|
ANTI-SARS-COV2-IGG QUALIT
|
Facility
|
IP
|
$169.00
|
|
|
Service Code
|
HCPCS 86769
|
| Hospital Charge Code |
40138679A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.35
|
|
|
ANTI-SARS-COV2-IGG QUALIT
|
Facility
|
OP
|
$169.00
|
|
|
Service Code
|
HCPCS 86769
|
| Hospital Charge Code |
40138679A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$152.08 |
| Rate for Payer: Aetna Commercial |
$114.59
|
| Rate for Payer: Aetna Medicare Advantage |
$136.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$152.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$152.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$42.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$81.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$152.08
|
| Rate for Payer: Cigna Commercial |
$84.50
|
| Rate for Payer: Cigna Medicare Advantage |
$42.13
|
| Rate for Payer: Clover Medicare Advantage |
$40.02
|
| Rate for Payer: EmblemHealth Commercial |
$126.39
|
| Rate for Payer: Humana Medicare Advantage |
$43.39
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$42.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$42.13
|
| Rate for Payer: Wellcare Medicare Advantage |
$42.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.48
|
|
|
ANTI-SARS-COV2-TOTAL (IGG-IGM)
|
Facility
|
OP
|
$169.00
|
|
|
Service Code
|
HCPCS 86769
|
| Hospital Charge Code |
40138679B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.48 |
| Max. Negotiated Rate |
$152.08 |
| Rate for Payer: Aetna Commercial |
$114.59
|
| Rate for Payer: Aetna Medicare Advantage |
$136.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$152.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$152.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$42.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$81.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$152.08
|
| Rate for Payer: Cigna Commercial |
$84.50
|
| Rate for Payer: Cigna Medicare Advantage |
$42.13
|
| Rate for Payer: Clover Medicare Advantage |
$40.02
|
| Rate for Payer: EmblemHealth Commercial |
$126.39
|
| Rate for Payer: Humana Medicare Advantage |
$43.39
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$42.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$50.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$33.70
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$42.13
|
| Rate for Payer: Wellcare Medicare Advantage |
$42.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.48
|
|
|
ANTI-SARS-COV2-TOTAL (IGG-IGM)
|
Facility
|
IP
|
$169.00
|
|
|
Service Code
|
HCPCS 86769
|
| Hospital Charge Code |
40138679B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.35 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$25.35
|
|
|
ANTISPERM ANTIBODIES
|
Facility
|
IP
|
$226.45
|
|
|
Service Code
|
HCPCS 89325
|
| Hospital Charge Code |
3002521
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$33.97 |
| Max. Negotiated Rate |
$33.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.97
|
|
|
ANTISPERM ANTIBODIES
|
Facility
|
OP
|
$226.45
|
|
|
Service Code
|
HCPCS 89325
|
| Hospital Charge Code |
3002521
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$29.02
|
| Rate for Payer: Aetna Medicare Advantage |
$34.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.52
|
| Rate for Payer: Cigna Commercial |
$113.22
|
| Rate for Payer: Cigna Medicare Advantage |
$10.67
|
| Rate for Payer: Clover Medicare Advantage |
$10.14
|
| Rate for Payer: EmblemHealth Commercial |
$32.01
|
| Rate for Payer: Humana Medicare Advantage |
$10.99
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$67.94
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.54
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.00
|
|
|
ANTISTREPTOLYSIN (ASO TITER)**
|
Facility
|
OP
|
$32.00
|
|
| Hospital Charge Code |
3010337
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$12.16
|
| Rate for Payer: Aetna Medicare Advantage |
$9.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$8.16
|
| Rate for Payer: Cigna Commercial |
$16.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.85
|
|
|
ANTISTREPTOLYSIN (ASO TITER)**
|
Facility
|
IP
|
$32.00
|
|
| Hospital Charge Code |
3010337
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$4.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.80
|
|
|
ANTI STREPTOLYSIN O
|
Facility
|
IP
|
$292.00
|
|
|
Service Code
|
HCPCS 86063
|
| Hospital Charge Code |
38476006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.80 |
| Max. Negotiated Rate |
$43.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.80
|
|
|
ANTI STREPTOLYSIN O
|
Facility
|
OP
|
$292.00
|
|
|
Service Code
|
HCPCS 86063
|
| Hospital Charge Code |
38476006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.32 |
| Max. Negotiated Rate |
$146.00 |
| Rate for Payer: Aetna Commercial |
$15.69
|
| Rate for Payer: Aetna Medicare Advantage |
$18.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$20.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$20.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$20.83
|
| Rate for Payer: Cigna Commercial |
$146.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.77
|
| Rate for Payer: Clover Medicare Advantage |
$5.48
|
| Rate for Payer: EmblemHealth Commercial |
$17.31
|
| Rate for Payer: Humana Medicare Advantage |
$5.94
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$87.60
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.74
|
|
|
ANTI STREPTOLYSIN O TITER
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
HCPCS 86060
|
| Hospital Charge Code |
3000338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$19.86
|
| Rate for Payer: Aetna Medicare Advantage |
$23.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.35
|
| Rate for Payer: Cigna Commercial |
$50.00
|
| Rate for Payer: Cigna Medicare Advantage |
$7.30
|
| Rate for Payer: Clover Medicare Advantage |
$6.93
|
| Rate for Payer: EmblemHealth Commercial |
$21.90
|
| Rate for Payer: Humana Medicare Advantage |
$7.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7.30
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.84
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7.30
|
| Rate for Payer: Wellcare Medicare Advantage |
$7.30
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.65
|
|
|
ANTI STREPTOLYSIN O TITER
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
HCPCS 86060
|
| Hospital Charge Code |
3000338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
|
|
ANTI-STRIATED AB SCREEN
|
Facility
|
OP
|
$121.00
|
|
|
Service Code
|
HCPCS 86255
|
| Hospital Charge Code |
