|
HB CORE AB (IGM)
|
Facility
|
IP
|
$80.90
|
|
|
Service Code
|
HCPCS 86705
|
| Hospital Charge Code |
39900245
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.13 |
| Max. Negotiated Rate |
$12.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.13
|
|
|
HB CORE AB (IGM)
|
Facility
|
OP
|
$80.90
|
|
|
Service Code
|
HCPCS 86705
|
| Hospital Charge Code |
39900245
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$32.01
|
| Rate for Payer: Aetna Medicare Advantage |
$38.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$26.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.70
|
| Rate for Payer: Cigna Commercial |
$40.45
|
| Rate for Payer: Cigna Medicare Advantage |
$11.77
|
| Rate for Payer: Clover Medicare Advantage |
$11.18
|
| Rate for Payer: EmblemHealth Commercial |
$35.31
|
| Rate for Payer: Humana Medicare Advantage |
$12.12
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.03
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.30
|
|
|
HB CORE AB,TOTAL
|
Facility
|
OP
|
$82.85
|
|
|
Service Code
|
HCPCS 86704
|
| Hospital Charge Code |
39900244
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$32.78
|
| Rate for Payer: Aetna Medicare Advantage |
$39.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.71
|
| 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 |
$21.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.71
|
| Rate for Payer: Cigna Commercial |
$41.42
|
| Rate for Payer: Cigna Medicare Advantage |
$12.05
|
| 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: Longevity Health Plan of New Jersey Medicare Advantage |
$12.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.54
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.35
|
|
|
HB CORE AB,TOTAL
|
Facility
|
IP
|
$82.85
|
|
|
Service Code
|
HCPCS 86704
|
| Hospital Charge Code |
39900244
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.43 |
| Max. Negotiated Rate |
$12.43 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.43
|
|
|
HB E AB
|
Facility
|
OP
|
$79.50
|
|
|
Service Code
|
HCPCS 86707
|
| Hospital Charge Code |
39900246
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$31.47
|
| Rate for Payer: Aetna Medicare Advantage |
$37.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.97
|
| Rate for Payer: Cigna Commercial |
$39.75
|
| Rate for Payer: Cigna Medicare Advantage |
$11.57
|
| Rate for Payer: Clover Medicare Advantage |
$10.99
|
| Rate for Payer: EmblemHealth Commercial |
$34.71
|
| Rate for Payer: Humana Medicare Advantage |
$11.92
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.57
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.67
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.26
|
|
|
HB E AB
|
Facility
|
IP
|
$79.50
|
|
|
Service Code
|
HCPCS 86707
|
| Hospital Charge Code |
39900246
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$11.93 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.93
|
|
|
HB E AG
|
Facility
|
OP
|
$79.20
|
|
|
Service Code
|
HCPCS 87350
|
| Hospital Charge Code |
39900287
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$31.36
|
| Rate for Payer: Aetna Medicare Advantage |
$37.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.83
|
| Rate for Payer: Cigna Commercial |
$39.60
|
| Rate for Payer: Cigna Medicare Advantage |
$11.53
|
| Rate for Payer: Clover Medicare Advantage |
$10.95
|
| Rate for Payer: EmblemHealth Commercial |
$34.59
|
| Rate for Payer: Humana Medicare Advantage |
$11.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.53
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$20.59
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.25
|
|
|
HB E AG
|
Facility
|
IP
|
$79.20
|
|
|
Service Code
|
HCPCS 87350
|
| Hospital Charge Code |
39900287
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.88 |
| Max. Negotiated Rate |
$11.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.88
|
|
|
HB S AB, I
|
Facility
|
IP
|
$103.05
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990031A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.46 |
| Max. Negotiated Rate |
$15.46 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.46
|
|
|
HB S AB, I
|
Facility
|
OP
|
$103.05
|
|
|
Service Code
|
HCPCS 86317
|
| Hospital Charge Code |
39990031A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna Medicare Advantage |
$48.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.38
|
| Rate for Payer: Cigna Commercial |
$51.52
|
| Rate for Payer: Cigna Medicare Advantage |
$14.99
|
| Rate for Payer: Clover Medicare Advantage |
$14.24
|
| Rate for Payer: EmblemHealth Commercial |
$44.97
|
| Rate for Payer: Humana Medicare Advantage |
$15.44
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.99
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.79
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.46
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.99
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.99
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.93
|
|
|
HB S AB, II
|
Facility
|
IP
|
$73.80
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
39990031B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.07
|
|
|
HB S AB, II
|
Facility
|
OP
|
$73.80
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
39990031B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.10 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$29.21
|
| Rate for Payer: Aetna Medicare Advantage |
$34.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.74
|
| 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 |
$38.96
|
| Rate for Payer: Cigna Commercial |
$36.90
|
| Rate for Payer: Cigna Medicare Advantage |
$10.74
|
| Rate for Payer: Clover Medicare Advantage |
$10.20
|
| Rate for Payer: EmblemHealth Commercial |
$32.22
|
| Rate for Payer: Humana Medicare Advantage |
$11.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.74
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.19
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.74
