|
JC/BK VIRUS RAPID PCR
|
Facility
|
OP
|
$260.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
3009260
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.89 |
| Max. Negotiated Rate |
$153.02 |
| 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 |
$153.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$126.66
|
| Rate for Payer: Cigna Commercial |
$130.00
|
| 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 |
$78.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$39.00
|
| 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 |
$6.89
|
|
|
JC/BK VIRUS,RAPID PCR. I
|
Facility
|
IP
|
$241.20
|
|
|
Service Code
|
HCPCS 8779891
|
| Hospital Charge Code |
39990057A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.18 |
| Max. Negotiated Rate |
$36.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.18
|
|
|
JC/BK VIRUS,RAPID PCR. I
|
Facility
|
OP
|
$241.20
|
|
|
Service Code
|
HCPCS 8779891
|
| Hospital Charge Code |
39990057A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.81 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$91.66
|
| Rate for Payer: Aetna Medicare Advantage |
$72.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.51
|
| Rate for Payer: Cigna Commercial |
$120.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.36
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.39
|
|
|
JC/BK VIRUS,RAPID PCR. II
|
Facility
|
IP
|
$241.20
|
|
|
Service Code
|
HCPCS 8779891
|
| Hospital Charge Code |
39990057B
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.18 |
| Max. Negotiated Rate |
$36.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.18
|
|
|
JC/BK VIRUS,RAPID PCR. II
|
Facility
|
OP
|
$241.20
|
|
|
Service Code
|
HCPCS 8779891
|
| Hospital Charge Code |
39990057B
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.81 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$91.66
|
| Rate for Payer: Aetna Medicare Advantage |
$72.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61.51
|
| Rate for Payer: Cigna Commercial |
$120.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$72.36
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$36.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.81
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.39
|
|
|
JC POLYOMA VIRUS DAN URINE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87799
|
| Hospital Charge Code |
39708011
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$116.52
|
| Rate for Payer: Aetna Medicare Advantage |
$138.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$154.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$154.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$42.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$154.64
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$42.84
|
| Rate for Payer: Clover Medicare Advantage |
$40.70
|
| Rate for Payer: EmblemHealth Commercial |
$128.52
|
| Rate for Payer: Humana Medicare Advantage |
$44.13
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$42.84
|
| 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 |
$34.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$42.84
|
| Rate for Payer: Wellcare Medicare Advantage |
$42.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
JC POLYOMA VIRUS DAN URINE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87799
|
| Hospital Charge Code |
39708011
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
JC POLYOMA VIRUS DNA RT PCR CF
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87799
|
| Hospital Charge Code |
401387799
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
JC POLYOMA VIRUS DNA RT PCR CF
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87799
|
| Hospital Charge Code |
401387799
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$116.52
|
| Rate for Payer: Aetna Medicare Advantage |
$138.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$154.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$154.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$42.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$154.64
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$42.84
|
| Rate for Payer: Clover Medicare Advantage |
$40.70
|
| Rate for Payer: EmblemHealth Commercial |
$128.52
|
| Rate for Payer: Humana Medicare Advantage |
$44.13
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$42.84
|
| 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 |
$34.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$42.84
|
| Rate for Payer: Wellcare Medicare Advantage |
$42.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
JET 7 Kit
|
Facility
|
IP
|
$13,975.00
|
|
| Hospital Charge Code |
270685060N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,096.25 |
| Max. Negotiated Rate |
$2,096.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,096.25
|
|
|
JET 7 Kit
|
Facility
|
OP
|
$13,975.00
|
|
| Hospital Charge Code |
270685060N
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$336.80 |
| Max. Negotiated Rate |
$6,987.50 |
| Rate for Payer: Aetna Commercial |
$5,310.50
|
| Rate for Payer: Aetna Medicare Advantage |
$4,192.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,563.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,563.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,563.62
|
| Rate for Payer: Cigna Commercial |
$6,987.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,192.50
|
| Rate for Payer: Oxford Commercial |
$2,795.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,096.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,795.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$336.80
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$370.34
|
|
|
JETWIRE JETSTREAM
|
Facility
|
IP
|
$500.00
|
|
| Hospital Charge Code |
270675788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
|
|
JETWIRE JETSTREAM
|
Facility
|
OP
|
$500.00
|
|
| Hospital Charge Code |
270675788
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.05 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: Aetna Commercial |
$190.00
|
| Rate for Payer: Aetna Medicare Advantage |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$127.50
|
| Rate for Payer: Cigna Commercial |
$250.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$150.00
|
| Rate for Payer: Oxford Commercial |
