|
PROTEIN C,FUNCTIONAL
|
Facility
|
OP
|
$95.05
|
|
|
Service Code
|
HCPCS 85303
|
| Hospital Charge Code |
39900167
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$37.64
|
| Rate for Payer: Aetna Medicare Advantage |
$44.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50.20
|
| Rate for Payer: Cigna Commercial |
$47.52
|
| Rate for Payer: Cigna Medicare Advantage |
$13.84
|
| Rate for Payer: Clover Medicare Advantage |
$13.15
|
| Rate for Payer: EmblemHealth Commercial |
$41.52
|
| Rate for Payer: Humana Medicare Advantage |
$14.26
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.84
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$24.71
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.07
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.84
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.84
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.70
|
|
|
PROTEIN C,FUNCTIONAL
|
Facility
|
IP
|
$95.05
|
|
|
Service Code
|
HCPCS 85303
|
| Hospital Charge Code |
39900167
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$14.26 |
| Max. Negotiated Rate |
$14.26 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.26
|
|
|
PROTEIN ELECTROPHORESIS, CSF
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
HCPCS 84166
|
| Hospital Charge Code |
38472581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
|
|
PROTEIN ELECTROPHORESIS, CSF
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
HCPCS 84166
|
| Hospital Charge Code |
38472581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.55 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$48.50
|
| Rate for Payer: Aetna Medicare Advantage |
$57.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$64.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$64.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$64.68
|
| Rate for Payer: Cigna Commercial |
$62.50
|
| Rate for Payer: Cigna Medicare Advantage |
$17.83
|
| Rate for Payer: Clover Medicare Advantage |
$16.94
|
| Rate for Payer: EmblemHealth Commercial |
$53.49
|
| Rate for Payer: Humana Medicare Advantage |
$18.36
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.55
|
|
|
PROTEIN ELECTROPHORESIS,SR
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
HCPCS 84165
|
| Hospital Charge Code |
38472575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.43 |
| 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 |
$9.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$38.96
|
| Rate for Payer: Cigna Commercial |
$78.00
|
| Rate for Payer: Cigna Medicare Advantage |
$10.74
|
| Rate for Payer: Clover Medicare Advantage |
$10.20
|
| Rate for Payer: EmblemHealth Commercial |
$32.22
|
| Rate for Payer: Humana Medicare Advantage |
$11.06
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.74
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$40.56
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
| 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 |
$4.43
|
|
|
PROTEIN ELECTROPHORESIS,SR
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
HCPCS 84165
|
| Hospital Charge Code |
38472575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$23.40
|
|
|
PROTEIN ELECTROPHORESIS, URINE
|
Facility
|
OP
|
$125.00
|
|
|
Service Code
|
HCPCS 84166
|
| Hospital Charge Code |
38472578
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.55 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$48.50
|
| Rate for Payer: Aetna Medicare Advantage |
$57.77
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$64.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$64.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$31.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$64.68
|
| Rate for Payer: Cigna Commercial |
$62.50
|
| Rate for Payer: Cigna Medicare Advantage |
$17.83
|
| Rate for Payer: Clover Medicare Advantage |
$16.94
|
| Rate for Payer: EmblemHealth Commercial |
$53.49
|
| Rate for Payer: Humana Medicare Advantage |
$18.36
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17.83
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$32.50
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$14.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17.83
|
| Rate for Payer: Wellcare Medicare Advantage |
$17.83
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.55
|
|
|
PROTEIN ELECTROPHORESIS, URINE
|
Facility
|
IP
|
$125.00
|
|
|
Service Code
|
HCPCS 84166
|
| Hospital Charge Code |
38472578
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.75 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$18.75
|
|
|
PROTEIN,FLUID
|
Facility
|
IP
|
$116.00
|
|
|
Service Code
|
HCPCS 84157
|
| Hospital Charge Code |
38479017
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.40 |
| Max. Negotiated Rate |
$17.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.40
|
|
|
PROTEIN,FLUID
|
Facility
|
OP
|
$116.00
|
|
|
Service Code
|
HCPCS 84157
|
| Hospital Charge Code |
38479017
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$15,880.57 |
| Rate for Payer: Aetna Commercial |
$10.88
|
| Rate for Payer: Aetna Medicare Advantage |
$12.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$14.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$14.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$14.51
