|
HIV-1 GENOTYPE RTI AND PI
|
Facility
|
OP
|
$1,811.00
|
|
|
Service Code
|
HCPCS 87901
|
| Hospital Charge Code |
38476283
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$51.43 |
| 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 |
$240.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$933.90
|
| Rate for Payer: Cigna Commercial |
$905.50
|
| 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 |
$470.86
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$271.65
|
| 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 |
$51.43
|
|
|
HIV-1 INTEGRASE GENOTYPE
|
Facility
|
IP
|
$1,092.00
|
|
|
Service Code
|
HCPCS 87906
|
| Hospital Charge Code |
397071377
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$163.80 |
| Max. Negotiated Rate |
$163.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.80
|
|
|
HIV-1 INTEGRASE GENOTYPE
|
Facility
|
OP
|
$1,092.00
|
|
|
Service Code
|
HCPCS 87906
|
| Hospital Charge Code |
397071377
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.01 |
| Max. Negotiated Rate |
$546.00 |
| Rate for Payer: Aetna Commercial |
$350.15
|
| Rate for Payer: Aetna Medicare Advantage |
$417.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$466.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$466.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$128.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$119.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$466.97
|
| Rate for Payer: Cigna Commercial |
$546.00
|
| Rate for Payer: Cigna Medicare Advantage |
$128.73
|
| Rate for Payer: Clover Medicare Advantage |
$122.29
|
| Rate for Payer: EmblemHealth Commercial |
$386.19
|
| Rate for Payer: Humana Medicare Advantage |
$132.59
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$128.73
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$283.92
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$163.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$102.98
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$128.73
|
| Rate for Payer: Wellcare Medicare Advantage |
$128.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$31.01
|
|
|
HIV-1P24 ANTIGEN
|
Facility
|
OP
|
$623.00
|
|
|
Service Code
|
HCPCS 87390
|
| Hospital Charge Code |
38476204
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$311.50 |
| Rate for Payer: Aetna Commercial |
$65.44
|
| Rate for Payer: Aetna Medicare Advantage |
$77.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$87.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$87.28
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24.06
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$16.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$87.28
|
| Rate for Payer: Cigna Commercial |
$311.50
|
| Rate for Payer: Cigna Medicare Advantage |
$24.06
|
| Rate for Payer: Clover Medicare Advantage |
$22.86
|
| Rate for Payer: EmblemHealth Commercial |
$72.18
|
| Rate for Payer: Humana Medicare Advantage |
$24.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24.06
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$161.98
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.25
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24.06
|
| Rate for Payer: Wellcare Medicare Advantage |
$24.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.69
|
|
|
HIV-1P24 ANTIGEN
|
Facility
|
IP
|
$623.00
|
|
|
Service Code
|
HCPCS 87390
|
| Hospital Charge Code |
38476204
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$93.45 |
| Max. Negotiated Rate |
$93.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$93.45
|
|
|
HIV-1 QUANTIFICATION
|
Facility
|
OP
|
$599.00
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
38476239
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna Commercial |
$231.47
|
| Rate for Payer: Aetna Medicare Advantage |
$275.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$193.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$308.70
|
| Rate for Payer: Cigna Commercial |
$299.50
|
| Rate for Payer: Cigna Medicare Advantage |
$85.10
|
| Rate for Payer: Clover Medicare Advantage |
$80.84
|
| Rate for Payer: EmblemHealth Commercial |
$255.30
|
| Rate for Payer: Humana Medicare Advantage |
$87.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$155.74
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$68.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.01
|
|
|
HIV-1 QUANTIFICATION
|
Facility
|
IP
|
$599.00
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
38476239
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$89.85 |
| Max. Negotiated Rate |
$89.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.85
|
|
|
HIV 1 RNA
|
Facility
|
IP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
39900397
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.72 |
| Max. Negotiated Rate |
$87.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.72
|
|
|
HIV 1 RNA
|
Facility
|
OP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
39900397
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna Commercial |
$231.47
|
| Rate for Payer: Aetna Medicare Advantage |
$275.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$193.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$308.70
