|
HISTAMINE RELEASE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86343
|
| Hospital Charge Code |
39900219
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
HISTAMINE (URINE)
|
Facility
|
IP
|
$281.65
|
|
|
Service Code
|
HCPCS 83088
|
| Hospital Charge Code |
3007507
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.25 |
| Max. Negotiated Rate |
$42.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.25
|
|
|
HISTAMINE (URINE)
|
Facility
|
OP
|
$281.65
|
|
|
Service Code
|
HCPCS 83088
|
| Hospital Charge Code |
3007507
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$140.82 |
| Rate for Payer: Aetna Commercial |
$80.32
|
| Rate for Payer: Aetna Medicare Advantage |
$95.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$106.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$106.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$29.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$77.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$106.59
|
| Rate for Payer: Cigna Commercial |
$140.82
|
| Rate for Payer: Cigna Medicare Advantage |
$29.53
|
| Rate for Payer: Clover Medicare Advantage |
$28.05
|
| Rate for Payer: EmblemHealth Commercial |
$88.59
|
| Rate for Payer: Humana Medicare Advantage |
$30.42
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$29.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$84.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$23.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$29.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$29.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.46
|
|
|
HISTO AB (HISTOPLASMA ANTIBODY
|
Facility
|
OP
|
$144.85
|
|
|
Service Code
|
HCPCS 86698
|
| Hospital Charge Code |
3009537
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$37.51
|
| Rate for Payer: Aetna Medicare Advantage |
$44.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.78
|
| Rate for Payer: Cigna Commercial |
$72.42
|
| Rate for Payer: Cigna Medicare Advantage |
$13.79
|
| Rate for Payer: Clover Medicare Advantage |
$13.10
|
| Rate for Payer: EmblemHealth Commercial |
$41.37
|
| Rate for Payer: Humana Medicare Advantage |
$14.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.45
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.84
|
|
|
HISTO AB (HISTOPLASMA ANTIBODY
|
Facility
|
IP
|
$144.85
|
|
|
Service Code
|
HCPCS 86698
|
| Hospital Charge Code |
3009537
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.73 |
| Max. Negotiated Rate |
$21.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.73
|
|
|
HISTO BONE MARROW
|
Facility
|
OP
|
$692.10
|
|
|
Service Code
|
HCPCS 88305
|
| Hospital Charge Code |
3004488
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.34 |
| Max. Negotiated Rate |
$223.48 |
| Rate for Payer: Aetna Commercial |
$168.40
|
| Rate for Payer: Aetna Medicare Advantage |
$200.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$223.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$223.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$61.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$223.48
|
| Rate for Payer: Cigna Commercial |
$124.10
|
| Rate for Payer: Cigna Medicare Advantage |
$61.91
|
| Rate for Payer: Clover Medicare Advantage |
$58.81
|
| Rate for Payer: EmblemHealth Commercial |
$185.73
|
| Rate for Payer: Humana Medicare Advantage |
$63.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$61.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$207.63
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$57.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$61.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$61.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.34
|
|
|
HISTO BONE MARROW
|
Facility
|
IP
|
$692.10
|
|
|
Service Code
|
HCPCS 88305
|
| Hospital Charge Code |
3004488
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$103.81 |
| Max. Negotiated Rate |
$103.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.81
|
|
|
HISTO BONE MARROW BILL
|
Facility
|
OP
|
$692.10
|
|
|
Service Code
|
HCPCS 88305
|
| Hospital Charge Code |
3005213
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$18.34 |
| Max. Negotiated Rate |
$223.48 |
| Rate for Payer: Aetna Commercial |
$168.40
|
| Rate for Payer: Aetna Medicare Advantage |
$200.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$223.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$223.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$61.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$223.48
|
| Rate for Payer: Cigna Commercial |
$124.10
|
| Rate for Payer: Cigna Medicare Advantage |
$61.91
