|
HEPATITIS BE ANTIBODY
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86707
|
| Hospital Charge Code |
39900383
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$31.47
|
| Rate for Payer: Aetna Medicare Advantage |
$37.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.76
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.57
|
| Rate for Payer: Clover Medicare Advantage |
$10.99
|
| Rate for Payer: EmblemHealth Commercial |
$34.71
|
| Rate for Payer: Humana Medicare Advantage |
$11.92
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.57
|
| 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 |
$9.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
HEPATITIS BE ANTIBODY HBE AB
|
Facility
|
IP
|
$559.00
|
|
|
Service Code
|
HCPCS 86707
|
| Hospital Charge Code |
38472359
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$83.85 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
|
|
HEPATITIS BE ANTIBODY HBE AB
|
Facility
|
OP
|
$559.00
|
|
|
Service Code
|
HCPCS 86707
|
| Hospital Charge Code |
38472359
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$279.50 |
| Rate for Payer: Aetna Commercial |
$31.47
|
| Rate for Payer: Aetna Medicare Advantage |
$37.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.76
|
| Rate for Payer: Cigna Commercial |
$279.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.57
|
| Rate for Payer: Clover Medicare Advantage |
$10.99
|
| Rate for Payer: EmblemHealth Commercial |
$34.71
|
| Rate for Payer: Humana Medicare Advantage |
$11.92
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$167.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.81
|
|
|
HEPATITIS BE ANTIBODY HBE AB
|
Facility
|
IP
|
$559.00
|
|
|
Service Code
|
HCPCS 86707
|
| Hospital Charge Code |
38479431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$83.85 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
|
|
HEPATITIS BE ANTIBODY HBE AB
|
Facility
|
OP
|
$559.00
|
|
|
Service Code
|
HCPCS 86707
|
| Hospital Charge Code |
38479431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$279.50 |
| Rate for Payer: Aetna Commercial |
$31.47
|
| Rate for Payer: Aetna Medicare Advantage |
$37.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.76
|
| Rate for Payer: Cigna Commercial |
$279.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.57
|
| Rate for Payer: Clover Medicare Advantage |
$10.99
|
| Rate for Payer: EmblemHealth Commercial |
$34.71
|
| Rate for Payer: Humana Medicare Advantage |
$11.92
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$167.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$14.81
|
|
|
HEPATITIS BE ANTIGEN
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87350
|
| Hospital Charge Code |
39900392
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
HEPATITIS BE ANTIGEN
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87350
|
| Hospital Charge Code |
39900392
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$31.36
|
| Rate for Payer: Aetna Medicare Advantage |
$37.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.62
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.53
|
| Rate for Payer: Clover Medicare Advantage |
$10.95
|
| Rate for Payer: EmblemHealth Commercial |
$34.59
|
| Rate for Payer: Humana Medicare Advantage |
$11.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.53
|
| 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 |
$9.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
HEPATITIS BE ANTIGEN, HBE AG
|
Facility
|
IP
|
$574.00
|
|
|
Service Code
|
HCPCS 86704
|
| Hospital Charge Code |
38472356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$86.10 |
| Max. Negotiated Rate |
$86.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.10
|
|
|
HEPATITIS BE ANTIGEN, HBE AG
|
Facility
|
IP
|
$574.00
|
|
|
Service Code
|
HCPCS 86704
|
| Hospital Charge Code |
38479430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$86.10 |
| Max. Negotiated Rate |
$86.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.10
|
|
|
HEPATITIS BE ANTIGEN, HBE AG
|
Facility
|
OP
|
$574.00
|
|
|
Service Code
|
HCPCS 86704
|
| Hospital Charge Code |
38479430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$287.00 |
| Rate for Payer: Aetna Commercial |
$32.78
|
| Rate for Payer: Aetna Medicare Advantage |
$39.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$287.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.05
|
| Rate for Payer: Clover Medicare Advantage |
$11.45
|
| Rate for Payer: EmblemHealth Commercial |
$36.15
|
| Rate for Payer: Humana Medicare Advantage |
$12.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$172.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.21
|
|
|
HEPATITIS BE ANTIGEN, HBE AG
|
Facility
|
OP
|
$574.00
|
|
|
Service Code
|
HCPCS 86704
|
| Hospital Charge Code |
38472356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$287.00 |
| Rate for Payer: Aetna Commercial |
$32.78
|
| Rate for Payer: Aetna Medicare Advantage |
$39.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$25.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$287.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.05
|
| Rate for Payer: Clover Medicare Advantage |
$11.45
|
| Rate for Payer: EmblemHealth Commercial |
$36.15
|
| Rate for Payer: Humana Medicare Advantage |
$12.41
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$172.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.21
|
|
|
HEPATITIS B GENOTYPE
|
Facility
|
OP
|
$1,769.40
|
|
|
Service Code
|
HCPCS 87912
|
| Hospital Charge Code |
39900309
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$46.89 |
| Max. Negotiated Rate |
$929.32 |
| Rate for Payer: Aetna Commercial |
$700.26
|
| Rate for Payer: Aetna Medicare Advantage |
$834.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$929.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$929.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$257.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$657.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$929.32
|
| Rate for Payer: Cigna Commercial |
$884.70
|
| Rate for Payer: Cigna Medicare Advantage |
$257.45
|
| Rate for Payer: Clover Medicare Advantage |
$244.58
|
| Rate for Payer: EmblemHealth Commercial |
$772.35
|
| Rate for Payer: Humana Medicare Advantage |
$265.17
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$257.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$530.82
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$265.41
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$205.96
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$257.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$257.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$46.89
|
|
|
HEPATITIS B GENOTYPE
|
Facility
|
IP
|
$1,769.40
|
|
|
Service Code
|
HCPCS 87912
|
| Hospital Charge Code |
39900309
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$265.41 |