3030335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$124.00 |
| 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 |
$15.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$60.50
|
| 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 |
$36.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.15
|
| 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 |
$3.21
|
|
|
ANTI-STRIATED AB SCREEN
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
HCPCS 86255
|
| Hospital Charge Code |
3030335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.15 |
| Max. Negotiated Rate |
$18.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.15
|
|
|
Antithrombin Activity
|
Facility
|
IP
|
$81.45
|
|
|
Service Code
|
HCPCS 85300
|
| Hospital Charge Code |
39888015
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.22 |
| Max. Negotiated Rate |
$12.22 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.22
|
|
|
Antithrombin Activity
|
Facility
|
OP
|
$81.45
|
|
|
Service Code
|
HCPCS 85300
|
| Hospital Charge Code |
39888015
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$32.23
|
| Rate for Payer: Aetna Medicare Advantage |
$38.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.85
|
| 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 |
$42.77
|
| Rate for Payer: Cigna Commercial |
$40.73
|
| Rate for Payer: Cigna Medicare Advantage |
$11.85
|
| Rate for Payer: Clover Medicare Advantage |
$11.26
|
| Rate for Payer: EmblemHealth Commercial |
$35.55
|
| Rate for Payer: Humana Medicare Advantage |
$12.21
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.43
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.16
|
|
|
ANTI-THROMBIN III
|
Facility
|
IP
|
$296.00
|
|
|
Service Code
|
HCPCS 85301
|
| Hospital Charge Code |
38478056
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$44.40 |
| Max. Negotiated Rate |
$44.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.40
|
|
|
ANTI-THROMBIN III
|
Facility
|
OP
|
$296.00
|
|
|
Service Code
|
HCPCS 85301
|
| Hospital Charge Code |
38478056
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.84 |
| Max. Negotiated Rate |
$148.00 |
| Rate for Payer: Aetna Commercial |
$29.40
|
| Rate for Payer: Aetna Medicare Advantage |
$35.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.02
|
| Rate for Payer: Cigna Commercial |
$148.00
|
| Rate for Payer: Cigna Medicare Advantage |
$10.81
|
| Rate for Payer: Clover Medicare Advantage |
$10.27
|
| Rate for Payer: EmblemHealth Commercial |
$32.43
|
| Rate for Payer: Humana Medicare Advantage |
$11.13
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$88.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.84
|
|
|
ANTI-THROMBIN III,ACTIVIT
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 85300
|
| Hospital Charge Code |
39900163
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.48 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$32.23
|
| Rate for Payer: Aetna Medicare Advantage |
$38.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.85
|
| 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 |
$42.77
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$11.85
|
| Rate for Payer: Clover Medicare Advantage |
$11.26
|
| Rate for Payer: EmblemHealth Commercial |
$35.55
|
| Rate for Payer: Humana Medicare Advantage |
$12.21
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.85
|
| 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 |
$9.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.69
|
|
|
ANTI-THROMBIN III,ACTIVIT
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 85300
|
| Hospital Charge Code |
39900163
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
ANTITHROMBIN III ACTIVITY
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 85300
|
| Hospital Charge Code |
401485300
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.48 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$32.23
|
| Rate for Payer: Aetna Medicare Advantage |
$38.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.85
|
| 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 |
$42.77
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.85
|
| Rate for Payer: Clover Medicare Advantage |
$11.26
|
| Rate for Payer: EmblemHealth Commercial |
$35.55
|
| Rate for Payer: Humana Medicare Advantage |
$12.21
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.85
|
| 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 |
$9.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.85
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.85
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
ANTITHROMBIN III ACTIVITY
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 85300
|
| Hospital Charge Code |
401485300
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ANTI THROMBIN III, ANTIGEN
|
Facility
|
OP
|
$256.00
|
|
|
Service Code
|
HCPCS 85301
|
| Hospital Charge Code |
3007135B
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.78 |
| Max. Negotiated Rate |
$128.00 |
| Rate for Payer: Aetna Commercial |
$29.40
|
| Rate for Payer: Aetna Medicare Advantage |
$35.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.02
|
| Rate for Payer: Cigna Commercial |
$128.00
|
| Rate for Payer: Cigna Medicare Advantage |
$10.81
|
| Rate for Payer: Clover Medicare Advantage |
$10.27
|
| Rate for Payer: EmblemHealth Commercial |
$32.43
|
| Rate for Payer: Humana Medicare Advantage |
$11.13
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.78
|
|
|
ANTI THROMBIN III, ANTIGEN
|
Facility
|
IP
|
$256.00
|
|
|
Service Code
|
HCPCS 85301
|
| Hospital Charge Code |
3007135B
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$38.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.40
|
|
|
ANTI-THROMBIN III,ANTIGEN
|
Facility
|
OP
|
$74.30
|
|
|
Service Code
|
HCPCS 85301
|
| Hospital Charge Code |
39900164
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$29.40
|
| Rate for Payer: Aetna Medicare Advantage |
$35.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39.02
|
| Rate for Payer: Cigna Commercial |
$37.15
|
| Rate for Payer: Cigna Medicare Advantage |
$10.81
|
| Rate for Payer: Clover Medicare Advantage |
$10.27
|
| Rate for Payer: EmblemHealth Commercial |
$32.43
|
| Rate for Payer: Humana Medicare Advantage |
$11.13
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.81
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.29
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.65
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.81
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.97
|
|
