|
LYMPHOCYTE SUBSET 1 IV
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86360
|
| Hospital Charge Code |
39990132D
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$127.79
|
| Rate for Payer: Aetna Medicare Advantage |
$152.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$170.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$170.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$46.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$170.42
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$46.98
|
| Rate for Payer: Clover Medicare Advantage |
$44.63
|
| Rate for Payer: EmblemHealth Commercial |
$140.94
|
| Rate for Payer: Humana Medicare Advantage |
$48.39
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$46.98
|
| 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 |
$37.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$46.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$46.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
LYMPHOCYTE SUBSET 3 I
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86359
|
| Hospital Charge Code |
39990081A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$102.63
|
| Rate for Payer: Aetna Medicare Advantage |
$122.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$136.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$136.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$37.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$29.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$136.87
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$37.73
|
| Rate for Payer: Clover Medicare Advantage |
$35.84
|
| Rate for Payer: EmblemHealth Commercial |
$113.19
|
| Rate for Payer: Humana Medicare Advantage |
$38.86
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$37.73
|
| 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 |
$30.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$37.73
|
| Rate for Payer: Wellcare Medicare Advantage |
$37.73
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
LYMPHOCYTE SUBSET 3 I
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86359
|
| Hospital Charge Code |
39990081A
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
LYMPHOCYTE SUBSET 3 II
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86360
|
| Hospital Charge Code |
39990081B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
LYMPHOCYTE SUBSET 3 II
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86360
|
| Hospital Charge Code |
39990081B
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$127.79
|
| Rate for Payer: Aetna Medicare Advantage |
$152.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$170.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$170.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$46.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$170.42
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$46.98
|
| Rate for Payer: Clover Medicare Advantage |
$44.63
|
| Rate for Payer: EmblemHealth Commercial |
$140.94
|
| Rate for Payer: Humana Medicare Advantage |
$48.39
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$46.98
|
| 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 |
$37.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$46.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$46.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
LYMPHOCYTE SUBSET 4
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 86360
|
| Hospital Charge Code |
39900431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$127.79
|
| Rate for Payer: Aetna Medicare Advantage |
$152.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$170.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$170.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$46.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$90.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$170.42
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$46.98
|
| Rate for Payer: Clover Medicare Advantage |
$44.63
|
| Rate for Payer: EmblemHealth Commercial |
$140.94
|
| Rate for Payer: Humana Medicare Advantage |
$48.39
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$46.98
|
| 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 |
$37.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$46.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$46.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.96
|
|
|
LYMPHOCYTE SUBSET 4
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 86360
|
| Hospital Charge Code |
39900431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
LYMPHOCYTE SUBSTATS
|
Facility
|
IP
|
$543.00
|
|
| Hospital Charge Code |
38473051
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$81.45 |
| Max. Negotiated Rate |
$81.45 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.45
|
|
|
LYMPHOCYTE SUBSTATS
|
Facility
|
OP
|
$543.00
|
|
| Hospital Charge Code |
38473051
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.42 |
| Max. Negotiated Rate |
$271.50 |
| Rate for Payer: Aetna Commercial |
$206.34
|
