|
ANTIB;LYMPHOCYTC CHORIOMENINGI
|
Facility
|
OP
|
$91.00
|
|
|
Service Code
|
HCPCS 86727
|
| Hospital Charge Code |
38477108
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$124.00 |
| 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 |
$29.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.46
|
| Rate for Payer: Cigna Commercial |
$45.50
|
| 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 |
$27.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.65
|
| 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 |
$2.41
|
|
|
ANTIBODY,ACTINOMYCES
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
HCPCS 86602
|
| Hospital Charge Code |
38477066
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
|
|
ANTIBODY,ACTINOMYCES
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
HCPCS 86602
|
| Hospital Charge Code |
38477066
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.91 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$27.69
|
| Rate for Payer: Aetna Medicare Advantage |
$32.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.75
|
| Rate for Payer: Cigna Commercial |
$36.00
|
| Rate for Payer: Cigna Medicare Advantage |
$10.18
|
| Rate for Payer: Clover Medicare Advantage |
$9.67
|
| Rate for Payer: EmblemHealth Commercial |
$30.54
|
| Rate for Payer: Humana Medicare Advantage |
$10.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.91
|
|
|
ANTIBODY AUTOABSORPTION, COLD
|
Facility
|
IP
|
$80.00
|
|
| Hospital Charge Code |
3100179
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.00
|
|
|
ANTIBODY AUTOABSORPTION, COLD
|
Facility
|
OP
|
$80.00
|
|
| Hospital Charge Code |
3100179
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.93 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$30.40
|
| Rate for Payer: Aetna Medicare Advantage |
$24.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.40
|
| Rate for Payer: Cigna Commercial |
$40.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$1.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.12
|
|
|
ANTIBODY,BACTERIUM,NOT SPEC (1
|
Facility
|
IP
|
$91.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
38476264
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$13.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.65
|
|
|
ANTIBODY,BACTERIUM,NOT SPEC (1
|
Facility
|
OP
|
$91.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
38476264
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$35.03
|
| Rate for Payer: Aetna Medicare Advantage |
$41.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.88
|
| 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 |
$46.49
|
| Rate for Payer: Cigna Commercial |
$45.50
|
| Rate for Payer: Cigna Medicare Advantage |
$12.88
|
| Rate for Payer: Clover Medicare Advantage |
$12.24
|
| Rate for Payer: EmblemHealth Commercial |
$38.64
|
| Rate for Payer: Humana Medicare Advantage |
$13.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.41
|
|
|
ANTIBODY,BACTERIUM,NOT SPEC(2)
|
Facility
|
OP
|
$91.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
38476265
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$35.03
|
| Rate for Payer: Aetna Medicare Advantage |
$41.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.88
|
| 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 |
$46.49
|
| Rate for Payer: Cigna Commercial |
$45.50
|
| Rate for Payer: Cigna Medicare Advantage |
$12.88
|
| Rate for Payer: Clover Medicare Advantage |
$12.24
|
| Rate for Payer: EmblemHealth Commercial |
$38.64
|
| Rate for Payer: Humana Medicare Advantage |
$13.27
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.88
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.88
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.41
|
|
|
ANTIBODY,BACTERIUM,NOT SPEC(2)
|
Facility
|
IP
|
$91.00
|
|
|
Service Code
|
HCPCS 86609
|
| Hospital Charge Code |
38476265
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$13.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.65
|
|
|
ANTIBODY, BARTONELLA
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
38476307
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
|
|
ANTIBODY, BARTONELLA
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
HCPCS 86611
|
| Hospital Charge Code |
38476307
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.91 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$27.69
|
| Rate for Payer: Aetna Medicare Advantage |
$32.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.75
|
| Rate for Payer: Cigna Commercial |
$36.00
|
| Rate for Payer: Cigna Medicare Advantage |
$10.18
|
| Rate for Payer: Clover Medicare Advantage |
$9.67
|
| Rate for Payer: EmblemHealth Commercial |
$30.54
|
| Rate for Payer: Humana Medicare Advantage |
$10.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.91
|
|
|
ANTIBODY BORDETELLA I
|
Facility
|
OP
|
$131.65
|
|
|
Service Code
|
HCPCS 86615
|
| Hospital Charge Code |
3036003A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$35.88
|
| Rate for Payer: Aetna Medicare Advantage |
$42.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.19
|
| 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 |
$47.61
|
| Rate for Payer: Cigna Commercial |
$65.83
|
| Rate for Payer: Cigna Medicare Advantage |
$13.19
|
| Rate for Payer: Clover Medicare Advantage |
$12.53
|
| Rate for Payer: EmblemHealth Commercial |
$39.57
|
| Rate for Payer: Humana Medicare Advantage |
$13.59
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.19
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.49
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.19
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.49
|
|
|
ANTIBODY BORDETELLA I
|
Facility
|
IP
|
$131.65
|
|
|
Service Code
|
HCPCS 86615
|
| Hospital Charge Code |
