|
AMYLASE ISOENZYMES I
|
Facility
|
OP
|
$322.47
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3038526A
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Commercial |
$6.48
|
| Rate for Payer: Cigna Medicare Advantage |
$3.24
|
| Rate for Payer: Clover Medicare Advantage |
$6.16
|
| Rate for Payer: EmblemHealth Commercial |
$19.44
|
| Rate for Payer: Humana Medicare Advantage |
$6.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.92
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.48
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.48
|
|
|
AMYLASE ISOENZYMES II
|
Facility
|
IP
|
$322.47
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3038526B
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.37 |
| Max. Negotiated Rate |
$48.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.37
|
|
|
AMYLASE ISOENZYMES II
|
Facility
|
OP
|
$322.47
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3038526B
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Commercial |
$6.48
|
| Rate for Payer: Cigna Medicare Advantage |
$3.24
|
| Rate for Payer: Clover Medicare Advantage |
$6.16
|
| Rate for Payer: EmblemHealth Commercial |
$19.44
|
| Rate for Payer: Humana Medicare Advantage |
$6.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.92
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.48
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.48
|
|
|
AMYLASE/LIPASE/PROTEASE CAP
|
Facility
|
OP
|
$5.36
|
|
|
Service Code
|
NDC 23611501
|
| Hospital Charge Code |
60632329
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.70 |
| Max. Negotiated Rate |
$2.68 |
| Rate for Payer: Aetna Commercial |
$1.61
|
| Rate for Payer: Aetna Medicare Advantage |
$1.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.37
|
| Rate for Payer: Cigna Commercial |
$2.68
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.70
|
| Rate for Payer: Oxford Commercial |
$2.68
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.68
|
|
|
AMYLASE/LIPASE/PROTEASE CAP
|
Facility
|
IP
|
$5.36
|
|
|
Service Code
|
NDC 23611501
|
| Hospital Charge Code |
60632329
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$0.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.80
|
|
|
AMYLASE PANCREATIC CYST
|
Facility
|
OP
|
$855.60
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3038543
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$128.34 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Commercial |
$6.48
|
| Rate for Payer: Cigna Medicare Advantage |
$3.24
|
| Rate for Payer: Clover Medicare Advantage |
$6.16
|
| Rate for Payer: EmblemHealth Commercial |
$19.44
|
| Rate for Payer: Humana Medicare Advantage |
$6.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$111.23
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$128.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.48
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.48
|
|
|
AMYLASE PANCREATIC CYST
|
Facility
|
IP
|
$855.60
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3038543
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$128.34 |
| Max. Negotiated Rate |
$128.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$128.34
|
|
|
AMYLASE PERICARDIAL FLUID
|
Facility
|
OP
|
$322.47
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3031011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Commercial |
$6.48
|
| Rate for Payer: Cigna Medicare Advantage |
$3.24
|
| Rate for Payer: Clover Medicare Advantage |
$6.16
|
| Rate for Payer: EmblemHealth Commercial |
$19.44
|
| Rate for Payer: Humana Medicare Advantage |
$6.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.92
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.48
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.48
|
|
|
AMYLASE PERICARDIAL FLUID
|
Facility
|
IP
|
$322.47
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3031011
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.37 |
| Max. Negotiated Rate |
$48.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.37
|
|
|
AMYLASE PERITONEAL FLUID
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3031013
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
AMYLASE PERITONEAL FLUID
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3031013
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Commercial |
$6.48
|
| Rate for Payer: Cigna Medicare Advantage |
$3.24
|
| Rate for Payer: Clover Medicare Advantage |
$6.16
|
| Rate for Payer: EmblemHealth Commercial |
$19.44
|
| Rate for Payer: Humana Medicare Advantage |
$6.67
|
| 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 |
$6.48
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.48
|
|
|
AMYLASE PLEURAL FLUID
|
Facility
|
OP
|
$322.47
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3031012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Commercial |
$6.48
|
| Rate for Payer: Cigna Medicare Advantage |
$3.24
|
| Rate for Payer: Clover Medicare Advantage |
$6.16
|
| Rate for Payer: EmblemHealth Commercial |
$19.44
|
