|
GLUCOSE CSF
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3031002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.26
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| 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 |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
GLUCOSE CSF
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
3031002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
GLUCOSE, FASTING
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
3030186
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
GLUCOSE, FASTING
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
3030186
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.26
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$173.57
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.96
|
|
|
GLUCOSE FLUID
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
38479401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
|
|
GLUCOSE FLUID
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
38479401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.26
|
| Rate for Payer: Cigna Commercial |
$78.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.56
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.43
|
|
|
GLUCOSE,FLUID
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
38472308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.26
|
| Rate for Payer: Cigna Commercial |
$78.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.56
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.43
|
|
|
GLUCOSE,FLUID
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
38472308
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
|
|
GLUCOSE,GESTATIONAL DIABETES
|
Facility
|
IP
|
$335.00
|
|
|
Service Code
|
HCPCS 82950
|
| Hospital Charge Code |
38472303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.25 |
| Max. Negotiated Rate |
$50.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.25
|
|
|
GLUCOSE,GESTATIONAL DIABETES
|
Facility
|
OP
|
$335.00
|
|
|
Service Code
|
HCPCS 82950
|
| Hospital Charge Code |
38472303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$167.50 |
| Rate for Payer: Aetna Commercial |
$12.92
|
| Rate for Payer: Aetna Medicare Advantage |
$15.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.23
|
| Rate for Payer: Cigna Commercial |
$167.50
|
| Rate for Payer: Cigna Medicare Advantage |
$4.75
|
| Rate for Payer: Clover Medicare Advantage |
$4.51
|
| Rate for Payer: EmblemHealth Commercial |
$14.25
|
| Rate for Payer: Humana Medicare Advantage |
$4.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.75
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$87.10
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$50.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$9.51
|
|
|
GLUCOSE POST GLUCOSE DOSE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82950
|
| Hospital Charge Code |
401082950
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
GLUCOSE POST GLUCOSE DOSE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82950
|
| Hospital Charge Code |
401082950
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$12.92
|
| Rate for Payer: Aetna Medicare Advantage |
$15.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$17.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$17.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$17.23
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$4.75
|
| Rate for Payer: Clover Medicare Advantage |
$4.51
|
| Rate for Payer: EmblemHealth Commercial |
$14.25
|
| Rate for Payer: Humana Medicare Advantage |
$4.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.75
|
| 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 |
$3.80
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.75
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
GLUCOSE,SYNOVIAL FLUID
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
39900086
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.26
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| 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 |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
GLUCOSE,SYNOVIAL FLUID
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
39900086
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
GLUCOSE TOLERANCE-3 SPECIMENS
|
Facility
|
OP
|
$763.00
|
|
|
Service Code
|
HCPCS 82951
|
| Hospital Charge Code |
38472311
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$381.50 |
| Rate for Payer: Aetna Commercial |
$35.01
|
| Rate for Payer: Aetna Medicare Advantage |
$41.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.69
|
| Rate for Payer: Cigna Commercial |
$381.50
|
| Rate for Payer: Cigna Medicare Advantage |
$12.87
|
| Rate for Payer: Clover Medicare Advantage |
$12.23
|
| Rate for Payer: EmblemHealth Commercial |
$38.61
|
| Rate for Payer: Humana Medicare Advantage |
$13.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.87
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$198.38
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$21.67
|
|
|
GLUCOSE TOLERANCE-3 SPECIMENS
|
Facility
|
IP
|
$763.00
|
|
|
Service Code
|
HCPCS 82951
|
| Hospital Charge Code |
38472311
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$114.45 |
| Max. Negotiated Rate |
$114.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$114.45
|
|
|
GLUCOSE TOLERANCE EA ADD SPEC.
|
Facility
|
OP
|
$403.00
|
|
|
Service Code
|
HCPCS 82952
|
| Hospital Charge Code |
38472325
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.65 |
| Max. Negotiated Rate |
$201.50 |
| Rate for Payer: Aetna Commercial |
$10.66
|
| Rate for Payer: Aetna Medicare Advantage |
$12.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.22
|
| Rate for Payer: Cigna Commercial |
$201.50
|
| Rate for Payer: Cigna Medicare Advantage |
$3.92
|
| Rate for Payer: Clover Medicare Advantage |
$3.72
|
| Rate for Payer: EmblemHealth Commercial |
$11.76
|
| Rate for Payer: Humana Medicare Advantage |
$4.04
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.92
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$104.78
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.92
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.92
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.45
|
|
|
GLUCOSE TOLERANCE EA ADD SPEC.
|
Facility
|
IP
|
$403.00
|
|
|
Service Code
|
HCPCS 82952
|
| Hospital Charge Code |
38472325
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.45 |
| Max. Negotiated Rate |
$60.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$60.45
|
|
|
GLUCOSE,URINE
|
Facility
|
OP
|
$233.00
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
38472305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$10.69
|
| Rate for Payer: Aetna Medicare Advantage |
$12.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.26
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.26
|
| Rate for Payer: Cigna Commercial |
$116.50
|
| Rate for Payer: Cigna Medicare Advantage |
$3.93
|
| Rate for Payer: Clover Medicare Advantage |
$3.73
|
| Rate for Payer: EmblemHealth Commercial |
$11.79
|
| Rate for Payer: Humana Medicare Advantage |
$4.05
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.93
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$60.58
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.93
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.62
|
|
|
GLUCOSE,URINE
|
Facility
|
IP
|
$233.00
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
38472305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.95 |
| Max. Negotiated Rate |
$34.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.95
|
|
|
GLUCOTROL/5MG/TAB
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
NDC 49411066
|
| Hospital Charge Code |
60633047
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.52
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.04
|
| Rate for Payer: Oxford Commercial |
$0.80
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$0.80
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.13
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.11
|
|
|
GLUCOTROL/5MG/TAB
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
NDC 49411066
|
| Hospital Charge Code |
60633047
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
GLUC TOLERANCE TEST 3HR
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82951
|
| Hospital Charge Code |
3001401A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$35.01
|
| Rate for Payer: Aetna Medicare Advantage |
$41.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$46.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$46.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$46.69
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.87
|
| Rate for Payer: Clover Medicare Advantage |
$12.23
|
| Rate for Payer: EmblemHealth Commercial |
$38.61
|
| Rate for Payer: Humana Medicare Advantage |
$13.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.87
|
| 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 |
$10.30
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.87
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.87
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
GLUC TOLERANCE TEST 3HR
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 82951
|
| Hospital Charge Code |
3001401A
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
GLUC TOLERANCE TEST EACH ADDI
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 82952
|
| Hospital Charge Code |
3001402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.65 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$10.66
|
| Rate for Payer: Aetna Medicare Advantage |
$12.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.92
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$1.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.22
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$3.92
|
| Rate for Payer: Clover Medicare Advantage |
$3.72
|
| Rate for Payer: EmblemHealth Commercial |
$11.76
|
| Rate for Payer: Humana Medicare Advantage |
$4.04
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.92
|
| 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 |
$3.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.92
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.92
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
