|
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC
|
Facility
|
IP
|
$127,107.05
|
|
|
Service Code
|
MSDRG 420
|
| Min. Negotiated Rate |
$38,702.47 |
| Max. Negotiated Rate |
$127,107.05 |
| Rate for Payer: Aetna Commercial |
$92,385.62
|
| Rate for Payer: Aetna Medicare Advantage |
$127,107.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$88,656.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$88,656.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$40,739.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$88,656.00
|
| Rate for Payer: Cigna Commercial |
$75,954.48
|
| Rate for Payer: Cigna Medicare Advantage |
$40,739.44
|
| Rate for Payer: Clover Medicare Advantage |
$38,702.47
|
| Rate for Payer: EmblemHealth Commercial |
$122,218.32
|
| Rate for Payer: Humana Medicare Advantage |
$41,961.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$40,739.44
|
| Rate for Payer: Oxford Commercial |
$60,033.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$80,356.45
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$40,739.44
|
| Rate for Payer: Wellcare Medicare Advantage |
$40,739.44
|
|
|
HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$63,679.86
|
|
|
Service Code
|
MSDRG 422
|
| Min. Negotiated Rate |
$19,389.70 |
| Max. Negotiated Rate |
$63,679.86 |
| Rate for Payer: Aetna Commercial |
$47,212.02
|
| Rate for Payer: Aetna Medicare Advantage |
$63,679.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$39,064.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$39,064.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20,410.21
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$39,064.05
|
| Rate for Payer: Cigna Commercial |
$31,199.05
|
| Rate for Payer: Cigna Medicare Advantage |
$20,410.21
|
| Rate for Payer: Clover Medicare Advantage |
$19,389.70
|
| Rate for Payer: EmblemHealth Commercial |
$61,230.63
|
| Rate for Payer: Humana Medicare Advantage |
$21,022.52
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20,410.21
|
| Rate for Payer: Oxford Commercial |
$24,659.19
|
| Rate for Payer: UnitedHealthcare Commercial |
$33,007.21
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20,410.21
|
| Rate for Payer: Wellcare Medicare Advantage |
$20,410.21
|
|
|
HEP A VIRUS ANT IGG
|
Facility
|
OP
|
$426.00
|
|
|
Service Code
|
HCPCS 86708
|
| Hospital Charge Code |
38479435
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.91 |
| Max. Negotiated Rate |
$213.00 |
| Rate for Payer: Aetna Commercial |
$33.70
|
| Rate for Payer: Aetna Medicare Advantage |
$40.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$44.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$44.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$28.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$44.94
|
| Rate for Payer: Cigna Commercial |
$213.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.39
|
| Rate for Payer: Clover Medicare Advantage |
$11.77
|
| Rate for Payer: EmblemHealth Commercial |
$37.17
|
| Rate for Payer: Humana Medicare Advantage |
$12.76
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$110.76
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.10
|
|
|
HEP A VIRUS ANT IGG
|
Facility
|
IP
|
$426.00
|
|
|
Service Code
|
HCPCS 86708
|
| Hospital Charge Code |
38479435
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$63.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$63.90
|
|
|
HEP B CORE ANTIB
|
Facility
|
IP
|
$559.00
|
|
|
Service Code
|
HCPCS 87350
|
| Hospital Charge Code |
38479493
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$83.85 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
|
|
HEP B CORE ANTIB
|
Facility
|
OP
|
$559.00
|
|
|
Service Code
|
HCPCS 87350
|
| Hospital Charge Code |
38479493
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$279.50 |
| 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 |
$279.50
|
| 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 |
$145.34
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
| 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 |
$15.88
|
|
|
HEP BE ANTIG
|
Facility
|
IP
|
$559.00
|
|
|
Service Code
|
HCPCS 86707
|
| Hospital Charge Code |
38479486
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$83.85 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
|
|
HEP BE ANTIG
|
Facility
|
OP
|
$559.00
|
|
|
Service Code
|
HCPCS 86707
|
| Hospital Charge Code |
38479486
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$279.50 |
| 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 |
$279.50
|
| 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 |
$145.34
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
| 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 |
$15.88
|
|
|
HEP BE ANTIGENT
|
Facility
|
IP
|
$574.00
|
|
|
Service Code
|
HCPCS 86704
|
| Hospital Charge Code |
38479487
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$86.10 |
| Max. Negotiated Rate |
$86.10 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.10
|
|
|
HEP BE ANTIGENT
|
Facility
|
OP
|
$574.00
|
|
|
Service Code
|
HCPCS 86704
|
| Hospital Charge Code |
38479487
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$287.00 |
| 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 |
$287.00
|
| 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 |
$149.24
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$86.10
|
| 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 |
$16.30
|
|
|
HEP B SURF
|
Facility
|
IP
|