| Rate for Payer: Aetna Medicare Advantage |
$162.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$138.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$138.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$138.47
|
| Rate for Payer: Cigna Commercial |
$271.50
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$141.18
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$81.45
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.16
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.42
|
|
|
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$90,190.00
|
|
|
Service Code
|
MSDRG 821
|
| Min. Negotiated Rate |
$27,461.70 |
| Max. Negotiated Rate |
$90,190.00 |
| Rate for Payer: Aetna Commercial |
$66,092.85
|
| Rate for Payer: Aetna Medicare Advantage |
$90,190.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61,782.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61,782.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$28,907.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61,782.15
|
| Rate for Payer: Cigna Commercial |
$49,905.11
|
| Rate for Payer: Cigna Medicare Advantage |
$28,907.05
|
| Rate for Payer: Clover Medicare Advantage |
$27,461.70
|
| Rate for Payer: EmblemHealth Commercial |
$86,721.15
|
| Rate for Payer: Humana Medicare Advantage |
$29,774.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$28,907.05
|
| Rate for Payer: Oxford Commercial |
$39,444.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$52,797.38
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$28,907.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$28,907.05
|
|
|
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$204,754.59
|
|
|
Service Code
|
MSDRG 820
|
| Min. Negotiated Rate |
$62,345.15 |
| Max. Negotiated Rate |
$204,754.59 |
| Rate for Payer: Aetna Commercial |
$147,687.07
|
| Rate for Payer: Aetna Medicare Advantage |
$204,754.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$167,615.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$167,615.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$65,626.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$167,615.25
|
| Rate for Payer: Cigna Commercial |
$130,743.99
|
| Rate for Payer: Cigna Medicare Advantage |
$65,626.47
|
| Rate for Payer: Clover Medicare Advantage |
$62,345.15
|
| Rate for Payer: EmblemHealth Commercial |
$196,879.41
|
| Rate for Payer: Humana Medicare Advantage |
$67,595.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$65,626.47
|
| Rate for Payer: Oxford Commercial |
$103,337.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$138,321.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$65,626.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$65,626.47
|
|
|
LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$57,503.32
|
|
|
Service Code
|
MSDRG 822
|
| Min. Negotiated Rate |
$17,509.02 |
| Max. Negotiated Rate |
$57,503.32 |
| Rate for Payer: Aetna Commercial |
$42,813.01
|
| Rate for Payer: Aetna Medicare Advantage |
$57,503.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34,354.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34,354.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$18,430.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34,354.20
|
| Rate for Payer: Cigna Commercial |
$26,840.77
|
| Rate for Payer: Cigna Medicare Advantage |
$18,430.55
|
| Rate for Payer: Clover Medicare Advantage |
$17,509.02
|
| Rate for Payer: EmblemHealth Commercial |
$55,291.65
|
| Rate for Payer: Humana Medicare Advantage |
$18,983.47
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$18,430.55
|
| Rate for Payer: Oxford Commercial |
$21,214.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$28,396.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$18,430.55
|
| Rate for Payer: Wellcare Medicare Advantage |
$18,430.55
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC
|
Facility
|
IP
|
$71,006.36
|
|
|
Service Code
|
MSDRG 841
|
| Min. Negotiated Rate |
$21,620.53 |
| Max. Negotiated Rate |
$71,006.36 |
| Rate for Payer: Aetna Commercial |
$52,430.06
|
| Rate for Payer: Aetna Medicare Advantage |
$71,006.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43,496.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43,496.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$22,758.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43,496.85
|
| Rate for Payer: Cigna Commercial |
$36,368.80
|
| Rate for Payer: Cigna Medicare Advantage |
$22,758.45
|
| Rate for Payer: Clover Medicare Advantage |
$21,620.53
|
| Rate for Payer: EmblemHealth Commercial |
$68,275.35
|
| Rate for Payer: Humana Medicare Advantage |
$23,441.20
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$22,758.45
|
| Rate for Payer: Oxford Commercial |
$28,745.27
|
| Rate for Payer: UnitedHealthcare Commercial |
$38,476.57
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$22,758.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$22,758.45
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC
|
Facility
|
IP
|
$121,666.68
|
|
|
Service Code
|
