|
CHROMOSOME ANALYSIS (15-20)
|
Facility
|
OP
|
$2,149.65
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
3030467
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$62.74 |
| Max. Negotiated Rate |
$459.80 |
| Rate for Payer: Aetna Commercial |
$406.59
|
| Rate for Payer: Aetna Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$459.80
|
| Rate for Payer: Cigna Commercial |
$125.49
|
| Rate for Payer: Cigna Medicare Advantage |
$62.74
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.45
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$322.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$133.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
|
|
CHROMOSOME ANALYSIS (15-20)
|
Facility
|
IP
|
$2,149.65
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
3030467
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$322.45 |
| Max. Negotiated Rate |
$322.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$322.45
|
|
|
CHROMOSOME ANALYSIS,BLOOD
|
Facility
|
IP
|
$4,469.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
38474106
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$670.35 |
| Max. Negotiated Rate |
$670.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$670.35
|
|
|
CHROMOSOME ANALYSIS,BLOOD
|
Facility
|
OP
|
$4,469.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
38474106
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$62.74 |
| Max. Negotiated Rate |
$670.35 |
| Rate for Payer: Aetna Commercial |
$406.59
|
| Rate for Payer: Aetna Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$459.80
|
| Rate for Payer: Cigna Commercial |
$125.49
|
| Rate for Payer: Cigna Medicare Advantage |
$62.74
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$580.97
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$670.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$133.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
|
|
CHROMOSOME ANALYSIS, LEUKEMIA
|
Facility
|
OP
|
$2,149.65
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
3009156
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$62.74 |
| Max. Negotiated Rate |
$459.80 |
| Rate for Payer: Aetna Commercial |
$406.59
|
| Rate for Payer: Aetna Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$459.80
|
| Rate for Payer: Cigna Commercial |
$125.49
|
| Rate for Payer: Cigna Medicare Advantage |
$62.74
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$279.45
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$322.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$133.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
|
|
CHROMOSOME ANALYSIS, LEUKEMIA
|
Facility
|
IP
|
$2,149.65
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
3009156
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$322.45 |
| Max. Negotiated Rate |
$322.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$322.45
|
|
|
CHROMOSOME ANALYSIS,TISSUE
|
Facility
|
OP
|
$1,000.00
|
|
|
Service Code
|
HCPCS 88233
|
| Hospital Charge Code |
38474109
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$70.36 |
| Max. Negotiated Rate |
$515.63 |
| Rate for Payer: Aetna Commercial |
$455.97
|
| Rate for Payer: Aetna Medicare Advantage |
$140.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$515.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$515.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$140.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$515.63
|
| Rate for Payer: Cigna Commercial |
$140.73
|
| Rate for Payer: Cigna Medicare Advantage |
$70.36
|
| Rate for Payer: Clover Medicare Advantage |
$133.69
|
| Rate for Payer: EmblemHealth Commercial |
$422.19
|
| Rate for Payer: Humana Medicare Advantage |
$144.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$130.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$140.73
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$149.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$140.73
|
|
|
CHROMOSOME ANALYSIS,TISSUE
|
Facility
|
IP
|
$1,000.00
|
|
|
Service Code
|
HCPCS 88233
|
| Hospital Charge Code |
38474109
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$150.00
|
|
|
CHROMOSOME ANALYZE 20-25 CELLS
|
Facility
|
OP
|
$882.69
|
|
|
Service Code
|
HCPCS 88264
|
| Hospital Charge Code |
38477208
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$529.85 |
| Rate for Payer: Aetna Commercial |
$468.54
|
| Rate for Payer: Aetna Medicare Advantage |
$144.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$529.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$529.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$144.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$529.85
|
| Rate for Payer: Cigna Commercial |
$144.61
|
| Rate for Payer: Cigna Medicare Advantage |
$72.31
|
| Rate for Payer: Clover Medicare Advantage |
$137.38
|
| Rate for Payer: EmblemHealth Commercial |
$433.83
|
| Rate for Payer: Humana Medicare Advantage |
$148.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$114.75
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$144.61
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$153.29
|
| Rate for Payer: Wellcare Medicare Advantage |
$144.61
|
|
|
CHROMOSOME ANALYZE 20-25 CELLS
|
Facility
|
IP
|
$882.69
|
|
|
Service Code
|
HCPCS 88264
|
| Hospital Charge Code |
38477208
