|
IMMUNOASSAY TUMOR ANTIGEN
|
Facility
|
OP
|
$115.74
|
|
|
Service Code
|
HCPCS 86294
|
| Hospital Charge Code |
38477136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.79 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$82.85
|
| Rate for Payer: Aetna Medicare Advantage |
$25.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$93.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$93.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$25.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$17.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$93.69
|
| Rate for Payer: Cigna Commercial |
$25.57
|
| Rate for Payer: Cigna Medicare Advantage |
$12.79
|
| Rate for Payer: Clover Medicare Advantage |
$24.29
|
| Rate for Payer: EmblemHealth Commercial |
$76.71
|
| Rate for Payer: Humana Medicare Advantage |
$26.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.05
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.36
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$25.57
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$27.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$25.57
|
|
|
IMMUNOASSAY TUMOR ANTIGEN
|
Facility
|
IP
|
$115.74
|
|
|
Service Code
|
HCPCS 86294
|
| Hospital Charge Code |
38477136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.36 |
| Max. Negotiated Rate |
$17.36 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.36
|
|
|
IMMUNO COMPLEX DETECTION BY C1
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86332
|
| Hospital Charge Code |
39900438
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.19 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$78.96
|
| Rate for Payer: Aetna Medicare Advantage |
$24.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$89.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$89.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$89.29
|
| Rate for Payer: Cigna Commercial |
$24.37
|
| Rate for Payer: Cigna Medicare Advantage |
$12.19
|
| Rate for Payer: Clover Medicare Advantage |
$23.15
|
| Rate for Payer: EmblemHealth Commercial |
$73.11
|
| Rate for Payer: Humana Medicare Advantage |
$25.10
|
| 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 |
$24.37
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$25.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$24.37
|
|
|
IMMUNO COMPLEX DETECTION BY C1
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86332
|
| Hospital Charge Code |
39900438
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
IMMUNOCYTOCHEMISTRY STAIN 1ST
|
Facility
|
IP
|
$1,082.30
|
|
|
Service Code
|
HCPCS 88342
|
| Hospital Charge Code |
3005338
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$162.34 |
| Max. Negotiated Rate |
$162.34 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$162.34
|
|
|
IMMUNOCYTOCHEMISTRY STAIN 1ST
|
Facility
|
OP
|
$1,082.30
|
|
|
Service Code
|
HCPCS 88342
|
| Hospital Charge Code |
3005338
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.80 |
| Max. Negotiated Rate |
$405.73 |
| Rate for Payer: Aetna Commercial |
$324.69
|
| Rate for Payer: Aetna Medicare Advantage |
$324.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$275.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$275.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$275.99
|
| Rate for Payer: Cigna Commercial |
$405.73
|
| Rate for Payer: Cigna Medicare Advantage |
$62.80
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$140.70
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$162.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
IMMUNOELECTROPHORESIS, CSF
|
Facility
|
OP
|
$198.45
|
|
|
Service Code
|
HCPCS 86325
|
| Hospital Charge Code |
3001013
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.56 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$74.94
|
| Rate for Payer: Aetna Medicare Advantage |
$23.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$84.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$84.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$23.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$46.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$84.75
|
| Rate for Payer: Cigna Commercial |
$23.13
|
| Rate for Payer: Cigna Medicare Advantage |
$11.56
|
| Rate for Payer: Clover Medicare Advantage |
$21.97
|
| Rate for Payer: EmblemHealth Commercial |
$69.39
|
| Rate for Payer: Humana Medicare Advantage |
$23.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.80
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$23.13
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$24.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$23.13
|
|
|
IMMUNOELECTROPHORESIS, CSF
|
Facility
|
IP
|
$198.45
|
|
|
Service Code
|
HCPCS 86325
|
| Hospital Charge Code |
3001013
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.77 |
| Max. Negotiated Rate |
$29.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$29.77
|
|
|
IMMUNOFIX AND PROTIN ELECTRO C
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
HCPCS 84157
|
| Hospital Charge Code |
3038077A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$11.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.25
|
|
|
IMMUNOFIX AND PROTIN ELECTRO C
|
Facility
|
IP
|
$113.00
|
|
|
Service Code
|
HCPCS 84166
|
| Hospital Charge Code |
3038077B
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.95 |
| Max. Negotiated Rate |
$16.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.95
|
|
|
IMMUNOFIX AND PROTIN ELECTRO C
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
HCPCS 84157
|
| Hospital Charge Code |
3038077A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$15,880.57 |
| Rate for Payer: Aetna Better Health Medicaid |
$15,569.19
|
| Rate for Payer: Aetna Commercial |
$12.96
|
| Rate for Payer: Aetna Medicare Advantage |
$4.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.66
|
| Rate for Payer: Cigna Commercial |
$4.00
|
| Rate for Payer: Cigna Medicare Advantage |
$2.00
|
| Rate for Payer: Clover Medicare Advantage |
$3.80
|
| Rate for Payer: EmblemHealth Commercial |
$12.00
|
| Rate for Payer: Humana Medicare Advantage |
$4.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.75
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.00
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$4.24
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.00
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$15,880.57
|
|
|
IMMUNOFIX AND PROTIN ELECTRO C
|
Facility
|
IP
|
$1,502.00
|
|
|
Service Code
|
HCPCS 86335
|
| Hospital Charge Code |
3038077C
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$225.30 |
| Max. Negotiated Rate |
$225.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.30
|
|
|
IMMUNOFIX AND PROTIN ELECTRO C
|
Facility
|
OP
|
$113.00
|
|
|
Service Code
|
HCPCS 84166
|
| Hospital Charge Code |
3038077B
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$57.77
|
| Rate for Payer: Aetna Medicare Advantage |
