|
ANTI GLIADIN ANTIBODY IGG IGA
|
Facility
|
OP
|
$253.45
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
3032364
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.63 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$55.95
|
| Rate for Payer: Aetna Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.28
|
| Rate for Payer: Cigna Commercial |
$17.27
|
| Rate for Payer: Cigna Medicare Advantage |
$8.63
|
| Rate for Payer: Clover Medicare Advantage |
$16.41
|
| Rate for Payer: EmblemHealth Commercial |
$51.81
|
| Rate for Payer: Humana Medicare Advantage |
$17.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.95
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
|
|
ANTIGLOBULIN TECHNIQUE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86922
|
| Hospital Charge Code |
3100583B
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.68 |
| Max. Negotiated Rate |
$405.73 |
| Rate for Payer: Aetna Commercial |
$117.00
|
| Rate for Payer: Aetna Medicare Advantage |
$117.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$99.45
|
| Rate for Payer: Cigna Commercial |
$405.73
|
| 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
|
|
|
ANTIGLOBULIN TECHNIQUE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86922
|
| Hospital Charge Code |
3100583B
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ANTIGLOMERULAR BM AB, QN
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
3007176
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.00 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
|
|
ANTIGLOMERULAR BM AB, QN
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
3007176
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$37.36
|
| Rate for Payer: Aetna Medicare Advantage |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.25
|
| Rate for Payer: Cigna Commercial |
$11.53
|
| Rate for Payer: Cigna Medicare Advantage |
$5.76
|
| Rate for Payer: Clover Medicare Advantage |
$10.95
|
| Rate for Payer: EmblemHealth Commercial |
$34.59
|
| Rate for Payer: Humana Medicare Advantage |
$11.88
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$39.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$45.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$12.22
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.53
|
|
|
ANTI GM1 ANTIBODY
|
Facility
|
IP
|
$376.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
38476236
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.40 |
| Max. Negotiated Rate |
$56.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.40
|
|
|
ANTI GM1 ANTIBODY
|
Facility
|
OP
|
$376.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
38476236
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.63 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$55.95
|
| Rate for Payer: Aetna Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.28
|
| Rate for Payer: Cigna Commercial |
$17.27
|
| Rate for Payer: Cigna Medicare Advantage |
$8.63
|
| Rate for Payer: Clover Medicare Advantage |
$16.41
|
| Rate for Payer: EmblemHealth Commercial |
$51.81
|
| Rate for Payer: Humana Medicare Advantage |
$17.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$48.88
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$56.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
|
|
ANTI HEMOPHILIC FACTOR VIII
|
Facility
|
OP
|
$4.00
|
|
| Hospital Charge Code |
3109015
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.60 |
| 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 |
$0.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
ANTI HEMOPHILIC FACTOR VIII
|
Facility
|
IP
|
$4.00
|
|
| Hospital Charge Code |
3109015
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.97
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
ANTI-HISTONE ANTIBODIES
|
Facility
|
OP
|
$417.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
38476154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.63 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$55.95
|
| Rate for Payer: Aetna Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.28
|
| Rate for Payer: Cigna Commercial |
$17.27
|
| Rate for Payer: Cigna Medicare Advantage |
$8.63
|
| Rate for Payer: Clover Medicare Advantage |
$16.41
|
| Rate for Payer: EmblemHealth Commercial |
$51.81
|
| Rate for Payer: Humana Medicare Advantage |
$17.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$54.21
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.27
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
|
|
ANTI-HISTONE ANTIBODIES
|
Facility
|
IP
|
$417.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
38476154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.55 |
| Max. Negotiated Rate |
$62.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$62.55
|
|
|
ANTI HISTONE ANTIBODY SERUM
|
Facility
|
OP
|
$143.99
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
3007051
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.96 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: Aetna Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$65.70
|
| Rate for Payer: Cigna Commercial |
$17.93
|
| Rate for Payer: Cigna Medicare Advantage |
$8.96
|
| Rate for Payer: Clover Medicare Advantage |
$17.03
|
| Rate for Payer: EmblemHealth Commercial |
$53.79
|
| Rate for Payer: Humana Medicare Advantage |
$18.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.72
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.93
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$19.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.93
|
|
|
ANTI HISTONE ANTIBODY SERUM
|
Facility
|
IP
|
$143.99
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
3007051
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
|
|
ANTI HU ANTIBODY
|
Facility
|
OP
|
$329.00
|
|
|
Service Code
|
HCPCS 86316
|
| Hospital Charge Code |
38476232
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$67.42
|
| Rate for Payer: Aetna Medicare Advantage |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$76.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$76.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$52.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$76.25
