|
CULTURE, OTHER SOURCES
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3000080
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE OTHER SPEC AEROBIC-SO
|
Facility
|
IP
|
$149.72
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40134556A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.46 |
| Max. Negotiated Rate |
$22.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.46
|
|
|
CULTURE OTHER SPEC AEROBIC-SO
|
Facility
|
OP
|
$149.72
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40134556A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.31 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$27.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.58
|
| Rate for Payer: Cigna Commercial |
$8.62
|
| Rate for Payer: Cigna Medicare Advantage |
$4.31
|
| Rate for Payer: Clover Medicare Advantage |
$8.19
|
| Rate for Payer: EmblemHealth Commercial |
$25.86
|
| Rate for Payer: Humana Medicare Advantage |
$8.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.46
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$9.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.62
|
|
|
CULTURE OTHR SPEC AEROBIC-SO
|
Facility
|
IP
|
$94.65
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4013388A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$14.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.20
|
|
|
CULTURE OTHR SPEC AEROBIC-SO
|
Facility
|
OP
|
$94.65
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4013388A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.31 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$27.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.58
|
| Rate for Payer: Cigna Commercial |
$8.62
|
| Rate for Payer: Cigna Medicare Advantage |
$4.31
|
| Rate for Payer: Clover Medicare Advantage |
$8.19
|
| Rate for Payer: EmblemHealth Commercial |
$25.86
|
| Rate for Payer: Humana Medicare Advantage |
$8.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$9.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.62
|
|
|
CULTURE OTHR SPEC AEROBIC-SO
|
Facility
|
OP
|
$63.93
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40134446A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.31 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$27.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.58
|
| Rate for Payer: Cigna Commercial |
$8.62
|
| Rate for Payer: Cigna Medicare Advantage |
$4.31
|
| Rate for Payer: Clover Medicare Advantage |
$8.19
|
| Rate for Payer: EmblemHealth Commercial |
$25.86
|
| Rate for Payer: Humana Medicare Advantage |
$8.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.31
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$9.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.62
|
|
|
CULTURE OTHR SPEC AEROBIC-SO
|
Facility
|
IP
|
$63.93
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40134446A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$9.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.59
|
|
|
Culture, Salmonella & Shigella
|
Facility
|
IP
|
$58.16
|
|
|
Service Code
|
HCPCS 10019
|
| Hospital Charge Code |
3000074
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$8.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.72
|
|
|
Culture, Salmonella & Shigella
|
Facility
|
OP
|
$58.16
|
|
|
Service Code
|
HCPCS 10019
|
| Hospital Charge Code |
3000074
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.56 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$17.45
|
| Rate for Payer: Aetna Medicare Advantage |
$17.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.83
|
| Rate for Payer: Cigna Commercial |
$29.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.56
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
CULTURE SALMONELLA/SHIGELLA
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87046
|
| Hospital Charge Code |
401187046A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$30.59
|
| Rate for Payer: Aetna Medicare Advantage |
$9.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.59
|
| Rate for Payer: Cigna Commercial |
$9.44
|
| Rate for Payer: Cigna Medicare Advantage |
$4.72
|
| Rate for Payer: Clover Medicare Advantage |
$8.97
|
| Rate for Payer: EmblemHealth Commercial |
$28.32
|
| Rate for Payer: Humana Medicare Advantage |
$9.72
|
| 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 |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.44
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$10.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.44
|
|
|
CULTURE SALMONELLA/SHIGELLA
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87046
|
| Hospital Charge Code |
401187046A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE SCREEN METHICILLIN RES
|
Facility
|
IP
|
$104.49
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
401387076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.67 |
| Max. Negotiated Rate |
$15.67 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.67
|
|
|
CULTURE SCREEN METHICILLIN RES
|
Facility
|
OP
|
$104.49
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
401387076
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$21.48
|
| Rate for Payer: Aetna Medicare Advantage |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.29
|
| 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 |
$18.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.29
|
| Rate for Payer: Cigna Commercial |
$6.63
|
| Rate for Payer: Cigna Medicare Advantage |
$3.31
|
| 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: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.58
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.67
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.63