$17.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$65.33
|
| Rate for Payer: Cigna Commercial |
$17.83
|
| Rate for Payer: Cigna Medicare Advantage |
$8.91
|
| Rate for Payer: Clover Medicare Advantage |
$16.94
|
| Rate for Payer: EmblemHealth Commercial |
$53.49
|
| Rate for Payer: Humana Medicare Advantage |
$18.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.69
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.83
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.90
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.83
|
|
|
IMMUNOFIX AND PROTIN ELECTRO C
|
Facility
|
OP
|
$1,502.00
|
|
|
Service Code
|
HCPCS 86335
|
| Hospital Charge Code |
3038077C
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.68 |
| Max. Negotiated Rate |
$225.30 |
| Rate for Payer: Aetna Commercial |
$95.09
|
| Rate for Payer: Aetna Medicare Advantage |
$29.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$107.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$107.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$29.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$61.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$107.54
|
| Rate for Payer: Cigna Commercial |
$29.35
|
| Rate for Payer: Cigna Medicare Advantage |
$14.68
|
| Rate for Payer: Clover Medicare Advantage |
$27.88
|
| Rate for Payer: EmblemHealth Commercial |
$88.05
|
| Rate for Payer: Humana Medicare Advantage |
$30.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$195.26
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$225.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$29.35
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$31.11
|
| Rate for Payer: Wellcare Medicare Advantage |
$29.35
|
|
|
IMMUNOFIXATION CSF
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
HCPCS 84166
|
| Hospital Charge Code |
3001627A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$57.77
|
| Rate for Payer: Aetna Medicare Advantage |
$17.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$35.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$65.33
|
| Rate for Payer: Cigna Commercial |
$17.83
|
| Rate for Payer: Cigna Medicare Advantage |
$8.91
|
| Rate for Payer: Clover Medicare Advantage |
$16.94
|
| Rate for Payer: EmblemHealth Commercial |
$53.49
|
| Rate for Payer: Humana Medicare Advantage |
$18.36
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.30
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.83
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.90
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.83
|
|
|
IMMUNOFIXATION CSF
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
HCPCS 84166
|
| Hospital Charge Code |
3001627A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.50
|
|
|
IMMUNOFIXATION ELECTROPHORESIS
|
Facility
|
IP
|
$552.00
|
|
|
Service Code
|
HCPCS 86334
|
| Hospital Charge Code |
38479105
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$82.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.80
|
|
|
IMMUNOFIXATION ELECTROPHORESIS
|
Facility
|
OP
|
$552.00
|
|
|
Service Code
|
HCPCS 86334
|
| Hospital Charge Code |
38479105
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$72.38
|
| Rate for Payer: Aetna Medicare Advantage |
$22.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$22.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.85
|
| Rate for Payer: Cigna Commercial |
$22.34
|
| Rate for Payer: Cigna Medicare Advantage |
$11.17
|
| Rate for Payer: Clover Medicare Advantage |
$21.22
|
| Rate for Payer: EmblemHealth Commercial |
$67.02
|
| Rate for Payer: Humana Medicare Advantage |
$23.01
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$71.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$22.34
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$23.68
|
| Rate for Payer: Wellcare Medicare Advantage |
$22.34
|
|
|
IMMUNOFIXATION ELECTROP, SERUM
|
Facility
|
OP
|
$56.60
|
|
|
Service Code
|
HCPCS 86344
|
| Hospital Charge Code |
3001625A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.20 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$33.66
|
| Rate for Payer: Aetna Medicare Advantage |
$10.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$22.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.07
|
| Rate for Payer: Cigna Commercial |
$10.39
|
| Rate for Payer: Cigna Medicare Advantage |
$5.20
|
| Rate for Payer: Clover Medicare Advantage |
$9.87
|
| Rate for Payer: EmblemHealth Commercial |
$31.17
|
| Rate for Payer: Humana Medicare Advantage |
$10.70
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$7.36
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.39
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$11.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.39
|
|
|
IMMUNOFIXATION ELECTROP, SERUM
|
Facility
|
IP
|
$56.60
|
|
|
Service Code
|
HCPCS 86344
|
| Hospital Charge Code |
3001625A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.49 |
| Max. Negotiated Rate |
$8.49 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.49
|
|
|
IMMUNOFIXATION (SERUM)
|
Facility
|
OP
|
$226.45
|
|
| Hospital Charge Code |
3001625
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.44 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$67.94
|
| Rate for Payer: Aetna Medicare Advantage |
$67.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.74
|
| Rate for Payer: Cigna Commercial |
$113.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.44
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.97
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
IMMUNOFIXATION (SERUM)
|
Facility
|
IP
|
$226.45
|
|
| Hospital Charge Code |
3001625
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.97 |
| Max. Negotiated Rate |
$33.97 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.97
|
|
|
IMMUNOFIXATION,SERUM
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86334
|
| Hospital Charge Code |
39900214
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$72.38
|
| Rate for Payer: Aetna Medicare Advantage |
$22.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$22.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$56.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.85
|
| Rate for Payer: Cigna Commercial |
$22.34
|
| Rate for Payer: Cigna Medicare Advantage |
$11.17
|
| Rate for Payer: Clover Medicare Advantage |
$21.22
|
| Rate for Payer: EmblemHealth Commercial |
$67.02
|
| Rate for Payer: Humana Medicare Advantage |
$23.01
|
| 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 |
$22.34
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$23.68
|
| Rate for Payer: Wellcare Medicare Advantage |
$22.34
|
|
|
IMMUNOFIXATION,SERUM
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86334
|
| Hospital Charge Code |
39900214
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
IMMUNOFIXATION,URINE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86335
|
| Hospital Charge Code |
39900215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