|
| Rate for Payer: Cigna Commercial |
$58.00
|
| Rate for Payer: Cigna Medicare Advantage |
$4.00
|
| Rate for Payer: Clover Medicare Advantage |
$3.80
|
| Rate for Payer: EmblemHealth Commercial |
$12.00
|
| Rate for Payer: Humana Medicare Advantage |
$4.12
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$30.16
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$17.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.20
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.00
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.00
|
| Rate for Payer: Wellcare New Jersey Medicaid/Family Care |
$15,880.57
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.29
|
|
|
PROTEIN IMMUNOELECTROPHORESIS
|
Facility
|
IP
|
$552.00
|
|
|
Service Code
|
HCPCS 86334
|
| Hospital Charge Code |
38472713
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$82.80 |
| Max. Negotiated Rate |
$82.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.80
|
|
|
PROTEIN IMMUNOELECTROPHORESIS
|
Facility
|
OP
|
$552.00
|
|
|
Service Code
|
HCPCS 86334
|
| Hospital Charge Code |
38472713
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.68 |
| Max. Negotiated Rate |
$276.00 |
| Rate for Payer: Aetna Commercial |
$60.76
|
| Rate for Payer: Aetna Medicare Advantage |
$72.38
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$81.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$81.04
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$22.34
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$49.50
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$81.04
|
| Rate for Payer: Cigna Commercial |
$276.00
|
| Rate for Payer: Cigna Medicare Advantage |
$22.34
|
| Rate for Payer: Clover Medicare Advantage |
$21.22
|
| Rate for Payer: EmblemHealth Commercial |
$67.02
|
| Rate for Payer: Humana Medicare Advantage |
$23.01
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$22.34
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$17.87
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$22.34
|
| Rate for Payer: Wellcare Medicare Advantage |
$22.34
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.68
|
|
|
PROTEIN MATRIX
|
Facility
|
IP
|
$15,000.00
|
|
| Hospital Charge Code |
270703279
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,250.00 |
| Max. Negotiated Rate |
$3,630.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,630.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,250.00
|
|
|
PROTEIN MATRIX
|
Facility
|
OP
|
$15,000.00
|
|
| Hospital Charge Code |
270703279
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.00 |
| Max. Negotiated Rate |
$7,500.00 |
| Rate for Payer: Aetna Commercial |
$5,700.00
|
| Rate for Payer: Aetna Medicare Advantage |
$4,500.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,825.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,825.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,000.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,825.00
|
| Rate for Payer: Cigna Commercial |
$7,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,630.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,250.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$474.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$426.00
|
|
|
PROTEIN MATRIX 10CC
|
Facility
|
OP
|
$15,000.00
|
|
| Hospital Charge Code |
270703017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$426.00 |
| Max. Negotiated Rate |
$7,500.00 |
| Rate for Payer: Aetna Commercial |
$5,700.00
|
| Rate for Payer: Aetna Medicare Advantage |
$4,500.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3,825.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3,825.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,000.00
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3,825.00
|
| Rate for Payer: Cigna Commercial |
$7,500.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,630.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,250.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$474.00
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$426.00
|
|
|
PROTEIN MATRIX 10CC
|
Facility
|
IP
|
$15,000.00
|
|
| Hospital Charge Code |
270703017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,250.00 |
| Max. Negotiated Rate |
$3,630.00 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$3,000.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3,630.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,250.00
|
|
|
PROTEIN S
|
Facility
|
IP
|
$410.00
|
|
|
Service Code
|
HCPCS 85305
|
| Hospital Charge Code |
38473076
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$61.50 |
| Max. Negotiated Rate |
$61.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.50
|
|
|
PROTEIN S
|
Facility
|
OP
|
$410.00
|
|
|
Service Code
|
HCPCS 85305
|
| Hospital Charge Code |
38473076
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.29 |
| Max. Negotiated Rate |
$205.00 |
| Rate for Payer: Aetna Commercial |
$31.58
|
| Rate for Payer: Aetna Medicare Advantage |
$37.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$26.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.12
