|
URETHRAL PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$76,175.08
|
|
|
Service Code
|
MSDRG 671
|
| Min. Negotiated Rate |
$23,194.34 |
| Max. Negotiated Rate |
$76,175.08 |
| Rate for Payer: Aetna Commercial |
$56,111.28
|
| Rate for Payer: Aetna Medicare Advantage |
$76,175.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$47,375.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$47,375.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$24,415.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$47,375.55
|
| Rate for Payer: Cigna Commercial |
$40,015.93
|
| Rate for Payer: Cigna Medicare Advantage |
$24,415.09
|
| Rate for Payer: Clover Medicare Advantage |
$23,194.34
|
| Rate for Payer: EmblemHealth Commercial |
$73,245.27
|
| Rate for Payer: Humana Medicare Advantage |
$25,147.54
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$24,415.09
|
| Rate for Payer: Oxford Commercial |
$31,627.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$42,335.07
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$24,415.09
|
| Rate for Payer: Wellcare Medicare Advantage |
$24,415.09
|
|
|
URETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$53,569.90
|
|
|
Service Code
|
MSDRG 672
|
| Min. Negotiated Rate |
$16,311.35 |
| Max. Negotiated Rate |
$53,569.90 |
| Rate for Payer: Aetna Commercial |
$40,011.60
|
| Rate for Payer: Aetna Medicare Advantage |
$53,569.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$26,042.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$26,042.70
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,169.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$26,042.70
|
| Rate for Payer: Cigna Commercial |
$24,065.29
|
| Rate for Payer: Cigna Medicare Advantage |
$17,169.84
|
| Rate for Payer: Clover Medicare Advantage |
$16,311.35
|
| Rate for Payer: EmblemHealth Commercial |
$51,509.52
|
| Rate for Payer: Humana Medicare Advantage |
$17,684.94
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,169.84
|
| Rate for Payer: Oxford Commercial |
$19,020.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$25,460.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,169.84
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,169.84
|
|
|
URETHRAL REPAIR PROCEDURES
|
Facility
|
IP
|
$16,607.90
|
|
|
Service Code
|
HCPCS 53502
|
| Hospital Charge Code |
93500202
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,491.18 |
| Max. Negotiated Rate |
$2,491.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,491.18
|
|
|
URETHRAL REPAIR PROCEDURES
|
Facility
|
IP
|
$16,607.90
|
|
|
Service Code
|
HCPCS 53502
|
| Hospital Charge Code |
93500203
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,491.18 |
| Max. Negotiated Rate |
$2,491.18 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,491.18
|
|
|
URETHRAL REPAIR PROCEDURES
|
Facility
|
OP
|
$16,607.90
|
|
|
Service Code
|
HCPCS 53502
|
| Hospital Charge Code |
93500202
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$471.66 |
| Max. Negotiated Rate |
$15,191.14 |
| Rate for Payer: Aetna Commercial |
$11,390.73
|
| Rate for Payer: Aetna Medicare Advantage |
$13,568.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,191.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,191.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,187.77
|
| 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 |
$15,191.14
|
| Rate for Payer: Cigna Commercial |
$8,394.37
|
| Rate for Payer: Cigna Medicare Advantage |
$4,187.77
|
| Rate for Payer: Clover Medicare Advantage |
$3,978.38
|
| Rate for Payer: EmblemHealth Commercial |
$12,563.31
|
| Rate for Payer: Humana Medicare Advantage |
$4,313.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,187.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,318.05
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,491.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$524.81
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$471.66
|
|
|
URETHRAL REPAIR PROCEDURES
|
Facility
|
OP
|
$16,607.90
|
|
|
Service Code
|
HCPCS 53502
|
| Hospital Charge Code |
93500203
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$471.66 |
| Max. Negotiated Rate |
$15,191.14 |
| Rate for Payer: Aetna Commercial |
$11,390.73
|
| Rate for Payer: Aetna Medicare Advantage |
$13,568.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15,191.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15,191.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4,187.77
|
| 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 |
$15,191.14
|
| Rate for Payer: Cigna Commercial |
$8,394.37
|
| Rate for Payer: Cigna Medicare Advantage |
$4,187.77
|
| Rate for Payer: Clover Medicare Advantage |
$3,978.38
|
| Rate for Payer: EmblemHealth Commercial |
$12,563.31
|
| Rate for Payer: Humana Medicare Advantage |
$4,313.40
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4,187.77
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$4,318.05
|
| Rate for Payer: Oxford Commercial |
$7,525.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$2,491.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$8,192.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$524.81
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellcare Medicare Advantage |
$4,187.77
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$471.66
|
|
|
URETHRAL STRICTURE
|
Facility
|
IP
|
$53,516.24
|
|
|
Service Code
|
MSDRG 697
|
| Min. Negotiated Rate |
$16,295.01 |
| Max. Negotiated Rate |
$53,516.24 |
| Rate for Payer: Aetna Commercial |
$39,973.37
|
| Rate for Payer: Aetna Medicare Advantage |
$53,516.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30,752.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30,752.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$17,152.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$30,752.55
|
| Rate for Payer: Cigna Commercial |
$24,027.40
|
| Rate for Payer: Cigna Medicare Advantage |
$17,152.64
|
| Rate for Payer: Clover Medicare Advantage |
$16,295.01
|
| Rate for Payer: EmblemHealth Commercial |
$51,457.92
|
| Rate for Payer: Humana Medicare Advantage |
$17,667.22
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$17,152.64
|
| Rate for Payer: Oxford Commercial |
$18,990.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$25,419.91
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$17,152.64
|
| Rate for Payer: Wellcare Medicare Advantage |
$17,152.64
|
|
|
URETRAL STENTS 10 FR 24 CM
|
Facility
|
IP
|
$618.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270679884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.70 |
| Max. Negotiated Rate |
$149.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$123.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$149.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.70
|
|
|
URETRAL STENTS 10 FR 24 CM
|
Facility
|
OP
|
$618.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270679884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.55 |
| Max. Negotiated Rate |
$309.00 |
| Rate for Payer: Aetna Commercial |
$234.84
|
| Rate for Payer: Aetna Medicare Advantage |
$185.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$157.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$157.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$123.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$157.59
|
| Rate for Payer: Cigna Commercial |