MSDRG 840
|
| Min. Negotiated Rate |
$37,045.94 |
| Max. Negotiated Rate |
$121,666.68 |
| Rate for Payer: Aetna Commercial |
$88,510.92
|
| Rate for Payer: Aetna Medicare Advantage |
$121,666.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$86,716.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$86,716.65
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$38,995.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$86,716.65
|
| Rate for Payer: Cigna Commercial |
$72,115.63
|
| Rate for Payer: Cigna Medicare Advantage |
$38,995.73
|
| Rate for Payer: Clover Medicare Advantage |
$37,045.94
|
| Rate for Payer: EmblemHealth Commercial |
$116,987.19
|
| Rate for Payer: Humana Medicare Advantage |
$40,165.60
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$38,995.73
|
| Rate for Payer: Oxford Commercial |
$56,998.94
|
| Rate for Payer: UnitedHealthcare Commercial |
$76,295.12
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$38,995.73
|
| Rate for Payer: Wellcare Medicare Advantage |
$38,995.73
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC
|
Facility
|
IP
|
$91,043.00
|
|
|
Service Code
|
MSDRG 824
|
| Min. Negotiated Rate |
$27,721.43 |
| Max. Negotiated Rate |
$91,043.00 |
| Rate for Payer: Aetna Commercial |
$66,700.39
|
| Rate for Payer: Aetna Medicare Advantage |
$91,043.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$61,782.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$61,782.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$29,180.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$61,782.15
|
| Rate for Payer: Cigna Commercial |
$50,507.02
|
| Rate for Payer: Cigna Medicare Advantage |
$29,180.45
|
| Rate for Payer: Clover Medicare Advantage |
$27,721.43
|
| Rate for Payer: EmblemHealth Commercial |
$87,541.35
|
| Rate for Payer: Humana Medicare Advantage |
$30,055.86
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$29,180.45
|
| Rate for Payer: Oxford Commercial |
$39,919.87
|
| Rate for Payer: UnitedHealthcare Commercial |
$53,434.18
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$29,180.45
|
| Rate for Payer: Wellcare Medicare Advantage |
$29,180.45
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC
|
Facility
|
IP
|
$164,314.77
|
|
|
Service Code
|
MSDRG 823
|
| Min. Negotiated Rate |
$50,031.74 |
| Max. Negotiated Rate |
$164,314.77 |
| Rate for Payer: Aetna Commercial |
$118,885.38
|
| Rate for Payer: Aetna Medicare Advantage |
$164,314.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$124,672.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$124,672.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$52,664.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$124,672.50
|
| Rate for Payer: Cigna Commercial |
$102,208.95
|
| Rate for Payer: Cigna Medicare Advantage |
$52,664.99
|
| Rate for Payer: Clover Medicare Advantage |
$50,031.74
|
| Rate for Payer: EmblemHealth Commercial |
$157,994.97
|
| Rate for Payer: Humana Medicare Advantage |
$54,244.94
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$52,664.99
|
| Rate for Payer: Oxford Commercial |
$80,784.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$108,132.51
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$52,664.99
|
| Rate for Payer: Wellcare Medicare Advantage |
$52,664.99
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$62,097.05
|
|
|
Service Code
|
MSDRG 825
|
| Min. Negotiated Rate |
$18,907.76 |
| Max. Negotiated Rate |
$62,097.05 |
| Rate for Payer: Aetna Commercial |
$46,084.73
|
| Rate for Payer: Aetna Medicare Advantage |
$62,097.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$35,739.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$35,739.45
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$19,902.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$35,739.45
|
| Rate for Payer: Cigna Commercial |
$30,082.17
|
| Rate for Payer: Cigna Medicare Advantage |
$19,902.90
|
| Rate for Payer: Clover Medicare Advantage |
$18,907.76
|
| Rate for Payer: EmblemHealth Commercial |
$59,708.70
|
| Rate for Payer: Humana Medicare Advantage |
$20,499.99
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$19,902.90
|
| Rate for Payer: Oxford Commercial |
$23,776.43
|
| Rate for Payer: UnitedHealthcare Commercial |
$31,825.60
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$19,902.90
|
| Rate for Payer: Wellcare Medicare Advantage |
$19,902.90
|
|
|
LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC
|
Facility
|
IP
|
$51,386.77
|
|
|
Service Code
|
MSDRG 842
|
| Min. Negotiated Rate |
$15,646.61 |
| Max. Negotiated Rate |
$51,386.77 |
| Rate for Payer: Aetna Commercial |
$38,456.76
|
| Rate for Payer: Aetna Medicare Advantage |
$51,386.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29,644.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29,644.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$16,470.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29,644.35
|
| Rate for Payer: Cigna Commercial |
$22,524.85
|
| Rate for Payer: Cigna Medicare Advantage |