$559.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$83.85 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
|
|
HEP B SURF
|
Facility
|
OP
|
$559.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479485
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.59 |
| Max. Negotiated Rate |
$279.50 |
| 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 |
$279.50
|
| 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 |
$145.34
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
| 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 |
$15.88
|
|
|
HEP B SURF AB QNT
|
Facility
|
OP
|
$559.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.59 |
| Max. Negotiated Rate |
$279.50 |
| 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 |
$279.50
|
| 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 |
$145.34
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
| 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 |
$15.88
|
|
|
HEP B SURF AB QNT
|
Facility
|
IP
|
$559.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479494
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$83.85 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
|
|
HEP B SURFACE AB QN
|
Facility
|
OP
|
$559.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.59 |
| Max. Negotiated Rate |
$279.50 |
| 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 |
$279.50
|
| 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 |
$145.34
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
| 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 |
$15.88
|
|
|
HEP B SURFACE AB QN
|
Facility
|
IP
|
$559.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$83.85 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
|
|
HEP B SURFACE ANTIBODY
|
Facility
|
IP
|
$559.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$83.85 |
| Max. Negotiated Rate |
$83.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
|
|
HEP B SURFACE ANTIBODY
|
Facility
|
OP
|
$559.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479489
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.59 |
| Max. Negotiated Rate |
$279.50 |
| 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 |
$279.50
|
| 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 |
$145.34
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$83.85
|
| 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 |
$15.88
|
|
|
HEP B SURF ANTIBODY
|
Facility
|
OP
|
$311.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.59 |
| 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 |
$155.50
|
| 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 |
$80.86
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
| 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 |
$8.83
|
|
|
HEP B SURF ANTIBODY
|
Facility
|
IP
|
$311.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.65 |
| Max. Negotiated Rate |
$46.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
|
|
HEP B SURF ANTIG
|
Facility
|
IP
|
$311.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.65 |
| Max. Negotiated Rate |
$46.65 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
|
|
HEP B SURF ANTIG
|
Facility
|
OP
|
$311.00
|
|
|
Service Code
|
HCPCS 86706
|
| Hospital Charge Code |
38479488
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.59 |
| 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 |
$155.50
|
| 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 |
$80.86
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$46.65
|
| 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 |
$8.83
|
|
|
HEP B VIRUSDRUGRESIST GENO BCP
|
Facility
|
OP
|
$399.96
|
|
|
Service Code
|
HCPCS 87912
|
| Hospital Charge Code |
397080003
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$933.90 |
| Rate for Payer: Aetna Commercial |
$700.26
|
| Rate for Payer: Aetna Medicare Advantage |
$834.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$933.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$933.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$257.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$560.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$933.90
|
| Rate for Payer: Cigna Commercial |
$199.98
|
| Rate for Payer: Cigna Medicare Advantage |
$257.45
|
| Rate for Payer: Clover Medicare Advantage |
$244.58
|
| Rate for Payer: EmblemHealth Commercial |
$772.35
|
| Rate for Payer: Humana Medicare Advantage |
$265.17
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$257.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.99
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$205.96
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$257.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$257.45
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.36
|
|
|
HEP B VIRUSDRUGRESIST GENO BCP
|
Facility
|
IP
|
$399.96
|
|
|
Service Code
|
HCPCS 87912
|
| Hospital Charge Code |
397080003
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.99 |
| Max. Negotiated Rate |
$59.99 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.99
|
|
|
HEP C AB W RFL HCV,RNA QNT PCR
|
Facility
|
OP
|
$97.20
|
|
| Hospital Charge Code |
39708041
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.76 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$36.94
|
| Rate for Payer: Aetna Medicare Advantage |
$29.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.79
|
| Rate for Payer: Cigna Commercial |
$48.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.27
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.76
|
|
