|
ENZYME IMMNASSAY.MULT.ASPERGIL
|
Facility
|
OP
|
$77.95
|
|
|
Service Code
|
HCPCS 87305
|
| Hospital Charge Code |
38477091
|
|
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 |
$28.78
|
| 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 |
$10.13
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
| 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
|
|
|
ENZYME IMMNASSAY.MULT.ASPERGIL
|
Facility
|
IP
|
$77.95
|
|
|
Service Code
|
HCPCS 87305
|
| Hospital Charge Code |
38477091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$11.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
|
|
ENZYME IMMN MULT GIARDIA
|
Facility
|
OP
|
$77.95
|
|
|
Service Code
|
HCPCS 87329
|
| Hospital Charge Code |
38477094
|
|
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 |
$22.44
|
| 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 |
$10.13
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
| 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
|
|
|
ENZYME IMMN MULT GIARDIA
|
Facility
|
IP
|
$77.95
|
|
|
Service Code
|
HCPCS 87329
|
| Hospital Charge Code |
38477094
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$11.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
|
|
ENZYME IMMUNOASSAY MULT ADENOV
|
Facility
|
OP
|
$77.95
|
|
|
Service Code
|
HCPCS 87301
|
| Hospital Charge Code |
38477090
|
|
Hospital Revenue Code
|
309
|
| 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 |
$10.13
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
| 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
|
|
|
ENZYME IMMUNOASSAY MULT ADENOV
|
Facility
|
IP
|
$77.95
|
|
|
Service Code
|
HCPCS 87301
|
| Hospital Charge Code |
38477090
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$11.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
|
|
ENZYME IMMUNOASSAY MULT HBSAG
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
HCPCS 87341
|
| Hospital Charge Code |
38477070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$33.47
|
| Rate for Payer: Aetna Medicare Advantage |
$10.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.85
|
| Rate for Payer: Cigna Commercial |
$10.33
|
| Rate for Payer: Cigna Medicare Advantage |
$5.17
|
| Rate for Payer: Clover Medicare Advantage |
$9.81
|
| Rate for Payer: EmblemHealth Commercial |
$30.99
|
| Rate for Payer: Humana Medicare Advantage |
$10.64
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.49
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.33
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$10.95
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.33
|
|
|
ENZYME IMMUNOASSAY MULT HBSAG
|
Facility
|
IP
|
$73.00
|
|
|
Service Code
|
HCPCS 87341
|
| Hospital Charge Code |
38477070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$10.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.95
|
|
|
ENZYME IMMUNOASSAY SNGL NOS,@
|
Facility
|
IP
|
$67.89
|
|
|
Service Code
|
HCPCS 87450
|
| Hospital Charge Code |
38477062
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.18 |
| Max. Negotiated Rate |
$10.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.18
|
|
|
ENZYME IMMUNOASSAY SNGL NOS,@
|
Facility
|
OP
|
$67.89
|
|
|
Service Code
|
HCPCS 87450
|
| Hospital Charge Code |
38477062
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.83 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$20.37
|
| Rate for Payer: Aetna Medicare Advantage |
$20.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.31
|
| Rate for Payer: Cigna Commercial |
$33.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.83
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
ENZYM IMM MULT SHUGA-LIKE TOXI
|
Facility
|
OP
|
$77.95
|
|
|
Service Code
|
HCPCS 87427
|
| Hospital Charge Code |
38477098
|
|
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 |
$10.13
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
| 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
|
|
|
ENZYM IMM MULT SHUGA-LIKE TOXI
|
Facility
|
IP
|
$77.95
|
|
|
Service Code
|
HCPCS 87427
|
| Hospital Charge Code |
38477098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$11.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
|
|
ENZYM IMMNASS.MULT INFLUENZA A
|
Facility
|
IP
|
$77.95
|
|
|
Service Code
|
HCPCS 87400
|
| Hospital Charge Code |
38477096
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$11.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
|
|
ENZYM IMMNASS.MULT INFLUENZA A
|
Facility
|
OP
|
$77.95
|
|
|
Service Code
|
HCPCS 87400
|
| Hospital Charge Code |
38477096
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Cigna Commercial |
$14.13
|
| Rate for Payer: Cigna Medicare Advantage |
$7.07
|
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: Aetna Medicare Advantage |
$14.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.13
|
| 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 |
$51.77
|
| Rate for Payer: Clover Medicare Advantage |
$13.42
|
| Rate for Payer: EmblemHealth Commercial |
$42.39
|
| Rate for Payer: Humana Medicare Advantage |
$14.55
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.13
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.13