|
| Rate for Payer: Clover Medicare Advantage |
$58.81
|
| Rate for Payer: EmblemHealth Commercial |
$185.73
|
| Rate for Payer: Humana Medicare Advantage |
$63.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$61.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$207.63
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$57.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$61.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$61.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.34
|
|
|
HISTO BONE MARROW BILL
|
Facility
|
IP
|
$692.10
|
|
|
Service Code
|
HCPCS 88305
|
| Hospital Charge Code |
3005212
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$103.81 |
| Max. Negotiated Rate |
$103.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.81
|
|
|
HISTO BONE MARROW BILL
|
Facility
|
IP
|
$692.10
|
|
|
Service Code
|
HCPCS 88305
|
| Hospital Charge Code |
3005213
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$103.81 |
| Max. Negotiated Rate |
$103.81 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.81
|
|
|
HISTO BONE MARROW BILL
|
Facility
|
OP
|
$692.10
|
|
|
Service Code
|
HCPCS 88305
|
| Hospital Charge Code |
3005212
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.34 |
| Max. Negotiated Rate |
$223.48 |
| Rate for Payer: Aetna Commercial |
$168.40
|
| Rate for Payer: Aetna Medicare Advantage |
$200.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$223.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$223.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$61.91
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$223.48
|
| Rate for Payer: Cigna Commercial |
$124.10
|
| Rate for Payer: Cigna Medicare Advantage |
$61.91
|
| Rate for Payer: Clover Medicare Advantage |
$58.81
|
| Rate for Payer: EmblemHealth Commercial |
$185.73
|
| Rate for Payer: Humana Medicare Advantage |
$63.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$61.91
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$207.63
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$103.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$57.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$61.91
|
| Rate for Payer: Wellcare Medicare Advantage |
$61.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.34
|
|
|
HISTO GROSS
|
Facility
|
OP
|
$465.00
|
|
|
Service Code
|
HCPCS 88300
|
| Hospital Charge Code |
3004967
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$12.32 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: Aetna Commercial |
$93.46
|
| Rate for Payer: Aetna Medicare Advantage |
$111.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$124.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$124.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$34.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$124.03
|
| Rate for Payer: Cigna Commercial |
$68.87
|
| Rate for Payer: Cigna Medicare Advantage |
$34.36
|
| Rate for Payer: Clover Medicare Advantage |
$32.64
|
| Rate for Payer: EmblemHealth Commercial |
$103.08
|
| Rate for Payer: Humana Medicare Advantage |
$35.39
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$34.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$139.50
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$34.36
|
| Rate for Payer: Wellcare Medicare Advantage |
$34.36
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.32
|
|
|
HISTO GROSS
|
Facility
|
IP
|
$465.00
|
|
|
Service Code
|
HCPCS 88300
|
| Hospital Charge Code |
3004967
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$69.75 |
| Max. Negotiated Rate |
$69.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$69.75
|
|
|
HISTO KIDNEY BIOPSY AST
|
Facility
|
OP
|
$1,082.30
|
|
|
Service Code
|
HCPCS 88342
|
| Hospital Charge Code |
3005261
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.68 |
| Max. Negotiated Rate |
$730.60 |
| Rate for Payer: Aetna Commercial |
$550.53
|
| Rate for Payer: Aetna Medicare Advantage |
$655.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$730.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$730.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$202.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$730.60
|
| Rate for Payer: Cigna Commercial |
$405.73
|
| Rate for Payer: Cigna Medicare Advantage |
$202.40
|
| Rate for Payer: Clover Medicare Advantage |
$192.28
|
| Rate for Payer: EmblemHealth Commercial |
$607.20
|
| Rate for Payer: Humana Medicare Advantage |
$208.47
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$202.40
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$324.69
