|
PARANEOPLASTIC AUTOANBD EVAL V
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070G
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.60 |
| 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 |
$24.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$49.00
|
| 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 |
$29.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| 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 |
$2.60
|
|
|
PARANEOPLASTIC AUTOANBD EVAL V
|
Facility
|
IP
|
$585.17
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
3038070E
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$87.78 |
| Max. Negotiated Rate |
$87.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.78
|
|
|
PARANEOPLASTIC AUTOANBD EVAL V
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070H
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.60 |
| 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 |
$24.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$49.00
|
| 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 |
$29.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| 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 |
$2.60
|
|
|
PARANEOPLASTIC AUTOANBD EVAL V
|
Facility
|
OP
|
$253.45
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
3038070F
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$126.72 |
| Rate for Payer: Aetna Commercial |
$46.97
|
| Rate for Payer: Aetna Medicare Advantage |
$55.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.34
|
| Rate for Payer: Cigna Commercial |
$126.72
|
| Rate for Payer: Cigna Medicare Advantage |
$17.27
|
| Rate for Payer: Clover Medicare Advantage |
$16.41
|
| Rate for Payer: EmblemHealth Commercial |
$51.81
|
| Rate for Payer: Humana Medicare Advantage |
$17.79
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.03
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.72
|
|
|
PARANEOPLASTIC AUTOANBD EVAL X
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070K
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.60 |
| 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 |
$24.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$49.00
|
| 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 |
$29.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| 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 |
$2.60
|
|
|
PARANEOPLASTIC AUTOANBD EVAL X
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070J
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.60 |
| 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 |
$24.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$49.00
|
| 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 |
$29.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| 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 |
$2.60
|
|
|
PARANEOPLASTIC AUTOANBD EVAL X
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070N
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.60 |
| 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 |
$24.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$49.00
|
| 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 |
$29.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| 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 |
$2.60
|
|
|
PARANEOPLASTIC AUTOANBD EVAL X
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070K
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
|
|
PARANEOPLASTIC AUTOANBD EVAL X
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070L
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
|
|
PARANEOPLASTIC AUTOANBD EVAL X
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070N
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
|
|
PARANEOPLASTIC AUTOANBD EVAL X
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070L
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.60 |
| 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 |
$24.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$49.00
|
| 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 |
$29.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| 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 |
$2.60
|
|
|
PARANEOPLASTIC AUTOANBD EVAL X
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070M
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
|
|
PARANEOPLASTIC AUTOANBD EVAL X
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070J
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
|
|
PARANEOPLASTIC AUTOANBD EVAL X
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070M
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.60 |
| 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 |
$24.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$49.00
|
| 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 |
$29.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| 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 |
$2.60
|
|
|
PARANEOPLASTIC AUTOANBD EVALXV
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070O
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
|
|
PARANEOPLASTIC AUTOANBD EVALXV
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
3038070O
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.60 |
| 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 |
$24.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.50
|
| Rate for Payer: Cigna Commercial |
$49.00
|
| 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 |
$29.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| 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 |
$2.60
|
|
|
PARAPLATIN/450MG
|
Facility
|
OP
|
$3,772.00
|
|
| Hospital Charge Code |
60633612
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$90.91 |
| Max. Negotiated Rate |
$1,886.00 |
| Rate for Payer: Aetna Commercial |
$1,433.36
|
| Rate for Payer: Aetna Medicare Advantage |
$1,131.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$961.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$961.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$961.86
|
| Rate for Payer: Cigna Commercial |
$1,886.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,131.60
|
| Rate for Payer: Oxford Commercial |
$754.40
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$565.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$754.40
|
| Rate for Payer: UnitedHealthcare Community & State |
$90.91
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$99.96
|
|
|
PARAPLATIN/450MG
|
Facility
|
IP
|
$3,772.00
|
|
| Hospital Charge Code |
60633612
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$565.80 |
| Max. Negotiated Rate |
$565.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$565.80
|
|
|
PARAPLATIN/50MG
|
Facility
|
IP
|
$299.00
|
|
| Hospital Charge Code |
60633610
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$44.85 |
| Max. Negotiated Rate |
$44.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.85
|
|
|
PARAPLATIN/50MG
|
Facility
|
OP
|
$299.00
|
|
| Hospital Charge Code |
60633610
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$7.21 |
| Max. Negotiated Rate |
$149.50 |
| Rate for Payer: Aetna Commercial |
$113.62
|
| Rate for Payer: Aetna Medicare Advantage |
$89.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$76.25
|
| Rate for Payer: Cigna Commercial |
$149.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$89.70
|
| Rate for Payer: Oxford Commercial |
$59.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$44.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$59.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.21
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.92
|
|
|
PARA SED FECAL CONC SYS
|
Facility
|
OP
|
$300.00
|
|
| Hospital Charge Code |
270651695
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.23 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Aetna Commercial |
$114.00
|
| Rate for Payer: Aetna Medicare Advantage |
$90.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$76.50
|
| Rate for Payer: Cigna Commercial |
$150.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$90.00
|
| Rate for Payer: Oxford Commercial |
$60.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$60.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.95
|
|
|
PARA SED FECAL CONC SYS
|
Facility
|
IP
|
$300.00
|
|
| Hospital Charge Code |
270651695
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
|
|
PARASITE IDENTIFICATION
|
Facility
|
IP
|
$29.35
|
|
|
Service Code
|
HCPCS 87169
|
| Hospital Charge Code |
39900275
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$4.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.40
|
|
|
PARASITE IDENTIFICATION
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
HCPCS 87177
|
| Hospital Charge Code |
3009578
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$24.21
|
| Rate for Payer: Aetna Medicare Advantage |
$28.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$32.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$32.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$32.13
|
| Rate for Payer: Cigna Commercial |
$50.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.90
|
| Rate for Payer: Clover Medicare Advantage |
$8.46
|
| Rate for Payer: EmblemHealth Commercial |
$26.70
|
| Rate for Payer: Humana Medicare Advantage |
$9.17
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.90
|
| 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 |
$7.12
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.90
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.90
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.65
|
|
|
PARASITE IDENTIFICATION
|
Facility
|
OP
|
$29.35
|
|
|
Service Code
|
HCPCS 87169
|
| Hospital Charge Code |
39900275
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$0.78 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$11.72
|
| Rate for Payer: Aetna Medicare Advantage |
$13.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.56
|
| Rate for Payer: Cigna Commercial |
$14.68
|
| Rate for Payer: Cigna Medicare Advantage |
$4.31
|
| Rate for Payer: Clover Medicare Advantage |
$4.09
|
| Rate for Payer: EmblemHealth Commercial |
$12.93
|
| Rate for Payer: Humana Medicare Advantage |
$4.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.31
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.45
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.31
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.78
|
|
