|
ENZYME IMMUNOASSAY MULT ADENOV
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
HCPCS 87301
|
| Hospital Charge Code |
38477090
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$11.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
|
|
ENZYME IMMUNOASSAY MULT ADENOV
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
HCPCS 87301
|
| Hospital Charge Code |
38477090
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$2.19 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Medicare Advantage |
$38.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.46
|
| Rate for Payer: Cigna Commercial |
$38.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.98
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.02
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.19
|
|
|
ENZYME IMMUNOASSAY MULT HBSAG
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
HCPCS 87341
|
| Hospital Charge Code |
38477070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.07 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$28.10
|
| Rate for Payer: Aetna Medicare Advantage |
$33.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.33
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.47
|
| Rate for Payer: Cigna Commercial |
$36.50
|
| Rate for Payer: Cigna Medicare Advantage |
$10.33
|
| Rate for Payer: Clover Medicare Advantage |
$9.81
|
| Rate for Payer: EmblemHealth Commercial |
$30.99
|
| Rate for Payer: Humana Medicare Advantage |
$10.64
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.33
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.98
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.33
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.33
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.07
|
|
|
ENZYME IMMUNOASSAY MULT HBSAG
|
Facility
|
IP
|
$73.00
|
|
|
Service Code
|
HCPCS 87341
|
| Hospital Charge Code |
38477070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$10.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.95
|
|
|
ENZYME IMMUNOASSAY SNGL NOS,@
|
Facility
|
IP
|
$67.00
|
|
|
Service Code
|
HCPCS 87450
|
| Hospital Charge Code |
38477062
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$10.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.05
|
|
|
ENZYME IMMUNOASSAY SNGL NOS,@
|
Facility
|
OP
|
$67.00
|
|
|
Service Code
|
HCPCS 87450
|
| Hospital Charge Code |
38477062
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$25.46
|
| Rate for Payer: Aetna Medicare Advantage |
$20.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.09
|
| Rate for Payer: Cigna Commercial |
$33.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.42
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.12
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.90
|
|
|
ENZYM IMM MULT SHUGA-LIKE TOXI
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
HCPCS 87427
|
| Hospital Charge Code |
38477098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.19 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Medicare Advantage |
$38.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.46
|
| Rate for Payer: Cigna Commercial |
$38.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.98
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.02
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.19
|
|
|
ENZYM IMM MULT SHUGA-LIKE TOXI
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
HCPCS 87427
|
| Hospital Charge Code |
38477098
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$11.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
|
|
ENZYM IMMNASS.MULT INFLUENZA A
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
HCPCS 87400
|
| Hospital Charge Code |
38477096
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$11.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
|
|
ENZYM IMMNASS.MULT INFLUENZA A
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
HCPCS 87400
|
| Hospital Charge Code |
38477096
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.19 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$38.43
|
| Rate for Payer: Aetna Medicare Advantage |
$45.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.26
|
| Rate for Payer: Cigna Commercial |
$38.50
|
| Rate for Payer: Cigna Medicare Advantage |
$14.13
|
| Rate for Payer: Clover Medicare Advantage |
$13.42
|
| Rate for Payer: EmblemHealth Commercial |
$42.39
|
| Rate for Payer: Humana Medicare Advantage |
$14.55
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.13
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.02
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.13
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.19
|
|
|
ENZYM IMMNASS MULT ROTAVIRUS
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
HCPCS 87425
|
| Hospital Charge Code |
38477097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$11.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
|
|
ENZYM IMMNASS MULT ROTAVIRUS
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
HCPCS 87425
|
| Hospital Charge Code |
38477097
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.19 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Medicare Advantage |
$38.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.46
|
| Rate for Payer: Cigna Commercial |
$38.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.98
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.02
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.19
|
|
|
ENZYM IMMN.MULT.CLOSTRIDIUM DI
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
HCPCS 87324
|
| Hospital Charge Code |
38477092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$11.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
|
|
ENZYM IMMN.MULT.CLOSTRIDIUM DI
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
HCPCS 87324
|
| Hospital Charge Code |
38477092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.19 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Medicare Advantage |
$38.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.46
|
| Rate for Payer: Cigna Commercial |
$38.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.98
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.02
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.19
|
|
|
ENZYM IMMN MULT CRYPTOCOCCUS N
|
Facility
|
OP
|
$77.00
|
|
|
Service Code
|
HCPCS 87327
|
| Hospital Charge Code |
38477093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.19 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$36.50