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$162.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$86.39
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$202.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$202.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$28.68
|
|
|
HISTO KIDNEY BIOPSY AST
|
Facility
|
IP
|
$1,082.30
|
|
|
Service Code
|
HCPCS 88342
|
| Hospital Charge Code |
3005261
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$162.34 |
| Max. Negotiated Rate |
$162.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$162.34
|
|
|
HISTONE ANTIBODY
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
39900457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
HISTONE ANTIBODY
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
39900457
|
|
Hospital Revenue Code
|
301
|
| 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 |
$17.42
|
| 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
|
|
|
HISTOPLASMA AB,ID
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86698
|
| Hospital Charge Code |
39900243
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$37.51
|
| Rate for Payer: Aetna Medicare Advantage |
$44.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.78
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$13.79
|
| Rate for Payer: Clover Medicare Advantage |
$13.10
|
| Rate for Payer: EmblemHealth Commercial |
$41.37
|
| Rate for Payer: Humana Medicare Advantage |
$14.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.79
|
| 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 |
$11.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
HISTOPLASMA AB,ID
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86698
|
| Hospital Charge Code |
39900243
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
HISTOPLASMA ANTIBODIES
|
Facility
|
IP
|
$88.54
|
|
|
Service Code
|
HCPCS 86698
|
| Hospital Charge Code |
38476040
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$13.28 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.28
|
|
|
HISTOPLASMA ANTIBODIES
|
Facility
|
OP
|
$88.54
|
|
|
Service Code
|
HCPCS 86698
|
| Hospital Charge Code |
38476040
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$37.51
|
| Rate for Payer: Aetna Medicare Advantage |
$44.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.78
|
| Rate for Payer: Cigna Commercial |
$44.27
|
| Rate for Payer: Cigna Medicare Advantage |
$13.79
|
| Rate for Payer: Clover Medicare Advantage |
$13.10
|
| Rate for Payer: EmblemHealth Commercial |
$41.37
|
| Rate for Payer: Humana Medicare Advantage |
$14.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.56
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.35
|
|
|
HISTOPLASMA ANTIBODY PROFILE 1
|
Facility
|
IP
|
$144.85
|
|
|
Service Code
|
HCPCS 86698
|
| Hospital Charge Code |
3009628A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.73 |
| Max. Negotiated Rate |
$21.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.73
|
|
|
HISTOPLASMA ANTIBODY PROFILE 1
|
Facility
|
OP
|
$144.85
|
|
|
Service Code
|
HCPCS 86698
|
| Hospital Charge Code |
3009628A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$37.51
|
| Rate for Payer: Aetna Medicare Advantage |
$44.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.78
|
| Rate for Payer: Cigna Commercial |
$72.42
|
| Rate for Payer: Cigna Medicare Advantage |
$13.79
|
| Rate for Payer: Clover Medicare Advantage |
$13.10
|
| Rate for Payer: EmblemHealth Commercial |
$41.37
|
| Rate for Payer: Humana Medicare Advantage |
$14.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.45
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.84
|
|
|
HISTOPLASMA ANTIBODY PROFILE 2
|
Facility
|
IP
|
$144.85
|
|
|
Service Code
|
HCPCS 86698
|
| Hospital Charge Code |
3009628B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.73 |
| Max. Negotiated Rate |
$21.73 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.73
|
|
|
HISTOPLASMA ANTIBODY PROFILE 2
|
Facility
|
OP
|
$144.85
|
|
|
Service Code
|
HCPCS 86698
|
| Hospital Charge Code |
3009628B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.84 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$37.51
|
| Rate for Payer: Aetna Medicare Advantage |
$44.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.78
|
| Rate for Payer: Cigna Commercial |
$72.42
|
| Rate for Payer: Cigna Medicare Advantage |
$13.79
|
| Rate for Payer: Clover Medicare Advantage |
$13.10
|
| Rate for Payer: EmblemHealth Commercial |
$41.37
|
| Rate for Payer: Humana Medicare Advantage |
$14.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$43.45
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.84
|
|