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$7.03
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.63
|
|
|
CULTURE, SPUTUM
|
Facility
|
IP
|
$770.30
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3000098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$115.55 |
| Max. Negotiated Rate |
$115.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.55
|
|
|
CULTURE, SPUTUM
|
Facility
|
OP
|
$770.30
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3000098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.31 |
| Max. Negotiated Rate |
$115.55 |
| Rate for Payer: Aetna Commercial |
$27.93
|
| Rate for Payer: Aetna Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.58
|
| Rate for Payer: Cigna Commercial |
$8.62
|
| Rate for Payer: Cigna Medicare Advantage |
$4.31
|
| Rate for Payer: Clover Medicare Advantage |
$8.19
|
| Rate for Payer: EmblemHealth Commercial |
$25.86
|
| Rate for Payer: Humana Medicare Advantage |
$8.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$100.14
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$9.14
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.62
|
|
|
CULTURE, SPUTUM****
|
Facility
|
IP
|
$32.00
|
|
| Hospital Charge Code |
3010097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$4.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.80
|
|
|
CULTURE, SPUTUM****
|
Facility
|
OP
|
$32.00
|
|
| Hospital Charge Code |
3010097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.16 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$9.60
|
| 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 |
$4.16
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
CULTURE, STOOL
|
Facility
|
IP
|
$869.58
|
|
|
Service Code
|
HCPCS 87045
|
| Hospital Charge Code |
3003274
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$130.44 |
| Max. Negotiated Rate |
$130.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.44
|
|
|
CULTURE, STOOL
|
Facility
|
OP
|
$869.58
|
|
|
Service Code
|
HCPCS 87045
|
| Hospital Charge Code |
3003274
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$130.44 |
| Rate for Payer: Aetna Commercial |
$30.59
|
| Rate for Payer: Aetna Medicare Advantage |
$9.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.59
|
| Rate for Payer: Cigna Commercial |
$9.44
|
| Rate for Payer: Cigna Medicare Advantage |
$4.72
|
| Rate for Payer: Clover Medicare Advantage |
$8.97
|
| Rate for Payer: EmblemHealth Commercial |
$28.32
|
| Rate for Payer: Humana Medicare Advantage |
$9.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.05
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$130.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.44
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$10.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.44
|
|
|
CULTURE, STOOL-SEND OUT I
|
Facility
|
OP
|
$150.45
|
|
|
Service Code
|
HCPCS 87045
|
| Hospital Charge Code |
3036031A
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$30.59
|
| Rate for Payer: Aetna Medicare Advantage |
$9.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.59
|
| Rate for Payer: Cigna Commercial |
$9.44
|
| Rate for Payer: Cigna Medicare Advantage |
$4.72
|
| Rate for Payer: Clover Medicare Advantage |
$8.97
|
| Rate for Payer: EmblemHealth Commercial |
$28.32
|
| Rate for Payer: Humana Medicare Advantage |
$9.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.56
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.44
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$10.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.44
|
|
|
CULTURE, STOOL-SEND OUT I
|
Facility
|
IP
|
$150.45
|
|
|
Service Code
|
HCPCS 87045
|
| Hospital Charge Code |
3036031A
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$22.57 |
| Max. Negotiated Rate |
$22.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.57
|
|
|
CULTURE, STOOL-SEND OUT II
|
Facility
|
OP
|
$150.45
|
|
|
Service Code
|
HCPCS 87046
|
| Hospital Charge Code |
3036031B
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$30.59
|
| Rate for Payer: Aetna Medicare Advantage |
$9.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.59
|
| Rate for Payer: Cigna Commercial |
$9.44
|
| Rate for Payer: Cigna Medicare Advantage |
$4.72
|
| Rate for Payer: Clover Medicare Advantage |
$8.97
|
| Rate for Payer: EmblemHealth Commercial |
$28.32
|
| Rate for Payer: Humana Medicare Advantage |
$9.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.56
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.57
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.44
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$10.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.44
|
|
|
CULTURE, STOOL-SEND OUT II
|
Facility
|
IP
|
$150.45
|
|
|
Service Code
|
HCPCS 87046
|
| Hospital Charge Code |
3036031B
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$22.57 |
| Max. Negotiated Rate |
$22.57 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$22.57
|
|
|
CULTURE, STOOL-SEND OUT III
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
HCPCS 87427
|
| Hospital Charge Code |
3036031C
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$38.82
|
| Rate for Payer: Aetna Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$11.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.89
|
| Rate for Payer: Cigna Commercial |
$11.98
|
| Rate for Payer: Cigna Medicare Advantage |
$5.99
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$12.70
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
|
|
CULTURE, STOOL-SEND OUT III
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
HCPCS 87427
|
| Hospital Charge Code |
3036031C
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
|