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$132.40 |
| Max. Negotiated Rate |
$132.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$132.40
|
|
|
CHROMOSOME BREAKAGE STUDY
|
Facility
|
OP
|
$2,082.00
|
|
|
Service Code
|
HCPCS 88248
|
| Hospital Charge Code |
38474100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$86.58 |
| Max. Negotiated Rate |
$634.49 |
| Rate for Payer: Aetna Commercial |
$561.07
|
| Rate for Payer: Aetna Medicare Advantage |
$173.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$634.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$634.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$173.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$634.49
|
| Rate for Payer: Cigna Commercial |
$173.17
|
| Rate for Payer: Cigna Medicare Advantage |
$86.58
|
| Rate for Payer: Clover Medicare Advantage |
$164.51
|
| Rate for Payer: EmblemHealth Commercial |
$519.51
|
| Rate for Payer: Humana Medicare Advantage |
$178.37
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$270.66
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$312.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.17
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$183.56
|
| Rate for Payer: Wellcare Medicare Advantage |
$173.17
|
|
|
CHROMOSOME BREAKAGE STUDY
|
Facility
|
IP
|
$2,082.00
|
|
|
Service Code
|
HCPCS 88248
|
| Hospital Charge Code |
38474100
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$312.30 |
| Max. Negotiated Rate |
$312.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$312.30
|
|
|
CHROMOSOME COUNT 45C,2KW BANDI
|
Facility
|
IP
|
$1,064.30
|
|
|
Service Code
|
HCPCS 88263
|
| Hospital Charge Code |
38477213
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$159.65 |
| Max. Negotiated Rate |
$159.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$159.65
|
|
|
CHROMOSOME COUNT 45C,2KW BANDI
|
Facility
|
OP
|
$1,064.30
|
|
|
Service Code
|
HCPCS 88263
|
| Hospital Charge Code |
38477213
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$75.14 |
| Max. Negotiated Rate |
$550.66 |
| Rate for Payer: Aetna Commercial |
$486.94
|
| Rate for Payer: Aetna Medicare Advantage |
$150.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$550.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$550.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$150.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$550.66
|
| Rate for Payer: Cigna Commercial |
$150.29
|
| Rate for Payer: Cigna Medicare Advantage |
$75.14
|
| Rate for Payer: Clover Medicare Advantage |
$142.78
|
| Rate for Payer: EmblemHealth Commercial |
$450.87
|
| Rate for Payer: Humana Medicare Advantage |
$154.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$138.36
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$159.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$150.29
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$159.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$150.29
|
|
|
CHROMOSOME IN SITU AMNIOTIC FL
|
Facility
|
IP
|
$1,177.90
|
|
|
Service Code
|
HCPCS 88269
|
| Hospital Charge Code |
38477214
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$176.69 |
| Max. Negotiated Rate |
$176.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$176.69
|
|
|
CHROMOSOME IN SITU AMNIOTIC FL
|
Facility
|
OP
|
$1,177.90
|
|
|
Service Code
|
HCPCS 88269
|
| Hospital Charge Code |
38477214
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$86.83 |
| Max. Negotiated Rate |
$636.29 |
| Rate for Payer: Aetna Commercial |
$562.66
|
| Rate for Payer: Aetna Medicare Advantage |
$173.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$636.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$636.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$173.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$636.29
|
| Rate for Payer: Cigna Commercial |
$173.66
|
| Rate for Payer: Cigna Medicare Advantage |
$86.83
|
| Rate for Payer: Clover Medicare Advantage |
$164.98
|
| Rate for Payer: EmblemHealth Commercial |
$520.98
|
| Rate for Payer: Humana Medicare Advantage |
$178.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$153.13
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$176.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.66
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$184.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$173.66
|
|
|
CHROMOSOME RFX TO MICROARRAY I
|
Facility
|
OP
|
$2,169.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
3038516B
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.74 |
| Max. Negotiated Rate |
$459.80 |
| Rate for Payer: Aetna Commercial |
$406.59
|
| Rate for Payer: Aetna Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$459.80
|
| Rate for Payer: Cigna Commercial |
$125.49
|
| Rate for Payer: Cigna Medicare Advantage |
$62.74
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$281.97
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$325.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$133.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
|
|
CHROMOSOME RFX TO MICROARRAY I
|
Facility
|
IP
|
$1,347.00
|
|
|
Service Code
|
HCPCS 88230
|
| Hospital Charge Code |
3038516A
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$202.05 |
| Max. Negotiated Rate |