|
| Rate for Payer: Aetna Medicare Advantage |
$43.48
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$48.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$48.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$48.68
|
| Rate for Payer: Cigna Commercial |
$38.50
|
| Rate for Payer: Cigna Medicare Advantage |
$13.42
|
| Rate for Payer: Clover Medicare Advantage |
$12.75
|
| Rate for Payer: EmblemHealth Commercial |
$40.26
|
| Rate for Payer: Humana Medicare Advantage |
$13.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.42
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.02
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.74
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.42
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.42
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.19
|
|
|
ENZYM IMMN MULT CRYPTOCOCCUS N
|
Facility
|
IP
|
$77.00
|
|
|
Service Code
|
HCPCS 87327
|
| Hospital Charge Code |
38477093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$11.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.55
|
|
|
EOSINOPHIL COUNT
|
Facility
|
IP
|
$368.00
|
|
|
Service Code
|
HCPCS 85048
|
| Hospital Charge Code |
38473015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.20 |
| Max. Negotiated Rate |
$55.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.20
|
|
|
EOSINOPHIL COUNT
|
Facility
|
OP
|
$368.00
|
|
|
Service Code
|
HCPCS 85048
|
| Hospital Charge Code |
38473015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.98 |
| Max. Negotiated Rate |
$184.00 |
| Rate for Payer: Aetna Commercial |
$6.91
|
| Rate for Payer: Aetna Medicare Advantage |
$8.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$9.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$9.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$9.21
|
| Rate for Payer: Cigna Commercial |
$184.00
|
| Rate for Payer: Cigna Medicare Advantage |
$2.54
|
| Rate for Payer: Clover Medicare Advantage |
$2.41
|
| Rate for Payer: EmblemHealth Commercial |
$7.62
|
| Rate for Payer: Humana Medicare Advantage |
$2.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$95.68
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$55.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$2.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$10.45
|
|
|
EOSINOPHIL COUNT, URINE
|
Facility
|
OP
|
$222.00
|
|
|
Service Code
|
HCPCS 81015
|
| Hospital Charge Code |
38477031
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$0.66 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$8.30
|
| Rate for Payer: Aetna Medicare Advantage |
$9.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$11.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$11.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$0.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$11.06
|
| Rate for Payer: Cigna Commercial |
$111.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.05
|
| Rate for Payer: Clover Medicare Advantage |
$2.90
|
| Rate for Payer: EmblemHealth Commercial |
$9.15
|
| Rate for Payer: Humana Medicare Advantage |
$3.14
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$57.72
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.44
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.30
|
|
|
EOSINOPHIL COUNT, URINE
|
Facility
|
IP
|
$222.00
|
|
|
Service Code
|
HCPCS 81015
|
| Hospital Charge Code |
38477031
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$33.30 |
| Max. Negotiated Rate |
$33.30 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$33.30
|
|
|
EOSINOPHILS, NASAL SMEAR
|
Facility
|
OP
|
$123.00
|
|
|
Service Code
|
HCPCS 89190
|
| Hospital Charge Code |
38475097
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$15.75
|
| Rate for Payer: Aetna Medicare Advantage |
$18.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21.00
|
| Rate for Payer: Cigna Commercial |
$61.50
|
| Rate for Payer: Cigna Medicare Advantage |
$5.79
|
| Rate for Payer: Clover Medicare Advantage |
$5.50
|
| Rate for Payer: EmblemHealth Commercial |
$17.37
|
| Rate for Payer: Humana Medicare Advantage |
$5.96
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$31.98
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.63
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.49
|
|
|
EOSINOPHILS, NASAL SMEAR
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
HCPCS 89190
|
| Hospital Charge Code |
38475097
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$18.45 |
| Max. Negotiated Rate |
$18.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.45
|
|
|
EOSINOPHILS (URINE)
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87205
|
| Hospital Charge Code |
3005436
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
EOSINOPHILS (URINE)
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87205
|
| Hospital Charge Code |
3005436
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$3.42 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$11.61
|
| Rate for Payer: Aetna Medicare Advantage |
$13.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.49
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$4.27
|
| Rate for Payer: Clover Medicare Advantage |
$4.06
|
| Rate for Payer: EmblemHealth Commercial |
$12.81
|
| Rate for Payer: Humana Medicare Advantage |
$4.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.27
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$101.40
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.27
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.27
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
EPF KIT
|
Facility
|
OP
|
$3,734.50
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
270703555
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$106.06 |
| Max. Negotiated Rate |
$1,867.25 |
| Rate for Payer: Aetna Commercial |
$1,419.11
|
| Rate for Payer: Aetna Medicare Advantage |
$1,120.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$952.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$952.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$746.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$952.30
|
| Rate for Payer: Cigna Commercial |
$1,867.25
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$903.75
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$560.17
|
| Rate for Payer: UnitedHealthcare Community & State |
$118.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$106.06
|
|