| Max. Negotiated Rate |
$265.41 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$265.41
|
|
|
HEPATITIS B-HEMOPHILUS INF B V
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
HCPCS 90748
|
| Hospital Charge Code |
83652341
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$108.80 |
| Rate for Payer: Aetna Commercial |
$36.10
|
| Rate for Payer: Aetna Medicare Advantage |
$28.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$108.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.23
|
| Rate for Payer: Cigna Commercial |
$47.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.25
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.29
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.52
|
|
|
HEPATITIS B-HEMOPHILUS INF B V
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
HCPCS 90748
|
| Hospital Charge Code |
83652341
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$22.99 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.99
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.25
|
|
|
HEPATITIS B IMMU GLOB INJ
|
Facility
|
OP
|
$2,107.55
|
|
| Hospital Charge Code |
60628286
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$50.79 |
| Max. Negotiated Rate |
$1,053.78 |
| Rate for Payer: Aetna Commercial |
$800.87
|
| Rate for Payer: Aetna Medicare Advantage |
$632.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$537.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$537.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$537.43
|
| Rate for Payer: Cigna Commercial |
$1,053.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$632.26
|
| Rate for Payer: Oxford Commercial |
$421.51
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$316.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$421.51
|
| Rate for Payer: UnitedHealthcare Community & State |
$50.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$55.85
|
|
|
HEPATITIS B IMMU GLOB INJ
|
Facility
|
IP
|
$2,107.55
|
|
| Hospital Charge Code |
60628286
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$316.13 |
| Max. Negotiated Rate |
$316.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$316.13
|
|
|
HEPATITIS B IMMU GLOB INJ 4 ML
|
Facility
|
IP
|
$839.05
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
6002752
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$125.86 |
| Max. Negotiated Rate |
$203.05 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$203.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.86
|
|
|
HEPATITIS B IMMU GLOB INJ 4 ML
|
Facility
|
OP
|
$839.05
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
6002752
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.22 |
| Max. Negotiated Rate |
$506.12 |
| Rate for Payer: Aetna Commercial |
$381.37
|
| Rate for Payer: Aetna Medicare Advantage |
$454.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$506.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$506.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$140.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$148.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$506.12
|
| Rate for Payer: Cigna Medicare Advantage |
$140.21
|
| Rate for Payer: Clover Medicare Advantage |
$133.20
|
| Rate for Payer: EmblemHealth Commercial |
$420.63
|
| Rate for Payer: Humana Medicare Advantage |
$144.42
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$140.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$203.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$125.86
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$140.21
|
| Rate for Payer: Wellcare Medicare Advantage |
$140.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.23
|
|
|
HEPATITISB IMMUNE GLOB 5ML INJ
|
Facility
|
OP
|
$4,582.80
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
60629108
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$110.45 |
| Max. Negotiated Rate |
$1,109.04 |
| Rate for Payer: Aetna Commercial |
$381.37
|
| Rate for Payer: Aetna Medicare Advantage |
$454.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$506.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$506.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$140.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$148.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$506.12
|
| Rate for Payer: Cigna Medicare Advantage |
$140.21
|
| Rate for Payer: Clover Medicare Advantage |
$133.20
|
| Rate for Payer: EmblemHealth Commercial |
$420.63
|
| Rate for Payer: Humana Medicare Advantage |
$144.42
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$140.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,109.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$687.42
|
| Rate for Payer: UnitedHealthcare Community & State |
$110.45
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$140.21
|
| Rate for Payer: Wellcare Medicare Advantage |
$140.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$121.44
|
|
|
HEPATITISB IMMUNE GLOB 5ML INJ
|
Facility
|
IP
|
$4,582.80
|
|
|
Service Code
|
HCPCS 90371
|
| Hospital Charge Code |
60629108
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$687.42 |
| Max. Negotiated Rate |
$1,109.04 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,109.04
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$687.42
|
|
|
HEPATITIS B INJ 10MCG/ML
|
Facility
|
OP
|
$472.35
|
|
| Hospital Charge Code |
60628303
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$236.18 |
| Rate for Payer: Aetna Commercial |
$179.49
|
| Rate for Payer: Aetna Medicare Advantage |
$141.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$120.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$120.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$120.45
|
| Rate for Payer: Cigna Commercial |
$236.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$141.71
|
| Rate for Payer: Oxford Commercial |
$94.47
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$94.47
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.38
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.52
|
|
|
HEPATITIS B INJ 10MCG/ML
|
Facility
|
IP
|
$472.35
|
|
| Hospital Charge Code |
60628303
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$70.85 |
| Max. Negotiated Rate |
$70.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$70.85
|
|
|
HEPATITIS B S ANTIBODY
|
Facility
|
OP
|
$139.25
|
|
|
Service Code
|
HCPCS 86706CF
|
| Hospital Charge Code |
8200343RS
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$52.91
|
| Rate for Payer: Aetna Medicare Advantage |
$41.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.51
|
| Rate for Payer: Cigna Commercial |
$69.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.77
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.69
|
|
|
HEPATITIS B S ANTIBODY
|
Facility
|
IP
|
$139.25
|
|
|
Service Code
|
HCPCS 86706CF
|
| Hospital Charge Code |
8200343RS
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
