|
SENSORY MOTOR NEUROPATHY AB IV
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990158D
|
|
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 |
$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 |
$17.27
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
|
|
SENSORY MOTOR NEUROPATHY AB IX
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990158I
|
|
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 |
$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 |
$17.27
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
|
|
SENSORY MOTOR NEUROPATHY AB IX
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990158I
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
SENSORY MOTOR NEUROPATHY AB V
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990158E
|
|
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 |
$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 |
$17.27
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
|
|
SENSORY MOTOR NEUROPATHY AB V
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990158E
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
SENSORY MOTOR NEUROPATHY AB VI
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990158F
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
SENSORY MOTOR NEUROPATHY AB VI
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990158F
|
|
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 |
$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 |
$17.27
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
|
|
SENSORY MOTOR NEUROPATHY ABVII
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990158G
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
SENSORY MOTOR NEUROPATHY ABVII
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990158G
|
|
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 |
$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 |
$17.27
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
|
|
SENSORY MOTOR NEUROPATHY VIII
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990158H
|
|
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 |
$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 |
$17.27
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.31
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.27
|
|
|
SENSORY MOTOR NEUROPATHY VIII
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990158H
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
SENSORY NERVE CONDUCTION
|
Facility
|
IP
|
$285.65
|
|
|
Service Code
|
HCPCS 95904
|
| Hospital Charge Code |
5500038
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$42.85 |
| Max. Negotiated Rate |
$42.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.85
|
|
|
SENSORY NERVE CONDUCTION
|
Facility
|
OP
|
$285.65
|
|
|
Service Code
|
HCPCS 95904
|
| Hospital Charge Code |
5500038
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$37.13 |
| Max. Negotiated Rate |
$1,673.00 |
| Rate for Payer: Aetna Commercial |
$85.69
|
| Rate for Payer: Aetna Medicare Advantage |
$85.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$72.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$72.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$72.84
|
| Rate for Payer: Cigna Commercial |
$142.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$37.13
|
| Rate for Payer: Oxford Commercial |
$1,474.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$42.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,673.00
|
|
|
SENSORY NEUROPATHY ANTIBODY I
|
Facility
|
OP
|
$89.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990148A
|
|
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 |
$11.57
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.35
|
| 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
|
|
|
SENSORY NEUROPATHY ANTIBODY I
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990148A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$13.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.35
|
|
|
SENSORY NEUROPATHY ANTIBODY I
|
Facility
|
IP
|
$89.00
|
|
| Hospital Charge Code |
3990148A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$13.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.35
|
|
|
SENSORY NEUROPATHY ANTIBODY I
|
Facility
|
OP
|
$89.00
|
|
| Hospital Charge Code |
3990148A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.57 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$26.70
|
| Rate for Payer: Aetna Medicare Advantage |
$26.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$22.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$22.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$22.70
|
| Rate for Payer: Cigna Commercial |
$44.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$11.57
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
|
|
SENSORY NEUROPATHY ANTIBODY II
|
Facility
|
OP
|
$116.20
|
|
|
Service Code
|
HCPCS 84181
|
| Hospital Charge Code |
39990148C
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Aetna Commercial |
$55.18
|
| Rate for Payer: Aetna Medicare Advantage |
$17.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$62.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$62.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.03
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$55.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$62.40
|
| Rate for Payer: Cigna Commercial |
$17.03
|
| Rate for Payer: Cigna Medicare Advantage |
$8.52
|
| Rate for Payer: Clover Medicare Advantage |
$16.18
|
| Rate for Payer: EmblemHealth Commercial |
$51.09
|
| Rate for Payer: Humana Medicare Advantage |
$17.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.11
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$114.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.03
|
| Rate for Payer: Wellcare Ambetter Commercial-Exchange |
$18.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.03
|
|
|
SENSORY NEUROPATHY ANTIBODY II
|
Facility
|
IP
|
$116.20
|
|
|
Service Code
|
HCPCS 84181
|
| Hospital Charge Code |
39990148C
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.43 |
| Max. Negotiated Rate |
$17.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.43
|
|
|
SENSORY NEUROPATHY ANTIBODY II
|
Facility
|
IP
|
$89.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990148B
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$13.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.35
|
|
|
SENSORY NEUROPATHY ANTIBODY II
|
Facility
|
OP
|
$89.00
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
39990148B
|
|
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 |
$11.57
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.35
|
| 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
|
|
|
SENSORY NEUROPATHY ANTIBODY IV
|
Facility
|
IP
|
$82.85
|
|
|
Service Code
|
HCPCS 86255
|
| Hospital Charge Code |
39990148D
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.43 |
| Max. Negotiated Rate |
$12.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.43
|
|
|
SENSORY NEUROPATHY ANTIBODY IV
|
Facility
|
OP
|
$82.85
|
|
|
Service Code
|
HCPCS 86255
|
| Hospital Charge Code |
39990148D
|
|
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 |
$10.77
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.43
|
| 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
|
|
|
SENSORY NEUROPATHY ANTIBODY V
|
Facility
|
OP
|
$82.85
|
|
|
Service Code
|
HCPCS 86255
|
| Hospital Charge Code |
39990148E
|
|
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 |
$10.77
|
| Rate for Payer: Oxford Commercial |
$101.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.43
|
| 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
|
|
|
SENSORY NEUROPATHY ANTIBODY V
|
Facility
|
IP
|
$82.85
|
|
|
Service Code
|
HCPCS 86255
|
| Hospital Charge Code |
39990148E
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.43 |
| Max. Negotiated Rate |
$12.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.43
|
|