|
RAST ALLERGEN #22
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200V
|
|
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
|
|
|
RAST ALLERGEN #22
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200V
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
RAST ALLERGEN #23
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200W
|
|
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
|
|
|
RAST ALLERGEN #23
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200W
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
RAST ALLERGEN #24
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200X
|
|
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
|
|
|
RAST ALLERGEN #24
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200X
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
RAST ALLERGEN #25
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200Y
|
|
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
|
|
|
RAST ALLERGEN #25
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200Y
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
RAST ALLERGEN #26
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200Z
|
|
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
|
|
|
RAST ALLERGEN #26
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200Z
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
RAST ALLERGEN #3
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200C
|
|
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 #3
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200C
|
|
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 #4
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200D
|
|
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
|
|
|
RAST ALLERGEN #4
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200D
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
RAST ALLERGEN #5
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200E
|
|
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
|
|
|
RAST ALLERGEN #5
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200E
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
RAST ALLERGEN #6
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200F
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
RAST ALLERGEN #6
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200F
|
|
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
|
|
|
RAST ALLERGEN #7
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200G
|
|
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
|
|
|
RAST ALLERGEN #7
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200G
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
RAST ALLERGEN #8
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200H
|
|
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
|
|
|
RAST ALLERGEN #8
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200H
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
RAST ALLERGEN #9
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200I
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|
|
RAST ALLERGEN #9
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3031200I
|
|
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
|
|
|
RAST TEST
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS 86003
|
| Hospital Charge Code |
3006871
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.80
|
|