|
| Rate for Payer: Cigna Commercial |
$20.81
|
| Rate for Payer: Cigna Medicare Advantage |
$10.40
|
| Rate for Payer: Clover Medicare Advantage |
$19.77
|
| Rate for Payer: EmblemHealth Commercial |
$62.43
|
| Rate for Payer: Humana Medicare Advantage |
$21.43
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$42.77
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.81
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$22.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.81
|
|
|
ANTI HU ANTIBODY
|
Facility
|
IP
|
$329.00
|
|
|
Service Code
|
HCPCS 86316
|
| Hospital Charge Code |
38476232
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$49.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$49.35
|
|
|
ANTI HYALURONIDASE, SERUM
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
HCPCS 86060
|
| Hospital Charge Code |
3007069
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
|
|
ANTI HYALURONIDASE, SERUM
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
HCPCS 86060
|
| Hospital Charge Code |
3007069
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$23.65
|
| Rate for Payer: Aetna Medicare Advantage |
$7.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26.75
|
| Rate for Payer: Cigna Commercial |
$7.30
|
| Rate for Payer: Cigna Medicare Advantage |
$3.65
|
| Rate for Payer: Clover Medicare Advantage |
$6.93
|
| Rate for Payer: EmblemHealth Commercial |
$21.90
|
| Rate for Payer: Humana Medicare Advantage |
$7.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.00
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7.30
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$7.74
|
| Rate for Payer: Wellcare Medicare Advantage |
$7.30
|
|
|
ANTI-ISLET CELL AB SCREEN
|
Facility
|
OP
|
$121.00
|
|
|
Service Code
|
HCPCS 86255
|
| Hospital Charge Code |
3007077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$39.04
|
| Rate for Payer: Aetna Medicare Advantage |
$12.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.15
|
| Rate for Payer: Cigna Commercial |
$12.05
|
| Rate for Payer: Cigna Medicare Advantage |
$6.03
|
| Rate for Payer: Clover Medicare Advantage |
$11.45
|
| Rate for Payer: EmblemHealth Commercial |
$36.15
|
| Rate for Payer: Humana Medicare Advantage |
$12.41
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.73
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.05
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$12.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.05
|
|
|
ANTI-ISLET CELL AB SCREEN
|
Facility
|
IP
|
$121.00
|
|
|
Service Code
|
HCPCS 86255
|
| Hospital Charge Code |
3007077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.15 |
| Max. Negotiated Rate |
$18.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.15
|
|
|
ANTI-JO 1 AB ENA
|
Facility
|
IP
|
$143.99
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
3008299
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
|
|
ANTI-JO 1 AB ENA
|
Facility
|
OP
|
$143.99
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
3008299
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.96 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$58.09
|
| Rate for Payer: Aetna Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$65.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$65.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$44.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$65.70
|
| Rate for Payer: Cigna Commercial |
$17.93
|
| Rate for Payer: Cigna Medicare Advantage |
$8.96
|
| Rate for Payer: Clover Medicare Advantage |
$17.03
|
| Rate for Payer: EmblemHealth Commercial |
$53.79
|
| Rate for Payer: Humana Medicare Advantage |
$18.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.72
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.93
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$19.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.93
|
|
|
ANTI KERATIN
|
Facility
|
OP
|
$1,259.35
|
|
| Hospital Charge Code |
270655021
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$163.72 |
| Max. Negotiated Rate |
$629.67 |
| Rate for Payer: Aetna Commercial |
$377.81
|
| Rate for Payer: Aetna Medicare Advantage |
$377.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$321.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$321.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$321.13
|
| Rate for Payer: Cigna Commercial |
$629.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$163.72
|
| Rate for Payer: Oxford Commercial |
$629.67
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$629.67
|
|
|
ANTI KERATIN
|
Facility
|
IP
|
$1,259.35
|
|
| Hospital Charge Code |
270655021
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$188.90 |
| Max. Negotiated Rate |
$188.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$188.90
|
|
|
ANTI MICROSOMAL ANTIBODIES
|
Facility
|
OP
|
$160.85
|
|
|
Service Code
|
HCPCS 86376
|
| Hospital Charge Code |
3007143
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$47.14
|
| Rate for Payer: Aetna Medicare Advantage |
$14.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$53.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$53.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$53.31
|
| Rate for Payer: Cigna Commercial |
$14.55
|
| Rate for Payer: Cigna Medicare Advantage |
$7.28
|
| Rate for Payer: Clover Medicare Advantage |
$13.82
|
| Rate for Payer: EmblemHealth Commercial |
$43.65
|
| Rate for Payer: Humana Medicare Advantage |
$14.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.91
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.55
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$15.42
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.55
|
|
|
ANTI MICROSOMAL ANTIBODIES
|
Facility
|
IP
|
$160.85
|
|
|
Service Code
|
HCPCS 86376
|
| Hospital Charge Code |
3007143
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.13 |
| Max. Negotiated Rate |
$24.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$24.13
|
|