|
ALLERGEN RED CEDAR
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 8600391
|
| Hospital Charge Code |
3031281
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
ALLERGEN RED MAPLE
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 8600391
|
| Hospital Charge Code |
3031279
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
ALLERGEN RED MAPLE
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 8600391
|
| Hospital Charge Code |
3031279
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$15.60
|
| Rate for Payer: Aetna Medicare Advantage |
$15.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.26
|
| Rate for Payer: Cigna Commercial |
$26.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
ALLERGEN RED MULBERRY
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 8600391
|
| Hospital Charge Code |
3031278
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
ALLERGEN RED MULBERRY
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 8600391
|
| Hospital Charge Code |
3031278
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$15.60
|
| Rate for Payer: Aetna Medicare Advantage |
$15.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.26
|
| Rate for Payer: Cigna Commercial |
$26.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
ALLERGEN,RESP
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479129
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.48
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
ALLERGEN,RESP
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479129
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
|
|
ALLERGEN RUSSIAN THISTLE
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031251
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
ALLERGEN RUSSIAN THISTLE
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031251
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
ALLERGEN RYE
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031244
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
ALLERGEN RYE
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031244
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
ALLERGEN RYE PERENNTAL
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031219
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
ALLERGEN RYE PERENNTAL
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031219
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
ALLERGEN SHEEP EPITHELIA
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031248
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
ALLERGEN SHEEP EPITHELIA
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031248
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
ALLERGEN SHEEP SORREL
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 8600391
|
| Hospital Charge Code |
3031277
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$15.60
|
| Rate for Payer: Aetna Medicare Advantage |
$15.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.26
|
| Rate for Payer: Cigna Commercial |
$26.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
ALLERGEN SHEEP SORREL
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 8600391
|
| Hospital Charge Code |
3031277
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
ALLERGEN SHRIMP
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031410
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
ALLERGEN SHRIMP
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031410
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
ALLERGEN SHRIMP
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031265
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
ALLERGEN SHRIMP
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031265
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
ALLERGEN SOYBEAN
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031304
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
ALLERGEN SOYBEAN
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031304
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
ALLERGEN SPEC-ANIMAL
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479126
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.48
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
ALLERGEN SPEC-ANIMAL
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38479126
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
|