|
STREP GP B CULT/DNA PROBE I
|
Facility
|
OP
|
$137.85
|
|
|
Service Code
|
HCPCS 87149
|
| Hospital Charge Code |
3038514A
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$54.54
|
| Rate for Payer: Aetna Medicare Advantage |
$64.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$72.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$72.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$42.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$72.37
|
| Rate for Payer: Cigna Commercial |
$68.92
|
| Rate for Payer: Cigna Medicare Advantage |
$20.05
|
| Rate for Payer: Clover Medicare Advantage |
$19.05
|
| Rate for Payer: EmblemHealth Commercial |
$60.15
|
| Rate for Payer: Humana Medicare Advantage |
$20.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.35
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.04
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.65
|
|
|
STREP GP B CULT/DNA PROBE I
|
Facility
|
IP
|
$137.85
|
|
|
Service Code
|
HCPCS 87149
|
| Hospital Charge Code |
3038514A
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.68 |
| Max. Negotiated Rate |
$20.68 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.68
|
|
|
STREP GP B CULT/DNA PROBE II
|
Facility
|
IP
|
$358.65
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
3038514B
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$53.80 |
| Max. Negotiated Rate |
$53.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.80
|
|
|
STREP GP B CULT/DNA PROBE II
|
Facility
|
OP
|
$358.65
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
3038514B
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$179.32 |
| Rate for Payer: Aetna Commercial |
$18.03
|
| Rate for Payer: Aetna Medicare Advantage |
$21.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.93
|
| Rate for Payer: Cigna Commercial |
$179.32
|
| Rate for Payer: Cigna Medicare Advantage |
$6.63
|
| Rate for Payer: Clover Medicare Advantage |
$6.30
|
| Rate for Payer: EmblemHealth Commercial |
$19.89
|
| Rate for Payer: Humana Medicare Advantage |
$6.83
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6.63
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$107.59
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$53.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$5.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.63
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.63
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.50
|
|
|
STREP GROUP A, DNA PROBE
|
Facility
|
OP
|
$180.85
|
|
|
Service Code
|
HCPCS 87650
|
| Hospital Charge Code |
3100675
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$54.54
|
| Rate for Payer: Aetna Medicare Advantage |
$64.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$72.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$72.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$72.37
|
| Rate for Payer: Cigna Commercial |
$90.42
|
| Rate for Payer: Cigna Medicare Advantage |
$20.05
|
| Rate for Payer: Clover Medicare Advantage |
$19.05
|
| Rate for Payer: EmblemHealth Commercial |
$60.15
|
| Rate for Payer: Humana Medicare Advantage |
$20.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.26
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.04
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.79
|
|
|
STREP GROUP A, DNA PROBE
|
Facility
|
IP
|
$180.85
|
|
|
Service Code
|
HCPCS 87650
|
| Hospital Charge Code |
3100675
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.13 |
| Max. Negotiated Rate |
$27.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$27.13
|
|
|
STREP PNEUMO ANTIBODY I
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
STREP PNEUMO ANTIBODY I
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna Medicare Advantage |
$48.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.11
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.99
|
| Rate for Payer: Clover Medicare Advantage |
$14.24
|
| Rate for Payer: EmblemHealth Commercial |
$44.97
|
| Rate for Payer: Humana Medicare Advantage |
$15.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.99
|
| 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 |
$11.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
STREP PNEUMO ANTIBODY II
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
STREP PNEUMO ANTIBODY II
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna Medicare Advantage |
$48.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.11
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.99
|
| Rate for Payer: Clover Medicare Advantage |
$14.24
|
| Rate for Payer: EmblemHealth Commercial |
$44.97
|
| Rate for Payer: Humana Medicare Advantage |
$15.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.99
|
| 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 |
$11.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
STREP PNEUMO ANTIBODY III
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145C
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna Medicare Advantage |
$48.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.11
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.99
|
| Rate for Payer: Clover Medicare Advantage |
$14.24
|
| Rate for Payer: EmblemHealth Commercial |
$44.97
|
| Rate for Payer: Humana Medicare Advantage |
$15.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.99
|
| 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 |
$11.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
STREP PNEUMO ANTIBODY III
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145C
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
STREP PNEUMO ANTIBODY IV
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145D
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna Medicare Advantage |
$48.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.11
