|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166AI
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.83 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166W
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: Aetna Medicare Advantage |
$19.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.57
|
| Rate for Payer: Cigna Commercial |
$32.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.45
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166JJ
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.83 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166X
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166AO
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.83 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166AP
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.83 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166EE
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.40
|
| Rate for Payer: Cigna Commercial |
$2.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.72
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166I
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.40
|
| Rate for Payer: Cigna Commercial |
$2.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.72
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166AL
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.83 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166AC
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.40
|
| Rate for Payer: Cigna Commercial |
$2.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.72
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166DD
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.40
|
| Rate for Payer: Cigna Commercial |
$2.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.72
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166VV
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166C
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.40
|
| Rate for Payer: Cigna Commercial |
$2.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.72
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166AB
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166Z
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$105.00
|
|
| Hospital Charge Code |
3004166D
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.75
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166AA
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: Aetna Medicare Advantage |
$19.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.57
|
| Rate for Payer: Cigna Commercial |
$32.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.45
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166TT
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: Aetna Medicare Advantage |
$19.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.57
|
| Rate for Payer: Cigna Commercial |
$32.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.45
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166AE
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.40
|
| Rate for Payer: Cigna Commercial |
$2.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.72
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166G
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.40
|
| Rate for Payer: Cigna Commercial |
$2.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.72
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$105.00
|
|
| Hospital Charge Code |
3004166C
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.75 |
| Max. Negotiated Rate |
$15.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.75
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166OO
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$19.50
|
| Rate for Payer: Aetna Medicare Advantage |
$19.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.57
|
| Rate for Payer: Cigna Commercial |
$32.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.45
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
OP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166AP
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: Aetna Medicare Advantage |
$1.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.40
|
| Rate for Payer: Cigna Commercial |
$2.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.72
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$5.50
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166AG
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.83 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.83
|
|
|
NUCLEIC ACID PROBE, EACH
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
HCPCS 83896
|
| Hospital Charge Code |
3035166RR
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.75
|
|