|
| Rate for Payer: Cigna Commercial |
$292.40
|
| Rate for Payer: Cigna Medicare Advantage |
$85.10
|
| Rate for Payer: Clover Medicare Advantage |
$80.84
|
| Rate for Payer: EmblemHealth Commercial |
$255.30
|
| Rate for Payer: Humana Medicare Advantage |
$87.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.05
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$68.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.61
|
|
|
HIV-1 RNA,BDNA (3RD GEN)
|
Facility
|
IP
|
$599.00
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
38475114
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$89.85 |
| Max. Negotiated Rate |
$89.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.85
|
|
|
HIV-1 RNA,BDNA (3RD GEN)
|
Facility
|
OP
|
$599.00
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
38475114
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna Commercial |
$231.47
|
| Rate for Payer: Aetna Medicare Advantage |
$275.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$193.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$308.70
|
| Rate for Payer: Cigna Commercial |
$299.50
|
| Rate for Payer: Cigna Medicare Advantage |
$85.10
|
| Rate for Payer: Clover Medicare Advantage |
$80.84
|
| Rate for Payer: EmblemHealth Commercial |
$255.30
|
| Rate for Payer: Humana Medicare Advantage |
$87.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$155.74
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$89.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$68.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.01
|
|
|
HIV-1 RNA QL TMA
|
Facility
|
OP
|
$1,250.00
|
|
|
Service Code
|
HCPCS 87535
|
| Hospital Charge Code |
401087535
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.07 |
| Max. Negotiated Rate |
$625.00 |
| Rate for Payer: Aetna Commercial |
$95.44
|
| Rate for Payer: Aetna Medicare Advantage |
$113.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$127.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$127.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$35.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$127.29
|
| Rate for Payer: Cigna Commercial |
$625.00
|
| Rate for Payer: Cigna Medicare Advantage |
$35.09
|
| Rate for Payer: Clover Medicare Advantage |
$33.34
|
| Rate for Payer: EmblemHealth Commercial |
$105.27
|
| Rate for Payer: Humana Medicare Advantage |
$36.14
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$35.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$325.00
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$187.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.07
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$35.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$35.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$35.50
|
|
|
HIV-1 RNA QL TMA
|
Facility
|
IP
|
$1,250.00
|
|
|
Service Code
|
HCPCS 87535
|
| Hospital Charge Code |
401087535
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$187.50 |
| Max. Negotiated Rate |
$187.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$187.50
|
|
|
HIV-1 RNA,QN RT-PCR,CSF
|
Facility
|
IP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
39900398
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.72 |
| Max. Negotiated Rate |
$87.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.72
|
|
|
HIV-1 RNA,QN RT-PCR,CSF
|
Facility
|
OP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
39900398
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna Commercial |
$231.47
|
| Rate for Payer: Aetna Medicare Advantage |
$275.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$193.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$308.70
|
| Rate for Payer: Cigna Commercial |
$292.40
|
| Rate for Payer: Cigna Medicare Advantage |
$85.10
|
| Rate for Payer: Clover Medicare Advantage |
$80.84
|
| Rate for Payer: EmblemHealth Commercial |
$255.30
|
| Rate for Payer: Humana Medicare Advantage |
$87.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.05
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$68.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.61
|
|
|
HIV -1 RNA QUAL REAL TIME PCR
|
Facility
|
OP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
39900433
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna Commercial |
$231.47
|
| Rate for Payer: Aetna Medicare Advantage |
$275.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$193.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$308.70
|
| Rate for Payer: Cigna Commercial |
$292.40
|
| Rate for Payer: Cigna Medicare Advantage |
$85.10
|
| Rate for Payer: Clover Medicare Advantage |
$80.84
|
| Rate for Payer: EmblemHealth Commercial |
$255.30
|
| Rate for Payer: Humana Medicare Advantage |
$87.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.05
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$68.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.61
|
|
|
HIV -1 RNA QUAL REAL TIME PCR
|
Facility
|
IP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
39900433
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.72 |
| Max. Negotiated Rate |
$87.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.72
|
|
|
HIV-1 RNA QUAL WITH REFLEX TO
|
Facility
|
