Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HIV-1 DNA,PCR

Facility

$501.00

Service Code	HCPCS 87535
Hospital Charge Code	38476238
Hospital Revenue Code	306
Min. Negotiated Rate	$75.15
Max. Negotiated Rate	$75.15
Rate for Payer: Qualcare PPO/HMO/WC	$75.15

HIV-1 DNA Qualitative PCR

Facility

$2,309.05

Service Code	HCPCS 87535
Hospital Charge Code	401187535
Hospital Revenue Code	306
Min. Negotiated Rate	$346.36
Max. Negotiated Rate	$346.36
Rate for Payer: Qualcare PPO/HMO/WC	$346.36

HIV-1 DNA Qualitative PCR

Facility

$2,309.05

Service Code	HCPCS 87535
Hospital Charge Code	401187535
Hospital Revenue Code	306
Min. Negotiated Rate	$28.07
Max. Negotiated Rate	$1,154.53
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	$38.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$1,154.53
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	$692.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$346.36
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	$61.19

HIV-1 GENOTYPE

Facility

$1,769.40

Service Code	HCPCS 87901
Hospital Charge Code	39900406
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	$282.38
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

HIV-1 GENOTYPE

Facility

$2,000.00

Service Code	HCPCS 87901
Hospital Charge Code	3035082
Hospital Revenue Code	306
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

HIV-1 GENOTYPE

Facility

$1,769.40

Service Code	HCPCS 87901
Hospital Charge Code	39900406
Hospital Revenue Code	306
Min. Negotiated Rate	$265.41
Max. Negotiated Rate	$265.41
Rate for Payer: Qualcare PPO/HMO/WC	$265.41

HIV-1 GENOTYPE

Facility

$2,000.00

Service Code	HCPCS 87901
Hospital Charge Code	3035082
Hospital Revenue Code	306
Min. Negotiated Rate	$53.00
Max. Negotiated Rate	$1,000.00
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	$282.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$929.32
Rate for Payer: Cigna Commercial	$1,000.00
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	$600.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
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	$53.00

HIV-1 GENOTYPE RTI AND PI

Facility

$1,823.20

Service Code	HCPCS 87901
Hospital Charge Code	38476283
Hospital Revenue Code	306
Min. Negotiated Rate	$48.31
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	$282.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$929.32
Rate for Payer: Cigna Commercial	$911.60
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	$546.96
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$273.48
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	$48.31

HIV-1 GENOTYPE RTI AND PI

Facility

$1,823.20

Service Code	HCPCS 87901
Hospital Charge Code	38476283
Hospital Revenue Code	306
Min. Negotiated Rate	$273.48
Max. Negotiated Rate	$273.48
Rate for Payer: Qualcare PPO/HMO/WC	$273.48

HIV-1 INTEGRASE GENOTYPE

Facility

$1,092.00

Service Code	HCPCS 87906
Hospital Charge Code	397071377
Hospital Revenue Code	306
Min. Negotiated Rate	$163.80
Max. Negotiated Rate	$163.80
Rate for Payer: Qualcare PPO/HMO/WC	$163.80

HIV-1 INTEGRASE GENOTYPE

Facility

$1,092.00

Service Code	HCPCS 87906
Hospital Charge Code	397071377
Hospital Revenue Code	306
Min. Negotiated Rate	$28.94
Max. Negotiated Rate	$546.00
Rate for Payer: Aetna Commercial	$350.15
Rate for Payer: Aetna Medicare Advantage	$417.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$464.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$464.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$128.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$464.68
Rate for Payer: Cigna Commercial	$546.00
Rate for Payer: Cigna Medicare Advantage	$128.73
Rate for Payer: Clover Medicare Advantage	$122.29
Rate for Payer: EmblemHealth Commercial	$386.19
Rate for Payer: Humana Medicare Advantage	$132.59
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$128.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$327.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$102.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$128.73
Rate for Payer: Wellcare Medicare Advantage	$128.73
Rate for Payer: Wellpoint Medicaid Managed Care	$28.94

HIV-1P24 ANTIGEN

Facility

$623.00

Service Code	HCPCS 87390
Hospital Charge Code	38476204
Hospital Revenue Code	306
Min. Negotiated Rate	$93.45
Max. Negotiated Rate	$93.45
Rate for Payer: Qualcare PPO/HMO/WC	$93.45

HIV-1P24 ANTIGEN

Facility

$623.00

Service Code	HCPCS 87390
Hospital Charge Code	38476204
Hospital Revenue Code	306
Min. Negotiated Rate	$16.51
Max. Negotiated Rate	$311.50
Rate for Payer: Aetna Commercial	$65.44
Rate for Payer: Aetna Medicare Advantage	$77.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.85
Rate for Payer: Cigna Commercial	$311.50
Rate for Payer: Cigna Medicare Advantage	$24.06
Rate for Payer: Clover Medicare Advantage	$22.86
Rate for Payer: EmblemHealth Commercial	$72.18
Rate for Payer: Humana Medicare Advantage	$24.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$186.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$93.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.06
Rate for Payer: Wellcare Medicare Advantage	$24.06
Rate for Payer: Wellpoint Medicaid Managed Care	$16.51

HIV-1 QUANTIFICATION

Facility

$602.59

Service Code	HCPCS 87536
Hospital Charge Code	38476239
Hospital Revenue Code	306
Min. Negotiated Rate	$15.97
Max. Negotiated Rate	$307.19
Rate for Payer: Aetna Commercial	$231.47
Rate for Payer: Aetna Medicare Advantage	$275.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.19
Rate for Payer: Cigna Commercial	$301.30
Rate for Payer: Cigna Medicare Advantage	$85.10
Rate for Payer: Clover Medicare Advantage	$80.84
Rate for Payer: EmblemHealth Commercial	$255.30
Rate for Payer: Humana Medicare Advantage	$87.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.78
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.39
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$68.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.10
Rate for Payer: Wellcare Medicare Advantage	$85.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.97