| Rate for Payer: Humana Medicare Advantage |
$6.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.92
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.48
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.48
|
|
|
AMYLASE PLEURAL FLUID
|
Facility
|
IP
|
$322.47
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3031012
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.37 |
| Max. Negotiated Rate |
$48.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.37
|
|
|
AMYLASE SERUM
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3000288
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
AMYLASE SERUM
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3000288
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Commercial |
$6.48
|
| Rate for Payer: Cigna Medicare Advantage |
$3.24
|
| Rate for Payer: Clover Medicare Advantage |
$6.16
|
| Rate for Payer: EmblemHealth Commercial |
$19.44
|
| Rate for Payer: Humana Medicare Advantage |
$6.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$86.79
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.48
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.48
|
|
|
AMYLASE SYNOVIAL FLUID
|
Facility
|
OP
|
$322.47
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3031014
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Cigna Commercial |
$6.48
|
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Medicare Advantage |
$3.24
|
| Rate for Payer: Clover Medicare Advantage |
$6.16
|
| Rate for Payer: EmblemHealth Commercial |
$19.44
|
| Rate for Payer: Humana Medicare Advantage |
$6.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.92
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.48
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.48
|
|
|
AMYLASE SYNOVIAL FLUID
|
Facility
|
IP
|
$322.47
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3031014
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.37 |
| Max. Negotiated Rate |
$48.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.37
|
|
|
AMYLASE URINE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3004900
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Commercial |
$6.48
|
| Rate for Payer: Cigna Medicare Advantage |
$3.24
|
| Rate for Payer: Clover Medicare Advantage |
$6.16
|
| Rate for Payer: EmblemHealth Commercial |
$19.44
|
| Rate for Payer: Humana Medicare Advantage |
$6.67
|
| 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 |
$6.48
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.48
|
|
|
AMYLASE URINE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3004900
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
AMYLASE URINE 24 HR
|
Facility
|
IP
|
$322.47
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3030640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.37 |
| Max. Negotiated Rate |
$48.37 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.37
|
|
|
AMYLASE URINE 24 HR
|
Facility
|
OP
|
$322.47
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
3030640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Commercial |
$6.48
|
| Rate for Payer: Cigna Medicare Advantage |
$3.24
|
| Rate for Payer: Clover Medicare Advantage |
$6.16
|
| Rate for Payer: EmblemHealth Commercial |
$19.44
|
| Rate for Payer: Humana Medicare Advantage |
$6.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$41.92
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$48.37
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.48
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.48
|
|
|
AMYLASE,URINE RANDOM
|
Facility
|
OP
|
$249.20
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
38479014
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$21.00
|
| Rate for Payer: Aetna Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$23.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$23.74
|
| Rate for Payer: Cigna Commercial |
$6.48
|
| Rate for Payer: Cigna Medicare Advantage |
$3.24
|
| Rate for Payer: Clover Medicare Advantage |
$6.16
|
| Rate for Payer: EmblemHealth Commercial |
$19.44
|
| Rate for Payer: Humana Medicare Advantage |
$6.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.40
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.48
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$6.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.48
|
|
|
AMYLASE,URINE RANDOM
|
Facility
|
IP
|
$249.20
|
|
|
Service Code
|
HCPCS 82150
|
| Hospital Charge Code |
38479014
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.38 |
| Max. Negotiated Rate |
$37.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.38
|
|
|
AMYL NITRITE 0.3 ML INH
|
Facility
|
OP
|
$4.00
|
|
| Hospital Charge Code |
60627645
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.20
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.52
|
| Rate for Payer: Oxford Commercial |
$2.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.00
|
|
|
AMYL NITRITE 0.3 ML INH
|
Facility
|
IP
|
$4.00
|
|
| Hospital Charge Code |
60627645
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|