$202.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$202.05
|
|
|
CHROMOSOME RFX TO MICROARRAY I
|
Facility
|
IP
|
$2,169.00
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
3038516B
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$325.35 |
| Max. Negotiated Rate |
$325.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$325.35
|
|
|
CHROMOSOME RFX TO MICROARRAY I
|
Facility
|
OP
|
$1,347.00
|
|
|
Service Code
|
HCPCS 88230
|
| Hospital Charge Code |
3038516A
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.24 |
| Max. Negotiated Rate |
$426.82 |
| Rate for Payer: Aetna Commercial |
$377.43
|
| Rate for Payer: Aetna Medicare Advantage |
$116.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$426.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$426.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$116.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$426.82
|
| Rate for Payer: Cigna Commercial |
$116.49
|
| Rate for Payer: Cigna Medicare Advantage |
$58.24
|
| Rate for Payer: Clover Medicare Advantage |
$110.67
|
| Rate for Payer: EmblemHealth Commercial |
$349.47
|
| Rate for Payer: Humana Medicare Advantage |
$119.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$175.11
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$202.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$116.49
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$123.48
|
| Rate for Payer: Wellcare Medicare Advantage |
$116.49
|
|
|
CHROMOSOMES, BLOOD I
|
Facility
|
IP
|
$800.70
|
|
|
Service Code
|
HCPCS 88230
|
| Hospital Charge Code |
39990122A
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$120.11 |
| Max. Negotiated Rate |
$120.11 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.11
|
|
|
CHROMOSOMES, BLOOD I
|
Facility
|
OP
|
$800.70
|
|
|
Service Code
|
HCPCS 88230
|
| Hospital Charge Code |
39990122A
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$58.24 |
| Max. Negotiated Rate |
$426.82 |
| Rate for Payer: Aetna Commercial |
$377.43
|
| Rate for Payer: Aetna Medicare Advantage |
$116.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$426.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$426.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$116.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$426.82
|
| Rate for Payer: Cigna Commercial |
$116.49
|
| Rate for Payer: Cigna Medicare Advantage |
$58.24
|
| Rate for Payer: Clover Medicare Advantage |
$110.67
|
| Rate for Payer: EmblemHealth Commercial |
$349.47
|
| Rate for Payer: Humana Medicare Advantage |
$119.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$104.09
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$120.11
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$116.49
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$123.48
|
| Rate for Payer: Wellcare Medicare Advantage |
$116.49
|
|
|
CHROMOSOMES, BLOOD II
|
Facility
|
IP
|
$856.65
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
39990122B
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$128.50 |
| Max. Negotiated Rate |
$128.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$128.50
|
|
|
CHROMOSOMES, BLOOD II
|
Facility
|
OP
|
$856.65
|
|
|
Service Code
|
HCPCS 88262
|
| Hospital Charge Code |
39990122B
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$62.74 |
| Max. Negotiated Rate |
$459.80 |
| Rate for Payer: Aetna Commercial |
$406.59
|
| Rate for Payer: Aetna Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$459.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$125.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$459.80
|
| Rate for Payer: Cigna Commercial |
$125.49
|
| Rate for Payer: Cigna Medicare Advantage |
$62.74
|
| Rate for Payer: Clover Medicare Advantage |
$119.22
|
| Rate for Payer: EmblemHealth Commercial |
$376.47
|
| Rate for Payer: Humana Medicare Advantage |
$129.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$111.36
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$128.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$125.49
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$133.02
|
| Rate for Payer: Wellcare Medicare Advantage |
$125.49
|
|
|
CHROMOSOMES,TISSUE I
|
Facility
|
OP
|
$967.20
|
|
|
Service Code
|
HCPCS 88233
|
| Hospital Charge Code |
39990123A
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$70.36 |
| Max. Negotiated Rate |
$515.63 |
| Rate for Payer: Aetna Commercial |
$455.97
|
| Rate for Payer: Aetna Medicare Advantage |
$140.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$515.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$515.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$140.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$515.63
|
| Rate for Payer: Cigna Commercial |
$140.73
|
| Rate for Payer: Cigna Medicare Advantage |
$70.36
|
| Rate for Payer: Clover Medicare Advantage |
$133.69
|
| Rate for Payer: EmblemHealth Commercial |
$422.19
|
| Rate for Payer: Humana Medicare Advantage |
$144.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$125.74
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$145.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$140.73
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$149.17
|
| Rate for Payer: Wellcare Medicare Advantage |
$140.73
|
|