|
HIV-1 RNA QUAL WITH REFLEX TO
|
Facility
|
OP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
3990434
|
|
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 WITH REFLEX TO
|
Facility
|
IP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
3990434
|
|
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 WITH REFLEX TO
|
Facility
|
IP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
39900434
|
|
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 WITH REFLEX TO
|
Facility
|
OP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
39900434
|
|
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 VIRT1
|
Facility
|
OP
|
$892.00
|
|
|
Service Code
|
HCPCS 87900
|
| Hospital Charge Code |
3035078A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$470.52 |
| Rate for Payer: Aetna Commercial |
$354.55
|
| Rate for Payer: Aetna Medicare Advantage |
$422.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$470.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$470.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$130.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$142.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$470.52
|
| Rate for Payer: Cigna Commercial |
$446.00
|
| Rate for Payer: Cigna Medicare Advantage |
$130.35
|
| Rate for Payer: Clover Medicare Advantage |
$123.83
|
| Rate for Payer: EmblemHealth Commercial |
$391.05
|
| Rate for Payer: Humana Medicare Advantage |
$134.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$130.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$267.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$104.28
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$130.35
|
| Rate for Payer: Wellcare Medicare Advantage |
$130.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.64
|
|
|
HIV-1 VIRT1
|
Facility
|
IP
|
$892.00
|
|
|
Service Code
|
HCPCS 87900
|
| Hospital Charge Code |
3035078A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$133.80 |
| Max. Negotiated Rate |
$133.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.80
|
|
|
HIV-1 VIRT2
|
Facility
|
OP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 87901
|
| Hospital Charge Code |
3035078B
|
|
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 VIRT2
|
Facility
|
IP
|
$2,000.00
|
|
|
Service Code
|
HCPCS 87901
|
| Hospital Charge Code |
3035078B
|
|
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 VIRTPHENO W/ INTERPRET.
|
Facility
|
IP
|
$1,784.00
|
|
| Hospital Charge Code |
3035078
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$267.60 |
| Max. Negotiated Rate |
$267.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$267.60
|
|
|
HIV-1 VIRTPHENO W/ INTERPRET.
|
Facility
|
OP
|
$1,784.00
|
|
| Hospital Charge Code |
3035078
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.99 |
| Max. Negotiated Rate |
$892.00 |
| Rate for Payer: Aetna Commercial |
$677.92
|
| Rate for Payer: Aetna Medicare Advantage |
$535.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$454.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$454.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$454.92
|
| Rate for Payer: Cigna Commercial |
$892.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$535.20
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$267.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$42.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$47.28
|
|
|
HIV-2 ABS
|
Facility
|
IP
|
$139.25
|
|
|
Service Code
|
HCPCS 86702
|
| Hospital Charge Code |
3032330
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$20.89 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.89
|
|
|
HIV-2 ABS
|
Facility
|
OP
|
$139.25
|
|
|
Service Code
|
HCPCS 86702
|
| Hospital Charge Code |
3032330
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.69 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$36.77
|
| Rate for Payer: Aetna Medicare Advantage |
$43.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.52
|
| 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 |
$48.80
|
| Rate for Payer: Cigna Commercial |
$69.62
|
| Rate for Payer: Cigna Medicare Advantage |
$13.52
|
| Rate for Payer: Clover Medicare Advantage |
$12.84
|
| Rate for Payer: EmblemHealth Commercial |
$40.56
|
| Rate for Payer: Humana Medicare Advantage |
$13.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.52
|
| 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 |
$10.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.69
|
|
|
HIV-2 AB,WESTERN BLOT
|
Facility
|
IP
|
$646.00
|
|
|
Service Code
|
HCPCS 86689
|
| Hospital Charge Code |
38476268
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$96.90 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.90
|
|
|
HIV-2 AB,WESTERN BLOT
|
Facility
|
OP
|
$646.00
|
|
|
Service Code
|
HCPCS 86689
|
| Hospital Charge Code |
38476268
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.48 |
| Max. Negotiated Rate |
$323.00 |
| Rate for Payer: Aetna Commercial |
$52.63
|
| Rate for Payer: Aetna Medicare Advantage |
$62.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$69.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$69.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$19.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$69.85
|
| Rate for Payer: Cigna Commercial |
$323.00
|
| Rate for Payer: Cigna Medicare Advantage |
$19.35
|
| Rate for Payer: Clover Medicare Advantage |
$18.38
|
| Rate for Payer: EmblemHealth Commercial |
$58.05
|
| Rate for Payer: Humana Medicare Advantage |
$19.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$19.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$193.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$19.35
|
| Rate for Payer: Wellcare Medicare Advantage |
$19.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.12
|
|