$16,470.12
|
| Rate for Payer: Clover Medicare Advantage |
$15,646.61
|
| Rate for Payer: EmblemHealth Commercial |
$49,410.36
|
| Rate for Payer: Humana Medicare Advantage |
$16,964.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$16,470.12
|
| Rate for Payer: Oxford Commercial |
$17,803.25
|
| Rate for Payer: UnitedHealthcare Commercial |
$23,830.28
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$16,470.12
|
| Rate for Payer: Wellcare Medicare Advantage |
$16,470.12
|
|
|
LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA
|
Facility
|
IP
|
$15,414.48
|
|
|
Service Code
|
APR-DRG 6912
|
| Min. Negotiated Rate |
$15,112.24 |
| Max. Negotiated Rate |
$15,414.48 |
| Rate for Payer: UnitedHealthcare Community & State |
$15,112.24
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$15,414.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15,112.24
|
|
|
LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA
|
Facility
|
IP
|
$43,731.06
|
|
|
Service Code
|
APR-DRG 6914
|
| Min. Negotiated Rate |
$42,873.59 |
| Max. Negotiated Rate |
$43,731.06 |
| Rate for Payer: UnitedHealthcare Community & State |
$42,873.59
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$43,731.06
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$42,873.59
|
|
|
LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA
|
Facility
|
IP
|
$22,794.48
|
|
|
Service Code
|
APR-DRG 6913
|
| Min. Negotiated Rate |
$22,347.53 |
| Max. Negotiated Rate |
$22,794.48 |
| Rate for Payer: UnitedHealthcare Community & State |
$22,347.53
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$22,794.48
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$22,347.53
|
|
|
LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA
|
Facility
|
IP
|
$11,652.17
|
|
|
Service Code
|
APR-DRG 6911
|
| Min. Negotiated Rate |
$11,423.70 |
| Max. Negotiated Rate |
$11,652.17 |
| Rate for Payer: UnitedHealthcare Community & State |
$11,423.70
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$11,652.17
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11,423.70
|
|
|
LYSIS ADHESIONS, MULTI 2DAYS
|
Facility
|
IP
|
$4,344.06
|
|
|
Service Code
|
HCPCS 62263
|
| Hospital Charge Code |
1600000758
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$651.61 |
| Max. Negotiated Rate |
$651.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$651.61
|
|
|
LYSIS ADHESIONS, MULTI 2DAYS
|
Facility
|
OP
|
$4,344.06
|
|
|
Service Code
|
HCPCS 62263
|
| Hospital Charge Code |
1600000758
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$123.37 |
| Max. Negotiated Rate |
$3,811.70 |
| Rate for Payer: Aetna Commercial |
$2,858.12
|
| Rate for Payer: Aetna Medicare Advantage |
$3,404.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,811.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,811.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$1,050.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,811.70
|
| Rate for Payer: Cigna Commercial |
$2,106.27
|
| Rate for Payer: Cigna Medicare Advantage |
$1,050.78
|
| Rate for Payer: Clover Medicare Advantage |
$998.24
|
| Rate for Payer: EmblemHealth Commercial |
$3,152.34
|
| Rate for Payer: Humana Medicare Advantage |
$1,082.30
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$1,050.78
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1,129.46
|
| Rate for Payer: Oxford Commercial |
$3,505.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$651.61
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,629.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$137.27
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellcare Medicare Advantage |
$1,050.78
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$123.37
|
|
|
LYSIS OF LABIAL LESION (S)
|
Facility
|
OP
|
$14,977.64
|
|
|
Service Code
|
HCPCS 56441
|
| Hospital Charge Code |
1600000536
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$425.36 |
| Max. Negotiated Rate |
$13,950.60 |
| Rate for Payer: Aetna Commercial |
$10,460.55
|
| Rate for Payer: Aetna Medicare Advantage |
$12,460.36
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13,950.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13,950.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3,845.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,536.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13,950.60
|
| Rate for Payer: Cigna Commercial |
$7,708.87
|
| Rate for Payer: Cigna Medicare Advantage |
$3,845.79
|
| Rate for Payer: Clover Medicare Advantage |
$3,653.50
|
| Rate for Payer: EmblemHealth Commercial |
$11,537.37
|
| Rate for Payer: Humana Medicare Advantage |
$3,961.16
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3,845.79
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,894.19
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,246.65
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$473.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3,845.79
|
| Rate for Payer: Wellcare Medicare Advantage |
$3,845.79
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$425.36
|
|
