$10.43
|
| Rate for Payer: Cigna Medicare Advantage |
$3.28
|
| Rate for Payer: Clover Medicare Advantage |
$3.12
|
| Rate for Payer: EmblemHealth Commercial |
$9.84
|
| Rate for Payer: Humana Medicare Advantage |
$3.38
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.28
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.25
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.28
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.28
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.55
|
|
|
GLUCOSE PERICARDIAL FLUID
|
Facility
|
IP
|
$117.65
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3031003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.65 |
| Max. Negotiated Rate |
$17.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
|
|
GLUCOSE PERICARDIAL FLUID
|
Facility
|
OP
|
$117.65
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3031003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.19
|
| Rate for Payer: Cigna Commercial |
$58.83
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.12
|
|
|
GLUCOSE POST GLUCOSE DOSE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82950
|
| Hospital Charge Code |
401082950
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$12.92
|
| Rate for Payer: Aetna Medicare Advantage |
$15.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.75
|
| 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 |
$17.15
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$4.75
|
| Rate for Payer: Clover Medicare Advantage |
$4.51
|
| Rate for Payer: EmblemHealth Commercial |
$14.25
|
| Rate for Payer: Humana Medicare Advantage |
$4.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.75
|
| 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 |
$3.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
GLUCOSE POST GLUCOSE DOSE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82950
|
| Hospital Charge Code |
401082950
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
GLUCOSE, QUANT, URINE, 24 HR
|
Facility
|
OP
|
$117.65
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3001427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.19
|
| Rate for Payer: Cigna Commercial |
$58.83
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.12
|
|
|
GLUCOSE, QUANT, URINE, 24 HR
|
Facility
|
IP
|
$117.65
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3001427
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.65 |
| Max. Negotiated Rate |
$17.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
|
|
GLUCOSE, RANDOM
|
Facility
|
OP
|
$117.65
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
8200348RS
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.19
|
| Rate for Payer: Cigna Commercial |
$58.83
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.12
|
|
|
GLUCOSE, RANDOM
|
Facility
|
IP
|
$117.65
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
8200348RS
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.65 |
| Max. Negotiated Rate |
$17.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
|
|
GLUCOSE SYNOVIAL FLUID
|
Facility
|
OP
|
$117.65
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3031004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.19
|
| Rate for Payer: Cigna Commercial |
$58.83
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.12
|
|
|
GLUCOSE SYNOVIAL FLUID
|
Facility
|
IP
|
$117.65
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3031004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.65 |
| Max. Negotiated Rate |
$17.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.65
|
|
|
GLUCOSE,SYNOVIAL FLUID
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
39900086
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
GLUCOSE,SYNOVIAL FLUID
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
39900086
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.19
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| 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 |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
Glucose Test strip
|
Facility
|
IP
|
$5.65
|
|
| Hospital Charge Code |
60628757
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$0.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.85
|
|
|
Glucose Test strip
|
Facility
|
OP
|
$5.65
|
|
| Hospital Charge Code |
60628757
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$2.83 |
| Rate for Payer: Aetna Commercial |
$2.15
|
| Rate for Payer: Aetna Medicare Advantage |
$1.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.44
|
| Rate for Payer: Cigna Commercial |
$2.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.70
|
| Rate for Payer: Oxford Commercial |
$1.13
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.13
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.15
|
|
|
GLUCOSE TOLERANCE-3 SPECIMENS
|
Facility
|
OP
|
$763.00
|
|
|
Service Code
|
HCPCS 82951
|
| Hospital Charge Code |
38472311
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.68 |
| Max. Negotiated Rate |
$381.50 |
| Rate for Payer: Aetna Commercial |
$35.01
|
| Rate for Payer: Aetna Medicare Advantage |
$41.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.46
|
| Rate for Payer: Cigna Commercial |
$381.50
|
| Rate for Payer: Cigna Medicare Advantage |
$12.87
|
| Rate for Payer: Clover Medicare Advantage |
$12.23
|
| Rate for Payer: EmblemHealth Commercial |
$38.61
|
| Rate for Payer: Humana Medicare Advantage |
$13.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$228.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$20.22
|
|
|
GLUCOSE TOLERANCE-3 SPECIMENS
|
Facility
|
IP
|
$763.00
|
|
|
Service Code
|
HCPCS 82951
|
| Hospital Charge Code |
38472311
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$114.45 |
| Max. Negotiated Rate |
$114.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.45
|
|