$309.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$149.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.55
|
|
|
URETRAL STENTS 8 FR 24 CM
|
Facility
|
IP
|
$618.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270623954
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$92.70 |
| Max. Negotiated Rate |
$149.56 |
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$123.60
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$149.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.70
|
|
|
URETRAL STENTS 8 FR 24 CM
|
Facility
|
OP
|
$618.00
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
270623954
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.55 |
| Max. Negotiated Rate |
$309.00 |
| Rate for Payer: Aetna Commercial |
$234.84
|
| Rate for Payer: Aetna Medicare Advantage |
$185.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$157.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$157.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$123.60
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$157.59
|
| Rate for Payer: Cigna Commercial |
$309.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$149.56
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$92.70
|
| Rate for Payer: UnitedHealthcare Community & State |
$19.53
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$17.55
|
|
|
URIC ACID (24 HR UR)
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
3007929
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
URIC ACID (24 HR UR)
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
3007929
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.43
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.08
|
| Rate for Payer: Clover Medicare Advantage |
$4.83
|
| Rate for Payer: EmblemHealth Commercial |
$15.24
|
| Rate for Payer: Humana Medicare Advantage |
$5.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.08
|
| 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 |
$4.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
URIC ACID,24HR URINE
|
Facility
|
OP
|
$227.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
38479044
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.43
|
| Rate for Payer: Cigna Commercial |
$113.50
|
| Rate for Payer: Cigna Medicare Advantage |
$5.08
|
| Rate for Payer: Clover Medicare Advantage |
$4.83
|
| Rate for Payer: EmblemHealth Commercial |
$15.24
|
| Rate for Payer: Humana Medicare Advantage |
$5.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.02
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.45
|
|
|
URIC ACID,24HR URINE
|
Facility
|
IP
|
$227.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
38479044
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.05 |
| Max. Negotiated Rate |
$34.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.05
|
|
|
URIC ACID OTH SOURCE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
39990241L
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.43
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.08
|
| Rate for Payer: Clover Medicare Advantage |
$4.83
|
| Rate for Payer: EmblemHealth Commercial |
$15.24
|
| Rate for Payer: Humana Medicare Advantage |
$5.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.08
|
| 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 |
$4.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
URIC ACID OTH SOURCE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
39990241L
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
URIC ACID, SERUM
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 84550
|
| Hospital Charge Code |
3002672
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$12.29
|
| Rate for Payer: Aetna Medicare Advantage |
$14.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.40
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$4.52
|
| Rate for Payer: Clover Medicare Advantage |
$4.29
|
| Rate for Payer: EmblemHealth Commercial |
$13.56
|
| Rate for Payer: Humana Medicare Advantage |
$4.66
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.52
|
| 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 |
$3.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.96
|
|
|
URIC ACID, SERUM
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 84550
|
| Hospital Charge Code |
3002672
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
URIC ACID,SERUM
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
HCPCS 84550
|
| Hospital Charge Code |
38472656
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.80 |
| Max. Negotiated Rate |
$37.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.80
|
|
|
URIC ACID,SERUM
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
HCPCS 84550
|
| Hospital Charge Code |
38472656
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$12.29
|
| Rate for Payer: Aetna Medicare Advantage |
$14.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$16.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$16.40
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$4.52
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$16.40
|
| Rate for Payer: Cigna Commercial |
$126.00
|
| Rate for Payer: Cigna Medicare Advantage |
$4.52
|
| Rate for Payer: Clover Medicare Advantage |
$4.29
|
| Rate for Payer: EmblemHealth Commercial |
$13.56
|
| Rate for Payer: Humana Medicare Advantage |
$4.66
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$4.52
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$65.52
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$37.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$3.62
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$4.52
|
| Rate for Payer: Wellcare Medicare Advantage |
$4.52
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.16
|
|
|
URIC ACID, SYNOVIAL FLUID
|
Facility
|
OP
|
$32.65
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
39900146
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.43
|
| Rate for Payer: Cigna Commercial |
$16.32
|
| Rate for Payer: Cigna Medicare Advantage |
$5.08
|
| Rate for Payer: Clover Medicare Advantage |
$4.83
|
| Rate for Payer: EmblemHealth Commercial |
$15.24
|
| Rate for Payer: Humana Medicare Advantage |
$5.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$8.49
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.93
|
|
|
URIC ACID, SYNOVIAL FLUID
|
Facility
|
IP
|
$32.65
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
39900146
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$4.90 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$4.90
|
|
|
URIC ACID,URINE
|
Facility
|
IP
|
$227.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
38472659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.05 |
| Max. Negotiated Rate |
$34.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.05
|
|
|
URIC ACID,URINE
|
Facility
|
OP
|
$227.00
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
38472659
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$13.82
|
| Rate for Payer: Aetna Medicare Advantage |
$16.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.43
|
| Rate for Payer: Cigna Commercial |
$113.50
|
| Rate for Payer: Cigna Medicare Advantage |
$5.08
|
| Rate for Payer: Clover Medicare Advantage |
$4.83
|
| Rate for Payer: EmblemHealth Commercial |
$15.24
|
| Rate for Payer: Humana Medicare Advantage |
$5.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$59.02
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$34.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.45
|
|
