|
ANTIBODY;FRANCISELLA TULARENSI
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
HCPCS 86668
|
| Hospital Charge Code |
38477073
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.07 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$38.52
|
| Rate for Payer: Aetna Medicare Advantage |
$45.88
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$51.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$51.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.16
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$19.80
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$51.37
|
| Rate for Payer: Cigna Commercial |
$36.50
|
| Rate for Payer: Cigna Medicare Advantage |
$14.16
|
| Rate for Payer: Clover Medicare Advantage |
$13.45
|
| Rate for Payer: EmblemHealth Commercial |
$42.48
|
| Rate for Payer: Humana Medicare Advantage |
$14.58
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.98
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.33
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.16
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.07
|
|
|
ANTIBODY;FRANCISELLA TULARENSI
|
Facility
|
IP
|
$73.00
|
|
|
Service Code
|
HCPCS 86668
|
| Hospital Charge Code |
38477073
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$10.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.95
|
|
|
ANTIBODY,GIARDIA LAMBIA
|
Facility
|
OP
|
$104.00
|
|
|
Service Code
|
HCPCS 86674
|
| Hospital Charge Code |
38477126
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$40.04
|
| Rate for Payer: Aetna Medicare Advantage |
$47.69
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$53.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$53.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$53.40
|
| Rate for Payer: Cigna Commercial |
$52.00
|
| Rate for Payer: Cigna Medicare Advantage |
$14.72
|
| Rate for Payer: Clover Medicare Advantage |
$13.98
|
| Rate for Payer: EmblemHealth Commercial |
$44.16
|
| Rate for Payer: Humana Medicare Advantage |
$15.16
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.72
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.04
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.78
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.72
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.72
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.95
|
|
|
ANTIBODY,GIARDIA LAMBIA
|
Facility
|
IP
|
$104.00
|
|
|
Service Code
|
HCPCS 86674
|
| Hospital Charge Code |
38477126
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$15.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.60
|
|
|
ANTIBODY;HAEMOPHILUS INFLUENZA
|
Facility
|
IP
|
$112.00
|
|
|
Service Code
|
HCPCS 86684
|
| Hospital Charge Code |
38477133
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$16.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.80
|
|
|
ANTIBODY;HAEMOPHILUS INFLUENZA
|
Facility
|
OP
|
$112.00
|
|
|
Service Code
|
HCPCS 86684
|
| Hospital Charge Code |
38477133
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.18 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$43.08
|
| Rate for Payer: Aetna Medicare Advantage |
$51.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$57.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$57.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$57.46
|
| Rate for Payer: Cigna Commercial |
$56.00
|
| Rate for Payer: Cigna Medicare Advantage |
$15.84
|
| Rate for Payer: Clover Medicare Advantage |
$15.05
|
| Rate for Payer: EmblemHealth Commercial |
$47.52
|
| Rate for Payer: Humana Medicare Advantage |
$16.32
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15.84
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.12
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.67
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15.84
|
| Rate for Payer: Wellcare Medicare Advantage |
$15.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.18
|
|
|
ANTIBODY,HERPES SIMPLEX,NON
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
HCPCS 86694
|
| Hospital Charge Code |
38476303
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.87 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$39.14
|
| Rate for Payer: Aetna Medicare Advantage |
$46.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$52.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$52.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$14.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$21.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$52.20
|
| Rate for Payer: Cigna Commercial |
$50.50
|
| Rate for Payer: Cigna Medicare Advantage |
$14.39
|
| Rate for Payer: Clover Medicare Advantage |
$13.67
|
| Rate for Payer: EmblemHealth Commercial |
$43.17
|
| Rate for Payer: Humana Medicare Advantage |
$14.82
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$14.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$26.26
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$14.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.87
|
|
|
ANTIBODY,HERPES SIMPLEX,NON
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
HCPCS 86694
|
| Hospital Charge Code |
38476303
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$15.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.15
