|
RASP SM CROSSCUT F/PEN DRIVE
|
Facility
|
OP
|
$616.00
|
|
| Hospital Charge Code |
270674680
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.08 |
| Max. Negotiated Rate |
$308.00 |
| Rate for Payer: Aetna Commercial |
$184.80
|
| Rate for Payer: Aetna Medicare Advantage |
$184.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$157.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$157.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$157.08
|
| Rate for Payer: Cigna Commercial |
$308.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$80.08
|
| Rate for Payer: Oxford Commercial |
$308.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$308.00
|
|
|
RASP SM CROSSCUT F/PEN DRIVE
|
Facility
|
IP
|
$616.00
|
|
| Hospital Charge Code |
270674680
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$92.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.40
|
|
|
RASP SML TEAR CROSSCUT 5x11MM
|
Facility
|
IP
|
$280.25
|
|
| Hospital Charge Code |
270674137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.04 |
| Max. Negotiated Rate |
$42.04 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.04
|
|
|
RASP SML TEAR CROSSCUT 5x11MM
|
Facility
|
OP
|
$280.25
|
|
| Hospital Charge Code |
270674137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.43 |
| Max. Negotiated Rate |
$140.12 |
| Rate for Payer: Aetna Commercial |
$84.08
|
| Rate for Payer: Aetna Medicare Advantage |
$84.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$71.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$71.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$71.46
|
| Rate for Payer: Cigna Commercial |
$140.12
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.43
|
| Rate for Payer: Oxford Commercial |
$140.12
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$140.12
|
|
|
RASP TEAR 13.0 X 7.0MM
|
Facility
|
IP
|
$249.20
|
|
| Hospital Charge Code |
270664104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.38 |
| Max. Negotiated Rate |
$37.38 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.38
|
|
|
RASP TEAR 13.0 X 7.0MM
|
Facility
|
OP
|
$249.20
|
|
| Hospital Charge Code |
270664104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32.40 |
| Max. Negotiated Rate |
$124.60 |
| Rate for Payer: Aetna Commercial |
$74.76
|
| Rate for Payer: Aetna Medicare Advantage |
$74.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$63.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$63.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$63.55
|
| Rate for Payer: Cigna Commercial |
$124.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.40
|
| Rate for Payer: Oxford Commercial |
$124.60
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.60
|
|
|
RAST(2)
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476783
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
|
|
RAST(2)
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476783
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.48
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RAST(3)
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476784
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
|
|
RAST(3)
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476784
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.48
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RAST(4)
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476785
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.48
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RAST(4)
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476785
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
|
|
RAST(5)
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476786
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
|
|
RAST(5)
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476786
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.48
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RAST(6)
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476787
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.48
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RAST(6)
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476787
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
|
|
RAST(7)
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476788
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.48
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RAST(7)
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476788
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
|
|
RAST(8)
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476789
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
|
|
RAST(8)
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476789
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.48
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RAST(9)
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476790
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$119.40 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
|
|
RAST(9)
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
38476790
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.48
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$119.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RAST ALLERGEN #1
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200A
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| 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 |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|
|
RAST ALLERGEN #1
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200A
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
RAST ALLERGEN #10
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200J
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.61 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$16.91
|
| Rate for Payer: Aetna Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$37.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.13
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$2.61
|
| Rate for Payer: Clover Medicare Advantage |
$4.96
|
| Rate for Payer: EmblemHealth Commercial |
$15.66
|
| Rate for Payer: Humana Medicare Advantage |
$5.38
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$6.76
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.22
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$5.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.22
|
|