|
HIV2 PROBE REVRSE TRNSCRIPJ
|
Facility
|
IP
|
$437.57
|
|
|
Service Code
|
HCPCS 87538
|
| Hospital Charge Code |
401187538
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$65.64 |
| Max. Negotiated Rate |
$65.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.64
|
|
|
HIV2 PROBE REVRSE TRNSCRIPJ
|
Facility
|
OP
|
$437.57
|
|
|
Service Code
|
HCPCS 87538
|
| Hospital Charge Code |
401187538
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$218.78 |
| 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 |
$218.78
|
| 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 |
$131.27
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.64
|
| 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 |
$11.60
|
|
|
HIV AB W/CONF P24, HTLV
|
Facility
|
IP
|
$246.45
|
|
|
Service Code
|
HCPCS 86689
|
| Hospital Charge Code |
3006657
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.97 |
| Max. Negotiated Rate |
$36.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.97
|
|
|
HIV AB W/CONF P24, HTLV
|
Facility
|
OP
|
$246.45
|
|
|
Service Code
|
HCPCS 86689
|
| Hospital Charge Code |
3006657
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$52.63
|
| Rate for Payer: Aetna Medicare Advantage |
$62.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$69.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$69.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$19.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$41.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$69.85
|
| Rate for Payer: Cigna Commercial |
$123.22
|
| Rate for Payer: Cigna Medicare Advantage |
$19.35
|
| Rate for Payer: Clover Medicare Advantage |
$18.38
|
| Rate for Payer: EmblemHealth Commercial |
$58.05
|
| Rate for Payer: Humana Medicare Advantage |
$19.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$19.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$73.94
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$19.35
|
| Rate for Payer: Wellcare Medicare Advantage |
$19.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.53
|
|
|
HIVAC 7 SINGLE/DOUBLE CEM INJ
|
Facility
|
IP
|
$1,175.00
|
|
| Hospital Charge Code |
270678234
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$176.25 |
| Max. Negotiated Rate |
$176.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$176.25
|
|
|
HIVAC 7 SINGLE/DOUBLE CEM INJ
|
Facility
|
OP
|
$1,175.00
|
|
| Hospital Charge Code |
270678234
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$28.32 |
| Max. Negotiated Rate |
$587.50 |
| Rate for Payer: Aetna Commercial |
$446.50
|
| Rate for Payer: Aetna Medicare Advantage |
$352.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$299.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$299.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$299.62
|
| Rate for Payer: Cigna Commercial |
$587.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$352.50
|
| Rate for Payer: Oxford Commercial |
$235.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$176.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$235.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.14
|
|
|
HIV DNA BY PCR
|
Facility
|
IP
|
$414.45
|
|
|
Service Code
|
HCPCS 87535
|
| Hospital Charge Code |
3000817
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.17 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
|
|
HIV DNA BY PCR
|
Facility
|
OP
|
$414.45
|
|
|
Service Code
|
HCPCS 87535
|
| Hospital Charge Code |
3000817
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.98 |
| Max. Negotiated Rate |
$207.22 |
| 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 |
$207.22
|
| 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 |
$124.33
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.17
|
| 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 |
$10.98
|
|
|
HIV - ENZYME IMMUNOASSAY
|
Facility
|
IP
|
$1,066.43
|
|
|
Service Code
|
HCPCS 87390
|
| Hospital Charge Code |
3000818
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$159.96 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$159.96
|
|
|
HIV - ENZYME IMMUNOASSAY
|
Facility
|
OP
|
$1,066.43
|
|
|
Service Code
|
HCPCS 87390
|
| Hospital Charge Code |
3000818
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.25 |
| Max. Negotiated Rate |
$533.22 |
| 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 |
$533.22
|
| 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 |
$319.93
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$159.96
|
| 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 |
$28.26
|
|
|
HIV GENOSURE MG
|
Facility
|
OP
|
$892.00
|
|
|
Service Code
|
HCPCS 87900
|
| Hospital Charge Code |
3038078
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$470.52 |
| Rate for Payer: Aetna Commercial |
$354.55
|
| Rate for Payer: Aetna Medicare Advantage |
$422.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$470.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$470.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$130.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$142.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$470.52
|
| Rate for Payer: Cigna Commercial |
$446.00
|
| Rate for Payer: Cigna Medicare Advantage |
$130.35
|
| Rate for Payer: Clover Medicare Advantage |
$123.83
|
| Rate for Payer: EmblemHealth Commercial |
$391.05
|
| Rate for Payer: Humana Medicare Advantage |
$134.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$130.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$267.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$133.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$104.28
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$130.35
|
| Rate for Payer: Wellcare Medicare Advantage |
$130.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$23.64
|
|