|
|
|
ANTIBODY;HIV-1 & HIV-2-SINGLA
|
Facility
|
OP
|
$97.00
|
|
|
Service Code
|
HCPCS 86703
|
| Hospital Charge Code |
38477119
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$37.29
|
| Rate for Payer: Aetna Medicare Advantage |
$44.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$49.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$49.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.71
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$34.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$49.73
|
| Rate for Payer: Cigna Commercial |
$48.50
|
| Rate for Payer: Cigna Medicare Advantage |
$13.71
|
| Rate for Payer: Clover Medicare Advantage |
$13.02
|
| Rate for Payer: EmblemHealth Commercial |
$41.13
|
| Rate for Payer: Humana Medicare Advantage |
$14.12
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.22
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$10.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.75
|
|
|
ANTIBODY;HIV-1 & HIV-2-SINGLA
|
Facility
|
IP
|
$97.00
|
|
|
Service Code
|
HCPCS 86703
|
| Hospital Charge Code |
38477119
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.55 |
| Max. Negotiated Rate |
$14.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.55
|
|
|
ANTIBODY IDENTIFICATION
|
Facility
|
IP
|
$229.00
|
|
|
Service Code
|
HCPCS 86870
|
| Hospital Charge Code |
38471007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.35 |
| Max. Negotiated Rate |
$34.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.35
|
|
|
ANTIBODY IDENTIFICATION
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 86870
|
| Hospital Charge Code |
3100542
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
ANTIBODY IDENTIFICATION
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 86870
|
| Hospital Charge Code |
3100542
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$1,544.73 |
| Rate for Payer: Aetna Commercial |
$1,158.28
|
| Rate for Payer: Aetna Medicare Advantage |
$1,379.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,544.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,544.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$425.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,544.73
|
| Rate for Payer: Cigna Commercial |
$853.60
|
| Rate for Payer: Cigna Medicare Advantage |
$425.84
|
| Rate for Payer: Clover Medicare Advantage |
$404.55
|
| Rate for Payer: EmblemHealth Commercial |
$1,277.52
|
| Rate for Payer: Humana Medicare Advantage |
$438.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$425.84
|
| 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 |
$9.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$425.84
|
| Rate for Payer: Wellcare Medicare Advantage |
$425.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.96
|
|
|
ANTIBODY IDENTIFICATION
|
Facility
|
OP
|
$229.00
|
|
|
Service Code
|
HCPCS 86870
|
| Hospital Charge Code |
38471007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$1,544.73 |
| Rate for Payer: Aetna Commercial |
$1,158.28
|
| Rate for Payer: Aetna Medicare Advantage |
$1,379.72
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1,544.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1,544.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$425.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1,544.73
|
| Rate for Payer: Cigna Commercial |
$853.60
|
| Rate for Payer: Cigna Medicare Advantage |
$425.84
|
| Rate for Payer: Clover Medicare Advantage |
$404.55
|
| Rate for Payer: EmblemHealth Commercial |
$1,277.52
|
| Rate for Payer: Humana Medicare Advantage |
$438.62
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$425.84
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.54
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.00
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$425.84
|
| Rate for Payer: Wellcare Medicare Advantage |
$425.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.50
|
|
|
ANTIBODY ID - LEUKOCYTE AB
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86021
|
| Hospital Charge Code |
3032059A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
ANTIBODY ID - LEUKOCYTE AB
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86021
|
| Hospital Charge Code |
3032059A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$40.94
|
| Rate for Payer: Aetna Medicare Advantage |
$48.76
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$54.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$54.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$54.59
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$15.05
|
| Rate for Payer: Clover Medicare Advantage |
$14.30
|
| Rate for Payer: EmblemHealth Commercial |
$45.15
|
| Rate for Payer: Humana Medicare Advantage |
$15.50
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15.05
|
| 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 |
$12.04
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$15.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
ANTIBODY ID PLATELET ASCT/IMMO
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
HCPCS 86023
|
| Hospital Charge Code |
38477105
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$33.89