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.10
|
|
|
HB S AG W/REFLEX CONF
|
Facility
|
IP
|
$71.00
|
|
|
Service Code
|
HCPCS 87340
|
| Hospital Charge Code |
39900286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.65 |
| Max. Negotiated Rate |
$10.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.65
|
|
|
HB S AG W/REFLEX CONF
|
Facility
|
OP
|
$71.00
|
|
|
Service Code
|
HCPCS 87340
|
| Hospital Charge Code |
39900286
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.02 |
| 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 |
$23.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.47
|
| Rate for Payer: Cigna Commercial |
$35.50
|
| 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 |
$18.46
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.65
|
| 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 |
$2.02
|
|
|
HBV1
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86704
|
| Hospital Charge Code |
39708025A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
HBV1
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86704
|
| Hospital Charge Code |
39708025A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$32.78
|
| Rate for Payer: Aetna Medicare Advantage |
$39.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.71
|
| 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 |
$21.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.71
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.05
|
| 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: Longevity Health Plan of New Jersey Medicare Advantage |
$12.05
|
| 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 |
$9.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
HBV2
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86705
|
| Hospital Charge Code |
39708025B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
HBV2
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86705
|
| Hospital Charge Code |
39708025B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.42 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$32.01
|
| Rate for Payer: Aetna Medicare Advantage |
$38.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$26.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.70
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.77
|
| Rate for Payer: Clover Medicare Advantage |
$11.18
|
| Rate for Payer: EmblemHealth Commercial |
$35.31
|
| Rate for Payer: Humana Medicare Advantage |
$12.12
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.77
|
| 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 |
$9.42
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
HBV3
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
39708025C
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
HBV3
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
39708025C
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.59 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$29.21
|
| Rate for Payer: Aetna Medicare Advantage |
$34.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$38.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$38.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.74
|
| 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 |
$38.96
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$10.74
|
| Rate for Payer: Clover Medicare Advantage |
$10.20
|
| Rate for Payer: EmblemHealth Commercial |
$32.22
|
| Rate for Payer: Humana Medicare Advantage |
$11.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.74
|
| 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 |
$8.59
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.74
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
HBV4
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86707
|
| Hospital Charge Code |
39708025D
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
HBV4
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86707
|
| Hospital Charge Code |
39708025D
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$31.47
|
| Rate for Payer: Aetna Medicare Advantage |
$37.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.97
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.57
|
| Rate for Payer: Clover Medicare Advantage |
$10.99
|
| Rate for Payer: EmblemHealth Commercial |
$34.71
|
| Rate for Payer: Humana Medicare Advantage |
$11.92
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.57
|
| 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 |
$9.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.57
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
HBV5
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87340
|
| Hospital Charge Code |
39708025E
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
HBV5
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87340
|
| Hospital Charge Code |
39708025E
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.26 |
| Max. Negotiated Rate |
$195.00 |
| 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 |
$23.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.47
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| 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 |
$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 |
$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 |
$11.08
|
|
|
HBV6
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87350
|
| Hospital Charge Code |
39708025F
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$31.36
|
| Rate for Payer: Aetna Medicare Advantage |
$37.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.83
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.53
|
| Rate for Payer: Clover Medicare Advantage |
$10.95
|
| Rate for Payer: EmblemHealth Commercial |
$34.59
|
| Rate for Payer: Humana Medicare Advantage |
$11.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.53
|
| 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 |
$9.22
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