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.99
|
| Rate for Payer: Clover Medicare Advantage |
$14.24
|
| Rate for Payer: EmblemHealth Commercial |
$44.97
|
| Rate for Payer: Humana Medicare Advantage |
$15.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.99
|
| 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 |
$11.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
STREP PNEUMO ANTIBODY IV
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145D
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
STREP PNEUMO ANTIBODY V
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145E
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
STREP PNEUMO ANTIBODY V
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145E
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna Medicare Advantage |
$48.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.11
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.99
|
| Rate for Payer: Clover Medicare Advantage |
$14.24
|
| Rate for Payer: EmblemHealth Commercial |
$44.97
|
| Rate for Payer: Humana Medicare Advantage |
$15.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.99
|
| 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 |
$11.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
STREP PNEUMO ANTIBODY VI
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145F
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
STREP PNEUMO ANTIBODY VI
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990145F
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna Medicare Advantage |
$48.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.11
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.11
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.99
|
| Rate for Payer: Clover Medicare Advantage |
$14.24
|
| Rate for Payer: EmblemHealth Commercial |
$44.97
|
| Rate for Payer: Humana Medicare Advantage |
$15.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.99
|
| 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 |
$11.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
STREP PNEUMO ANTIGEN, URINE
|
Facility
|
IP
|
$728.00
|
|
|
Service Code
|
HCPCS 87899
|
| Hospital Charge Code |
39990239
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.20
|
|
|
STREP PNEUMO ANTIGEN, URINE
|
Facility
|
OP
|
$728.00
|
|
|
Service Code
|
HCPCS 87899
|
| Hospital Charge Code |
39990239
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.86 |
| Max. Negotiated Rate |
$364.00 |
| Rate for Payer: Aetna Commercial |
$43.71
|
| Rate for Payer: Aetna Medicare Advantage |
$52.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.01
|
| Rate for Payer: Cigna Commercial |
$364.00
|
| Rate for Payer: Cigna Medicare Advantage |
$16.07
|
| Rate for Payer: Clover Medicare Advantage |
$15.27
|
| Rate for Payer: EmblemHealth Commercial |
$48.21
|
| Rate for Payer: Humana Medicare Advantage |
$16.55
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$218.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$109.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.07
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$19.29
|
|
|
STREP SCREEN
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
87502745
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
STREP SCREEN
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
87502745
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$31.39
|
| Rate for Payer: Aetna Medicare Advantage |
$37.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.66
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.54
|
| Rate for Payer: Clover Medicare Advantage |
$10.96
|
| Rate for Payer: EmblemHealth Commercial |
$34.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.54
|
| 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 |
$9.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.34
|
|
|
STREPTASE/250KU
|
Facility
|
OP
|
$505.00
|
|
| Hospital Charge Code |
60633922
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.17 |
| Max. Negotiated Rate |
$252.50 |
| Rate for Payer: Aetna Commercial |
$191.90
|
| Rate for Payer: Aetna Medicare Advantage |
$151.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$128.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$128.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$128.78
|
| Rate for Payer: Cigna Commercial |
$252.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$122.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.75
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$13.38
|
|
|
STREPTASE/250KU
|
Facility
|
IP
|
$505.00
|
|
| Hospital Charge Code |
60633922
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$75.75 |
| Max. Negotiated Rate |
$122.21 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$122.21
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$75.75
|
|
|
STREPTOCOCCUS, GROUP A
|
Facility
|
OP
|
$77.95
|
|
|
Service Code
|
HCPCS 87880
|
| Hospital Charge Code |
38472339
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.07 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial |
$44.96
|
| Rate for Payer: Aetna Medicare Advantage |
$53.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$59.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$59.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$23.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$59.67
|
| Rate for Payer: Cigna Commercial |
$38.98
|
| Rate for Payer: Cigna Medicare Advantage |
$16.53
|
| Rate for Payer: Clover Medicare Advantage |
$15.70
|
| Rate for Payer: EmblemHealth Commercial |
$49.59
|
| Rate for Payer: Humana Medicare Advantage |
$17.03
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$23.39
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$13.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.07
|
|
