|
IGF BINDING PRO 3
|
Facility
|
OP
|
$95.69
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
38472936
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.42
|
| Rate for Payer: Cigna Commercial |
$18.40
|
| Rate for Payer: Cigna Medicare Advantage |
$9.20
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.44
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$19.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
|
|
IGF BINDING PRO 3
|
Facility
|
IP
|
$95.69
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
38472936
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.35 |
| Max. Negotiated Rate |
$14.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.35
|
|
|
IGF BINDING PROTEIN 1
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
39900436
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.42
|
| Rate for Payer: Cigna Commercial |
$18.40
|
| Rate for Payer: Cigna Medicare Advantage |
$9.20
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| 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 |
$18.40
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$19.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
|
|
IGF BINDING PROTEIN 1
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
39900436
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
IGF BINDING PROTEIN 2
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
39900437
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
IGF BINDING PROTEIN 2
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
39900437
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.42
|
| Rate for Payer: Cigna Commercial |
$18.40
|
| Rate for Payer: Cigna Medicare Advantage |
$9.20
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| 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 |
$18.40
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$19.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
|
|
IGF BINDING PROTEIN-3
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
39900335
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.42
|
| Rate for Payer: Cigna Commercial |
$18.40
|
| Rate for Payer: Cigna Medicare Advantage |
$9.20
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| 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 |
$18.40
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$19.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
|
|
IGF BINDING PROTEIN-3
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
39900335
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
IGF-I
|
Facility
|
IP
|
$585.17
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
3001313
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$87.78 |
| Max. Negotiated Rate |
$87.78 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.78
|
|
|
IGF-I
|
Facility
|
OP
|
$585.17
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
3001313
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.42
|
| Rate for Payer: Cigna Commercial |
$18.40
|
| Rate for Payer: Cigna Medicare Advantage |
$9.20
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$76.07
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$19.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
|
|
IGF II
|
Facility
|
IP
|
$95.69
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
38472938
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.35 |
| Max. Negotiated Rate |
$14.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.35
|
|
|
IGF II
|
Facility
|
OP
|
$95.69
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
38472938
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.42
|
| Rate for Payer: Cigna Commercial |
$18.40
|
| Rate for Payer: Cigna Medicare Advantage |
$9.20
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.44
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18.40
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$19.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
|
|
IGF-II
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
39900435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
IGF-II
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83519
|
| Hospital Charge Code |
39900435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$67.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$67.42
|
| Rate for Payer: Cigna Commercial |
$18.40
|
| Rate for Payer: Cigna Medicare Advantage |
$9.20
|
| Rate for Payer: Clover Medicare Advantage |
$17.48
|
| Rate for Payer: EmblemHealth Commercial |
$55.20
|
| Rate for Payer: Humana Medicare Advantage |
$18.95
|
| 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 |
$18.40
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$19.50
|
| Rate for Payer: Wellcare Medicare Advantage |
$18.40
|
|
|
IgG
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38472410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$30.13
|
| Rate for Payer: Aetna Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.08
|
| Rate for Payer: Cigna Commercial |
$9.30
|
| Rate for Payer: Cigna Medicare Advantage |
$4.65
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.91
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$9.86
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
|
|
IgG
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38472410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$31.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.05
|
|
|
IGG
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38479416
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$31.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.05
|
|
|
IGG
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
HCPCS 86671
|
| Hospital Charge Code |
3035174A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.12 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$39.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$30.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.88
|
| Rate for Payer: Cigna Commercial |
$12.25
|
| Rate for Payer: Cigna Medicare Advantage |
$6.12
|
| Rate for Payer: Clover Medicare Advantage |
$11.64
|
| Rate for Payer: EmblemHealth Commercial |
$36.75
|
| Rate for Payer: Humana Medicare Advantage |
$12.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$12.74
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.25
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$12.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.25
|
|
|
IGG
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38479416
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$30.13
|
| Rate for Payer: Aetna Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.08
|
| Rate for Payer: Cigna Commercial |
$9.30
|
| Rate for Payer: Cigna Medicare Advantage |
$4.65
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.91
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$9.86
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
|
|
IGG
|
Facility
|
OP
|
$207.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38479448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$30.13
|
| Rate for Payer: Aetna Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.08
|
| Rate for Payer: Cigna Commercial |
$9.30
|
| Rate for Payer: Cigna Medicare Advantage |
$4.65
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.91
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$9.86
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
|
|
IGG
|
Facility
|
IP
|
$207.00
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
38479448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$31.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.05
|
|
|
IGG
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
HCPCS 86671
|
| Hospital Charge Code |
3035174A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.70 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.70
|
|
|
IGG CSF
|
Facility
|
IP
|
$81.25
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
3032299
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.19 |
| Max. Negotiated Rate |
$12.19 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.19
|
|
|
IGG CSF
|
Facility
|
OP
|
$81.25
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
3032299
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$30.13
|
| Rate for Payer: Aetna Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.08
|
| Rate for Payer: Cigna Commercial |
$9.30
|
| Rate for Payer: Cigna Medicare Advantage |
$4.65
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$10.56
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.30
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$9.86
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
|
|
IGG, CSF
|
Facility
|
OP
|
$63.90
|
|
|
Service Code
|
HCPCS 82784
|
| Hospital Charge Code |
39900082
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$30.13
|
| Rate for Payer: Aetna Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.08
|
| Rate for Payer: Cigna Commercial |
$9.30
|
| Rate for Payer: Cigna Medicare Advantage |
$4.65
|
| Rate for Payer: Clover Medicare Advantage |
$8.84
|
| Rate for Payer: EmblemHealth Commercial |
$27.90
|
| Rate for Payer: Humana Medicare Advantage |
$9.58
|
| 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 |
$9.30
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$9.86
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.30
|
|