|
| Rate for Payer: Aetna Medicare Advantage |
$40.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$45.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$45.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$12.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$45.20
|
| Rate for Payer: Cigna Commercial |
$44.00
|
| Rate for Payer: Cigna Medicare Advantage |
$12.46
|
| Rate for Payer: Clover Medicare Advantage |
$11.84
|
| Rate for Payer: EmblemHealth Commercial |
$37.38
|
| Rate for Payer: Humana Medicare Advantage |
$12.83
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$12.46
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$22.88
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.97
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$12.46
|
| Rate for Payer: Wellcare Medicare Advantage |
$12.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.50
|
|
|
ANTIBODY ID PLATELET ASCT/IMMO
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
HCPCS 86023
|
| Hospital Charge Code |
38477105
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$13.20 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.20
|
|
|
ANTIBODY; LEPTOSPIRA
|
Facility
|
IP
|
$93.00
|
|
|
Service Code
|
HCPCS 86720
|
| Hospital Charge Code |
38477113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.95 |
| Max. Negotiated Rate |
$13.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.95
|
|
|
ANTIBODY; LEPTOSPIRA
|
Facility
|
OP
|
$93.00
|
|
|
Service Code
|
HCPCS 86720
|
| Hospital Charge Code |
38477113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$44.06
|
| Rate for Payer: Aetna Medicare Advantage |
$52.49
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$58.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$58.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$24.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$58.77
|
| Rate for Payer: Cigna Commercial |
$46.50
|
| Rate for Payer: Cigna Medicare Advantage |
$16.20
|
| Rate for Payer: Clover Medicare Advantage |
$15.39
|
| Rate for Payer: EmblemHealth Commercial |
$48.60
|
| Rate for Payer: Humana Medicare Advantage |
$16.69
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16.20
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.18
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$13.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.96
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16.20
|
| Rate for Payer: Wellcare Medicare Advantage |
$16.20
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.64
|
|
|
ANTIBODY,RICKETTSIA
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
HCPCS 86757
|
| Hospital Charge Code |
38476305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.86 |
| Max. Negotiated Rate |
$156.00 |
| 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 |
$18.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$70.19
|
| Rate for Payer: Cigna Commercial |
$68.00
|
| 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 |
$35.36
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.40
|
| 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 |
$3.86
|
|
|
ANTIBODY,RICKETTSIA
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
HCPCS 86757
|
| Hospital Charge Code |
38476305
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$20.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.40
|
|
|
ANTIBODY SCREEN
|
Facility
|
IP
|
$775.02
|
|
|
Service Code
|
HCPCS 86850
|
| Hospital Charge Code |
3100526
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$116.25 |
| Max. Negotiated Rate |
$116.25 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$116.25
|
|
|
ANTIBODY SCREEN
|
Facility
|
OP
|
$775.02
|
|
|
Service Code
|
HCPCS 86850
|
| Hospital Charge Code |
3100526
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$201.51 |
| Rate for Payer: Aetna Commercial |
$26.57
|
| Rate for Payer: Aetna Medicare Advantage |
$31.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.44
|
| Rate for Payer: Cigna Commercial |
$124.10
|
| Rate for Payer: Cigna Medicare Advantage |
$9.77
|
| Rate for Payer: Clover Medicare Advantage |
$9.28
|
| Rate for Payer: EmblemHealth Commercial |
$29.31
|
| Rate for Payer: Humana Medicare Advantage |
$10.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$201.51
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$116.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22.01
|
|
|
ANTIBODY SCREEN (INDIRECT COOM
|
Facility
|
OP
|
$455.00
|
|
|
Service Code
|
HCPCS 86850
|
| Hospital Charge Code |
38471004
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$26.57
|
| Rate for Payer: Aetna Medicare Advantage |
$31.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35.44
|
| Rate for Payer: Cigna Commercial |
$124.10
|
| Rate for Payer: Cigna Medicare Advantage |
$9.77
|
| Rate for Payer: Clover Medicare Advantage |
$9.28
|
| Rate for Payer: EmblemHealth Commercial |
$29.31
|
| Rate for Payer: Humana Medicare Advantage |
$10.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$118.30
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$68.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.82
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.92
|
|