$100.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$100.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.25
|
|
|
JEVITY
|
Facility
|
IP
|
$23.00
|
|
| Hospital Charge Code |
60634851
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.45 |
| Max. Negotiated Rate |
$3.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.45
|
|
|
JEVITY
|
Facility
|
OP
|
$23.00
|
|
| Hospital Charge Code |
60634851
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$11.50 |
| Rate for Payer: Aetna Commercial |
$8.74
|
| Rate for Payer: Aetna Medicare Advantage |
$6.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.87
|
| Rate for Payer: Cigna Commercial |
$11.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.90
|
| Rate for Payer: Oxford Commercial |
$4.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$4.60
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.55
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.61
|
|
|
JEVITY PLUS
|
Facility
|
OP
|
$6.00
|
|
| Hospital Charge Code |
60635158
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Aetna Commercial |
$2.28
|
| Rate for Payer: Aetna Medicare Advantage |
$1.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.53
|
| Rate for Payer: Cigna Commercial |
$3.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.80
|
| Rate for Payer: Oxford Commercial |
$1.20
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$1.20
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.14
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.16
|
|
|
JEVITY PLUS
|
Facility
|
IP
|
$6.00
|
|
| Hospital Charge Code |
60635158
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$0.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.90
|
|
|
JEWETT BRACE STANDARD
|
Facility
|
IP
|
$2,068.85
|
|
| Hospital Charge Code |
270613129
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$310.33 |
| Max. Negotiated Rate |
$500.66 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$413.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$500.66
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$455.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$310.33
|
|
|
JEWETT BRACE STANDARD
|
Facility
|
OP
|
$2,068.85
|
|
| Hospital Charge Code |
270613129
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$49.86 |
| Max. Negotiated Rate |
$1,034.42 |
| Rate for Payer: Aetna Commercial |
$786.16
|
| Rate for Payer: Aetna Medicare Advantage |
$620.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$527.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$527.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$413.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$527.56
|
| Rate for Payer: Cigna Commercial |
$1,034.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$500.66
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$455.15
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$310.33
|
| Rate for Payer: UnitedHealthcare Community & State |
$49.86
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$54.82
|
|
|
JGRKNT2.9MM #2 BLUE MB
|
Facility
|
IP
|
$2,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$427.50 |
| Max. Negotiated Rate |
$689.70 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$570.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$689.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$627.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$427.50
|
|
|
JGRKNT2.9MM #2 BLUE MB
|
Facility
|
OP
|
$2,850.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
270681524
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$68.69 |
| Max. Negotiated Rate |
$1,425.00 |
| Rate for Payer: Aetna Commercial |
$1,083.00
|
| Rate for Payer: Aetna Medicare Advantage |
$855.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$726.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$726.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$570.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$726.75
|
| Rate for Payer: Cigna Commercial |
$1,425.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$689.70
|
| Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan |
$627.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$427.50
|
| Rate for Payer: UnitedHealthcare Community & State |
$68.69
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$75.53
|
|
|
JO-1 AB
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
39900363
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
JO-1 AB
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
39900363
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$48.77
|
| Rate for Payer: Aetna Medicare Advantage |
$58.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$64.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$64.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$64.72
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$17.93
|
| Rate for Payer: Clover Medicare Advantage |
$17.03
|
| Rate for Payer: EmblemHealth Commercial |
$53.79
|
| Rate for Payer: Humana Medicare Advantage |
$18.47
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.93
|
| 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 |
$14.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
JO-1-ANTIBODY
|
Facility
|
OP
|
$476.00
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
38476207
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.61 |
| Max. Negotiated Rate |
$238.00 |
| Rate for Payer: Aetna Commercial |
$48.77
|
| Rate for Payer: Aetna Medicare Advantage |
$58.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$64.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$64.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$64.72
|
| Rate for Payer: Cigna Commercial |
$238.00
|
| Rate for Payer: Cigna Medicare Advantage |
$17.93
|
| Rate for Payer: Clover Medicare Advantage |
$17.03
|
| Rate for Payer: EmblemHealth Commercial |
$53.79
|
| Rate for Payer: Humana Medicare Advantage |
$18.47
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$142.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.61
|
|
|
JO-1-ANTIBODY
|
Facility
|
IP
|
$476.00
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
38476207
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$71.40 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$71.40
|
|