HIV-1 QUANTIFICATION

Facility

$602.59

Service Code	HCPCS 87536
Hospital Charge Code	38476239
Hospital Revenue Code	306
Min. Negotiated Rate	$90.39
Max. Negotiated Rate	$90.39
Rate for Payer: Qualcare PPO/HMO/WC	$90.39

HIV 1 RNA

Facility

$584.80

Service Code	HCPCS 87536
Hospital Charge Code	39900397
Hospital Revenue Code	306
Min. Negotiated Rate	$15.50
Max. Negotiated Rate	$307.19
Rate for Payer: Aetna Commercial	$231.47
Rate for Payer: Aetna Medicare Advantage	$275.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.19
Rate for Payer: Cigna Commercial	$292.40
Rate for Payer: Cigna Medicare Advantage	$85.10
Rate for Payer: Clover Medicare Advantage	$80.84
Rate for Payer: EmblemHealth Commercial	$255.30
Rate for Payer: Humana Medicare Advantage	$87.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.72
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$68.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.10
Rate for Payer: Wellcare Medicare Advantage	$85.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

HIV 1 RNA

Facility

$584.80

Service Code	HCPCS 87536
Hospital Charge Code	39900397
Hospital Revenue Code	306
Min. Negotiated Rate	$87.72
Max. Negotiated Rate	$87.72
Rate for Payer: Qualcare PPO/HMO/WC	$87.72

HIV-1 RNA,BDNA (3RD GEN)

Facility

$602.59

Service Code	HCPCS 87536
Hospital Charge Code	38475114
Hospital Revenue Code	306
Min. Negotiated Rate	$90.39
Max. Negotiated Rate	$90.39
Rate for Payer: Qualcare PPO/HMO/WC	$90.39

HIV-1 RNA,BDNA (3RD GEN)

Facility

$602.59

Service Code	HCPCS 87536
Hospital Charge Code	38475114
Hospital Revenue Code	306
Min. Negotiated Rate	$15.97
Max. Negotiated Rate	$307.19
Rate for Payer: Aetna Commercial	$231.47
Rate for Payer: Aetna Medicare Advantage	$275.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.19
Rate for Payer: Cigna Commercial	$301.30
Rate for Payer: Cigna Medicare Advantage	$85.10
Rate for Payer: Clover Medicare Advantage	$80.84
Rate for Payer: EmblemHealth Commercial	$255.30
Rate for Payer: Humana Medicare Advantage	$87.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.78
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$90.39
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$68.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.10
Rate for Payer: Wellcare Medicare Advantage	$85.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.97

HIV-1 RNA QL TMA

Facility

$1,250.00

Service Code	HCPCS 87535
Hospital Charge Code	401087535
Hospital Revenue Code	306
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

HIV-1 RNA QL TMA

Facility

$1,250.00

Service Code	HCPCS 87535
Hospital Charge Code	401087535
Hospital Revenue Code	306
Min. Negotiated Rate	$28.07
Max. Negotiated Rate	$625.00
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	$38.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$625.00
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	$375.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
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	$33.12

HIV-1 RNA,QN RT-PCR,CSF

Facility

$584.80

Service Code	HCPCS 87536
Hospital Charge Code	39900398
Hospital Revenue Code	306
Min. Negotiated Rate	$15.50
Max. Negotiated Rate	$307.19
Rate for Payer: Aetna Commercial	$231.47
Rate for Payer: Aetna Medicare Advantage	$275.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.19
Rate for Payer: Cigna Commercial	$292.40
Rate for Payer: Cigna Medicare Advantage	$85.10
Rate for Payer: Clover Medicare Advantage	$80.84
Rate for Payer: EmblemHealth Commercial	$255.30
Rate for Payer: Humana Medicare Advantage	$87.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.72
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$68.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.10
Rate for Payer: Wellcare Medicare Advantage	$85.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

HIV-1 RNA,QN RT-PCR,CSF

Facility

$584.80

Service Code	HCPCS 87536
Hospital Charge Code	39900398
Hospital Revenue Code	306
Min. Negotiated Rate	$87.72
Max. Negotiated Rate	$87.72
Rate for Payer: Qualcare PPO/HMO/WC	$87.72

HIV -1 RNA QUAL REAL TIME PCR

Facility

$584.80

Service Code	HCPCS 87536
Hospital Charge Code	39900433
Hospital Revenue Code	306
Min. Negotiated Rate	$15.50
Max. Negotiated Rate	$307.19
Rate for Payer: Aetna Commercial	$231.47
Rate for Payer: Aetna Medicare Advantage	$275.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$226.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.19
Rate for Payer: Cigna Commercial	$292.40
Rate for Payer: Cigna Medicare Advantage	$85.10
Rate for Payer: Clover Medicare Advantage	$80.84
Rate for Payer: EmblemHealth Commercial	$255.30
Rate for Payer: Humana Medicare Advantage	$87.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.44
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.72
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$68.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.10
Rate for Payer: Wellcare Medicare Advantage	$85.10
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

HIV -1 RNA QUAL REAL TIME PCR

Facility

$584.80

Service Code	HCPCS 87536
Hospital Charge Code	39900433
Hospital Revenue Code	306
Min. Negotiated Rate	$87.72
Max. Negotiated Rate	$87.72
Rate for Payer: Qualcare PPO/HMO/WC	$87.72

Know your out-of-pocket cost for care.

All Charges