3036003A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.75 |
| Max. Negotiated Rate |
$19.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.75
|
|
|
ANTIBODY BORDETELLA II
|
Facility
|
IP
|
$131.65
|
|
|
Service Code
|
HCPCS 86615
|
| Hospital Charge Code |
3036003B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.75 |
| Max. Negotiated Rate |
$19.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.75
|
|
|
ANTIBODY BORDETELLA II
|
Facility
|
OP
|
$131.65
|
|
|
Service Code
|
HCPCS 86615
|
| Hospital Charge Code |
3036003B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$35.88
|
| Rate for Payer: Aetna Medicare Advantage |
$42.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.19
|
| 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 |
$47.61
|
| Rate for Payer: Cigna Commercial |
$65.83
|
| Rate for Payer: Cigna Medicare Advantage |
$13.19
|
| Rate for Payer: Clover Medicare Advantage |
$12.53
|
| Rate for Payer: EmblemHealth Commercial |
$39.57
|
| Rate for Payer: Humana Medicare Advantage |
$13.59
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.19
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.49
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$19.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.19
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.19
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.49
|
|
|
ANTIBODY,COCCIDIODES
|
Facility
|
IP
|
$116.00
|
|
|
Service Code
|
HCPCS 86635
|
| Hospital Charge Code |
38479403
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.40 |
| Max. Negotiated Rate |
$17.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.40
|
|
|
ANTIBODY,COCCIDIODES
|
Facility
|
OP
|
$116.00
|
|
|
Service Code
|
HCPCS 86635
|
| Hospital Charge Code |
38479403
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$31.20
|
| Rate for Payer: Aetna Medicare Advantage |
$37.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.40
|
| Rate for Payer: Cigna Commercial |
$58.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.47
|
| Rate for Payer: Clover Medicare Advantage |
$10.90
|
| Rate for Payer: EmblemHealth Commercial |
$34.41
|
| Rate for Payer: Humana Medicare Advantage |
$11.81
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$34.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.07
|
|
|
ANTIBODY;DIPHTHERIA
|
Facility
|
IP
|
$107.70
|
|
|
Service Code
|
HCPCS 86648
|
| Hospital Charge Code |
38477129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.16 |
| Max. Negotiated Rate |
$16.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.16
|
|
|
ANTIBODY;DIPHTHERIA
|
Facility
|
OP
|
$107.70
|
|
|
Service Code
|
HCPCS 86648
|
| Hospital Charge Code |
38477129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.85 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$41.37
|
| Rate for Payer: Aetna Medicare Advantage |
$49.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.90
|
| Rate for Payer: Cigna Commercial |
$53.85
|
| Rate for Payer: Cigna Medicare Advantage |
$15.21
|
| Rate for Payer: Clover Medicare Advantage |
$14.45
|
| Rate for Payer: EmblemHealth Commercial |
$45.63
|
| Rate for Payer: Humana Medicare Advantage |
$15.67
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15.21
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.31
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15.21
|
| Rate for Payer: Wellcare Medicare Advantage |
$15.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.85
|
|
|
ANTIBODY, EHRLICHIA
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
HCPCS 86666
|
| Hospital Charge Code |
38476302
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.91 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$27.69
|
| Rate for Payer: Aetna Medicare Advantage |
$32.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.75
|
| Rate for Payer: Cigna Commercial |
$36.00
|
| Rate for Payer: Cigna Medicare Advantage |
$10.18
|
| Rate for Payer: Clover Medicare Advantage |
$9.67
|
| Rate for Payer: EmblemHealth Commercial |
$30.54
|
| Rate for Payer: Humana Medicare Advantage |
$10.49
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.91
|
|
|
ANTIBODY, EHRLICHIA
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
HCPCS 86666
|
| Hospital Charge Code |
38476302
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
|
|
ANTIBODY ELUTION
|
Facility
|
OP
|
$223.00
|
|
|
Service Code
|
HCPCS 86860
|
| Hospital Charge Code |
38471041
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.20 |
| 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) NJ Health |
$8.94
|
| 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 |
$66.90
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$202.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$202.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.91
|
|
|
ANTIBODY ELUTION
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 86860
|
| Hospital Charge Code |
3100187
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
ANTIBODY ELUTION
|
Facility
|
IP
|
$223.00
|
|
|
Service Code
|
HCPCS 86860
|
| Hospital Charge Code |
38471041
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.45 |
| Max. Negotiated Rate |
$33.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.45
|
|
|
ANTIBODY ELUTION
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 86860
|
| Hospital Charge Code |
3100187
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.20 |
| 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) NJ Health |
$8.94
|
| 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 |
$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 |
$4.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$202.40
|
| Rate for Payer: Wellcare Medicare Advantage |
$202.40
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.69
|
|