|
| Rate for Payer: Cigna Commercial |
$205.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.61
|
| Rate for Payer: Clover Medicare Advantage |
$11.03
|
| Rate for Payer: EmblemHealth Commercial |
$34.83
|
| Rate for Payer: Humana Medicare Advantage |
$11.96
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.61
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$106.60
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$61.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.64
|
|
|
PROTEIN S,ACTIVITY
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 85306
|
| Hospital Charge Code |
39900169
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.26 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: Aetna Medicare Advantage |
$49.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$55.57
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$15.32
|
| Rate for Payer: Clover Medicare Advantage |
$14.55
|
| Rate for Payer: EmblemHealth Commercial |
$45.96
|
| Rate for Payer: Humana Medicare Advantage |
$15.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15.32
|
| 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 |
$12.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$15.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.96
|
|
|
PROTEIN S,ACTIVITY
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 85306
|
| Hospital Charge Code |
39900169
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
PROTEIN S,ANTIGENIC
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 85305
|
| Hospital Charge Code |
39900168
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.29 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$31.58
|
| Rate for Payer: Aetna Medicare Advantage |
$37.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$42.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$42.12
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.61
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$26.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$42.12
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$11.61
|
| Rate for Payer: Clover Medicare Advantage |
$11.03
|
| Rate for Payer: EmblemHealth Commercial |
$34.83
|
| Rate for Payer: Humana Medicare Advantage |
$11.96
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.61
|
| 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 |
$9.29
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.61
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.61
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.96
|
|
|
PROTEIN S,ANTIGENIC
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 85305
|
| Hospital Charge Code |
39900168
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
PROTEIN S,FUNCTIONAL
|
Facility
|
OP
|
$105.30
|
|
|
Service Code
|
HCPCS 85306
|
| Hospital Charge Code |
39900170
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: Aetna Medicare Advantage |
$49.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$55.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$55.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$15.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$32.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$55.57
|
| Rate for Payer: Cigna Commercial |
$52.65
|
| Rate for Payer: Cigna Medicare Advantage |
$15.32
|
| Rate for Payer: Clover Medicare Advantage |
$14.55
|
| Rate for Payer: EmblemHealth Commercial |
$45.96
|
| Rate for Payer: Humana Medicare Advantage |
$15.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$15.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.38
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$12.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$15.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$15.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.99
|
|
|
PROTEIN S,FUNCTIONAL
|
Facility
|
IP
|
$105.30
|
|
|
Service Code
|
HCPCS 85306
|
| Hospital Charge Code |
39900170
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$15.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.79
|
|
|
PROTEIN, TOTAL, BLOOD
|
Facility
|
OP
|
$112.38
|
|
|
Service Code
|
HCPCS 84155
|
| Hospital Charge Code |
3002268
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$9.98
|
| Rate for Payer: Aetna Medicare Advantage |
$11.89
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$13.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$13.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$3.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$2.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$13.31
|
| Rate for Payer: Cigna Commercial |
$56.19
|
| Rate for Payer: Cigna Medicare Advantage |
$3.67
|
| Rate for Payer: Clover Medicare Advantage |
$3.49
|
| Rate for Payer: EmblemHealth Commercial |
$11.01
|
| Rate for Payer: Humana Medicare Advantage |
$3.78
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$3.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$29.22
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$16.86
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$3.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$3.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.19
|
|
