|
VACCINE ADMIN FLU
|
Facility
|
IP
|
$254.15
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
93500180
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$38.12 |
| Max. Negotiated Rate |
$38.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.12
|
|
|
VACCINE ADMIN FLU
|
Facility
|
IP
|
$254.15
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
83652295
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$38.12 |
| Max. Negotiated Rate |
$38.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.12
|
|
|
VACCINE ADMIN FLU
|
Facility
|
OP
|
$254.15
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
5792170
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$7.22 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.08
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.22
|
|
|
VACCINE ADMIN FLU
|
Facility
|
OP
|
$254.15
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
911025
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$7.22 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.08
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.22
|
|
|
VACCINE ADMIN FLU
|
Facility
|
OP
|
$254.15
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
100140
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$7.22 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$66.08
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$7.22
|
|
|
VACCINE ADMIN FLU
|
Facility
|
IP
|
$254.15
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
100140
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$38.12 |
| Max. Negotiated Rate |
$38.12 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$38.12
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
OP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
83652523
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.30
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
IP
|
$20.35
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
87502410
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$3.05 |
| Max. Negotiated Rate |
$3.05 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.05
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
OP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
8200500
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.30
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
OP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
87502405
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.30
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
IP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
8200500
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
IP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
93500185
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
OP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
87502060
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.30
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
IP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
83652523
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
OP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
100141
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.30
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
IP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
100141
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
IP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
87502060
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
IP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
5792272
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
OP
|
$20.35
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
87502410
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.29
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.05
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
OP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
5792272
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.30
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
OP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
93500185
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.30
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
VACCINE ADMIN HEPATITIS B
|
Facility
|
IP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
87502405
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
|
|
VACCINE ADMIN INITIAL
|
Facility
|
OP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
83090025
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$310.30 |
| Rate for Payer: Aetna Commercial |
$232.67
|
| Rate for Payer: Aetna Medicare Advantage |
$277.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$310.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$85.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$20.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$310.30
|
| Rate for Payer: Cigna Commercial |
$171.47
|
| Rate for Payer: Cigna Medicare Advantage |
$85.54
|
| Rate for Payer: Clover Medicare Advantage |
$81.26
|
| Rate for Payer: EmblemHealth Commercial |
$256.62
|
| Rate for Payer: Humana Medicare Advantage |
$88.11
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$85.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$5.30
|
| Rate for Payer: Oxford Commercial |
$140.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
| Rate for Payer: UnitedHealthcare Commercial |
$159.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$0.64
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$85.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$0.58
|
|
|
VACCINE ADMIN INITIAL
|
Facility
|
IP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
5700285
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
|
|
VACCINE ADMIN INITIAL
|
Facility
|
IP
|
$20.38
|
|
|
Service Code
|
HCPCS 90471
|
| Hospital Charge Code |
83090025
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$3.06 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.06
|
|