IP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
39900434
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.72 |
| Max. Negotiated Rate |
$87.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.72
|
|
|
HIV-1 RNA QUAL WITH REFLEX TO
|
Facility
|
OP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
39900434
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna Commercial |
$231.47
|
| Rate for Payer: Aetna Medicare Advantage |
$275.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$193.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$308.70
|
| Rate for Payer: Cigna Commercial |
$292.40
|
| Rate for Payer: Cigna Medicare Advantage |
$85.10
|
| Rate for Payer: Clover Medicare Advantage |
$80.84
|
| Rate for Payer: EmblemHealth Commercial |
$255.30
|
| Rate for Payer: Humana Medicare Advantage |
$87.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.05
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$68.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.61
|
|
|
HIV-1 RNA QUAL WITH REFLEX TO
|
Facility
|
OP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
3990434
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$308.70 |
| Rate for Payer: Aetna Commercial |
$231.47
|
| Rate for Payer: Aetna Medicare Advantage |
$275.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$308.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$193.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$308.70
|
| Rate for Payer: Cigna Commercial |
$292.40
|
| Rate for Payer: Cigna Medicare Advantage |
$85.10
|
| Rate for Payer: Clover Medicare Advantage |
$80.84
|
| Rate for Payer: EmblemHealth Commercial |
$255.30
|
| Rate for Payer: Humana Medicare Advantage |
$87.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.10
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$152.05
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$68.08
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.10
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$16.61
|
|
|
HIV-1 RNA QUAL WITH REFLEX TO
|
Facility
|
IP
|
$584.80
|
|
|
Service Code
|
HCPCS 87536
|
| Hospital Charge Code |
3990434
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.72 |
| Max. Negotiated Rate |
$87.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$87.72
|
|
|
HIV-2 AB,WESTERN BLOT
|
Facility
|
OP
|
$646.00
|
|
|
Service Code
|
HCPCS 86689
|
| Hospital Charge Code |
38476268
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.48 |
| Max. Negotiated Rate |
$323.00 |
| Rate for Payer: Aetna Commercial |
$52.63
|
| Rate for Payer: Aetna Medicare Advantage |
$62.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$70.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$70.19
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$19.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.19
|
| Rate for Payer: Cigna Commercial |
$323.00
|
| Rate for Payer: Cigna Medicare Advantage |
$19.35
|
| Rate for Payer: Clover Medicare Advantage |
$18.38
|
| Rate for Payer: EmblemHealth Commercial |
$58.05
|
| Rate for Payer: Humana Medicare Advantage |
$19.93
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$19.35
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$167.96
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$15.48
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$19.35
|
| Rate for Payer: Wellcare Medicare Advantage |
$19.35
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.35
|
|
|
HIV-2 AB,WESTERN BLOT
|
Facility
|
IP
|
$646.00
|
|
|
Service Code
|
HCPCS 86689
|
| Hospital Charge Code |
38476268
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$96.90 |
| Max. Negotiated Rate |
$96.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$96.90
|
|
|
HIV2 PROBE REVRSE TRNSCRIPJ
|
Facility
|
IP
|
$437.57
|
|
|
Service Code
|
HCPCS 87538
|
| Hospital Charge Code |
401187538
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$65.64 |
| Max. Negotiated Rate |
$65.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.64
|
|
|
HIV2 PROBE REVRSE TRNSCRIPJ
|
Facility
|
OP
|
$437.57
|
|
|
Service Code
|
HCPCS 87538
|
| Hospital Charge Code |
401187538
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.43 |
| Max. Negotiated Rate |
$218.78 |
| Rate for Payer: Aetna Commercial |
$95.44
|
| Rate for Payer: Aetna Medicare Advantage |
$113.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$127.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$127.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$35.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$127.29
|
| Rate for Payer: Cigna Commercial |
$218.78
|
| Rate for Payer: Cigna Medicare Advantage |
$35.09
|
| Rate for Payer: Clover Medicare Advantage |
$33.34
|
| Rate for Payer: EmblemHealth Commercial |
$105.27
|
| Rate for Payer: Humana Medicare Advantage |
$36.14
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$35.09
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$113.77
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$65.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$28.07
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$35.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$35.09
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.43
|
|