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$14.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.13
|
|
|
ENZYM IMMNASS MULT ROTAVIRUS
|
Facility
|
OP
|
$77.95
|
|
|
Service Code
|
HCPCS 87425
|
| Hospital Charge Code |
38477097
|
|
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 |
$24.31
|
| 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 |
$10.13
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
| 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
|
|
|
ENZYM IMMNASS MULT ROTAVIRUS
|
Facility
|
IP
|
$77.95
|
|
|
Service Code
|
HCPCS 87425
|
| Hospital Charge Code |
38477097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$11.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
|
|
ENZYM IMMN.MULT.CLOSTRIDIUM DI
|
Facility
|
IP
|
$77.95
|
|
|
Service Code
|
HCPCS 87324
|
| Hospital Charge Code |
38477092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$11.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
|
|
ENZYM IMMN.MULT.CLOSTRIDIUM DI
|
Facility
|
OP
|
$77.95
|
|
|
Service Code
|
HCPCS 87324
|
| Hospital Charge Code |
38477092
|
|
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 |
$10.13
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
| 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
|
|
|
ENZYM IMMN MULT CRYPTOCOCCUS N
|
Facility
|
OP
|
$77.95
|
|
|
Service Code
|
HCPCS 87327
|
| Hospital Charge Code |
38477093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.71 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$43.48
|
| Rate for Payer: Aetna Medicare Advantage |
$13.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.17
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.42
|
| 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 |
$49.17
|
| Rate for Payer: Cigna Commercial |
$13.42
|
| Rate for Payer: Cigna Medicare Advantage |
$6.71
|
| Rate for Payer: Clover Medicare Advantage |
$12.75
|
| Rate for Payer: EmblemHealth Commercial |
$40.26
|
| Rate for Payer: Humana Medicare Advantage |
$13.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.13
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.42
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$14.23
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.42
|
|
|
ENZYM IMMN MULT CRYPTOCOCCUS N
|
Facility
|
IP
|
$77.95
|
|
|
Service Code
|
HCPCS 87327
|
| Hospital Charge Code |
38477093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$11.69 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.69
|
|
|
EOINTRAK NEUROMA KIT ******
|
Facility
|
OP
|
$316.00
|
|
| Hospital Charge Code |
1606565
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.08 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna Commercial |
$94.80
|
| Rate for Payer: Aetna Medicare Advantage |
$94.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$80.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$80.58
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$80.58
|
| Rate for Payer: Cigna Commercial |
$158.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.08
|
| Rate for Payer: Oxford Commercial |
$158.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$158.00
|
|
|
EOINTRAK NEUROMA KIT ******
|
Facility
|
IP
|
$316.00
|
|
| Hospital Charge Code |
1606565
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$47.40 |
| Max. Negotiated Rate |
$47.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$47.40
|
|
|
EON MINI CHARGING SYSTEM 3721
|
Facility
|
IP
|
$5,930.00
|
|
| Hospital Charge Code |
270642322
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$889.50 |
| Max. Negotiated Rate |
$889.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$889.50
|
|
|
EON MINI CHARGING SYSTEM 3721
|
Facility
|
OP
|
$5,930.00
|
|
| Hospital Charge Code |
270642322
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$770.90 |
| Max. Negotiated Rate |
$2,965.00 |
| Rate for Payer: Aetna Commercial |
$1,779.00
|
| Rate for Payer: Aetna Medicare Advantage |
$1,779.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,512.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,512.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,512.15
|
| Rate for Payer: Cigna Commercial |
$2,965.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$770.90
|
| Rate for Payer: Oxford Commercial |
$2,965.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$889.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,965.00
|
|
|
EOSINOPHIL COUNT
|
Facility
|
OP
|
$368.00
|
|
|
Service Code
|
HCPCS 85048
|
| Hospital Charge Code |
38473015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.27 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$8.23
|
| Rate for Payer: Aetna Medicare Advantage |
$2.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.31
|
| Rate for Payer: Cigna Commercial |
$2.54
|
| Rate for Payer: Cigna Medicare Advantage |
$1.27
|
| Rate for Payer: Clover Medicare Advantage |
$2.41
|
| Rate for Payer: EmblemHealth Commercial |
$7.62
|
| Rate for Payer: Humana Medicare Advantage |
$2.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$47.84
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2.54
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$2.69
|
| Rate for Payer: Wellcare Medicare Advantage |
$2.54
|
|