|
CRYPRECIPITATE EACH UNIT
|
Facility
|
OP
|
$291.95
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
3101501
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$8.29 |
| Max. Negotiated Rate |
$1,167.00 |
| Rate for Payer: Aetna Commercial |
$227.58
|
| Rate for Payer: Aetna Medicare Advantage |
$271.09
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$303.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$303.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$83.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$303.51
|
| Rate for Payer: Cigna Commercial |
$167.72
|
| Rate for Payer: Cigna Medicare Advantage |
$83.67
|
| Rate for Payer: Clover Medicare Advantage |
$79.49
|
| Rate for Payer: EmblemHealth Commercial |
$251.01
|
| Rate for Payer: Humana Medicare Advantage |
$86.18
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$83.67
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$75.91
|
| Rate for Payer: Oxford Commercial |
$1,028.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.79
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,167.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$83.67
|
| Rate for Payer: Wellcare Medicare Advantage |
$83.67
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$8.29
|
|
|
CRYPRECIPITATE EACH UNIT
|
Facility
|
IP
|
$291.95
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
3101501
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$43.79 |
| Max. Negotiated Rate |
$43.79 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$43.79
|
|
|
CRYPTOCOCCAL AG,SERUM
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
38479057
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.04 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$31.39
|
| Rate for Payer: Aetna Medicare Advantage |
$37.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.86
|
| Rate for Payer: Cigna Commercial |
$36.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.54
|
| Rate for Payer: Clover Medicare Advantage |
$10.96
|
| Rate for Payer: EmblemHealth Commercial |
$34.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.72
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.04
|
|
|
CRYPTOCOCCAL AG,SERUM
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
38479057
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
|
|
CRYPTOCOCCAL AG,TIGER
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
38479059
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
|
|
CRYPTOCOCCAL AG,TIGER
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
38479059
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.04 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$31.39
|
| Rate for Payer: Aetna Medicare Advantage |
$37.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.86
|
| Rate for Payer: Cigna Commercial |
$36.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.54
|
| Rate for Payer: Clover Medicare Advantage |
$10.96
|
| Rate for Payer: EmblemHealth Commercial |
$34.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.72
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.04
|
|
|
CRYPTOCOCCUS AG CSF
|
Facility
|
IP
|
$70.05
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
39900476
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.51 |
| Max. Negotiated Rate |
$10.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.51
|
|
|
CRYPTOCOCCUS AG CSF
|
Facility
|
OP
|
$70.05
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
39900476
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.99 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$31.39
|
| Rate for Payer: Aetna Medicare Advantage |
$37.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.86
|
| Rate for Payer: Cigna Commercial |
$35.02
|
| Rate for Payer: Cigna Medicare Advantage |
$11.54
|
| Rate for Payer: Clover Medicare Advantage |
$10.96
|
| Rate for Payer: EmblemHealth Commercial |
$34.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.21
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.99
|
|
|
CRYPTOCOCCUS AG SERUM
|
Facility
|
IP
|
$70.05
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
39900477
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.51 |
| Max. Negotiated Rate |
$10.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.51
|
|
|
CRYPTOCOCCUS AG SERUM
|
Facility
|
OP
|
$70.05
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
39900477
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.99 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$31.39
|
| Rate for Payer: Aetna Medicare Advantage |
$37.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.86
|
| Rate for Payer: Cigna Commercial |
$35.02
|
| Rate for Payer: Cigna Medicare Advantage |
$11.54
|
| Rate for Payer: Clover Medicare Advantage |
$10.96
|
| Rate for Payer: EmblemHealth Commercial |
$34.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.21
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.99
|
|
|
CRYPTOCOCCUS ANTIGEN CSF
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
39900505
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$31.39
|
| Rate for Payer: Aetna Medicare Advantage |
$37.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.86
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.54
|
| Rate for Payer: Clover Medicare Advantage |
$10.96
|
| Rate for Payer: EmblemHealth Commercial |
$34.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.54
|
| 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 |
$9.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CRYPTOCOCCUS ANTIGEN CSF
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
39900505
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CRYPTOCOCCUS ANTIGEN DETECTION
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
38475041
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
|
|
CRYPTOCOCCUS ANTIGEN DETECTION
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
38475041
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.04 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$31.39
|
| Rate for Payer: Aetna Medicare Advantage |
$37.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.86
|
| Rate for Payer: Cigna Commercial |
$36.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.54
|
| Rate for Payer: Clover Medicare Advantage |
$10.96
|
| Rate for Payer: EmblemHealth Commercial |
$34.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.54
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.72
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.04
|
|
|
CRYPTOCOCCUS ANTIGEN SERUM
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
39900504
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$31.39
|
| Rate for Payer: Aetna Medicare Advantage |
$37.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.86
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.54
|
| Rate for Payer: Clover Medicare Advantage |
$10.96
|
| Rate for Payer: EmblemHealth Commercial |
$34.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.54
|
| 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 |
$9.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CRYPTOCOCCUS ANTIGEN SERUM
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
39900504
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CRYPTOCOCCUS SERUM
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
39900430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CRYPTOCOCCUS SERUM
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86403
|
| Hospital Charge Code |
39900430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.23 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$31.39
|
| Rate for Payer: Aetna Medicare Advantage |
$37.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$41.86
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.54
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$13.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$41.86
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$11.54
|
| Rate for Payer: Clover Medicare Advantage |
$10.96
|
| Rate for Payer: EmblemHealth Commercial |
$34.62
|
| Rate for Payer: Humana Medicare Advantage |
$11.89
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.54
|
| 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 |
$9.23
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.54
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CRYPTOSPORIDIUM
|
Facility
|
IP
|
$178.00
|
|
|
Service Code
|
HCPCS 87328
|
| Hospital Charge Code |
38475104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.70 |
| Max. Negotiated Rate |
$26.70 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.70
|
|
|
CRYPTOSPORIDIUM
|
Facility
|
IP
|
$433.00
|
|
|
Service Code
|
HCPCS 87272
|
| Hospital Charge Code |
38475038
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$64.95 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$64.95
|
|
|
CRYPTOSPORIDIUM
|
Facility
|
OP
|
$433.00
|
|
|
Service Code
|
HCPCS 87272
|
| Hospital Charge Code |
38475038
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$216.50 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Medicare Advantage |
$38.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.46
|
| Rate for Payer: Cigna Commercial |
$216.50
|
| Rate for Payer: Cigna Medicare Advantage |
$11.98
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$112.58
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$64.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$12.30
|
|
|
CRYPTOSPORIDIUM
|
Facility
|
OP
|
$178.00
|
|
|
Service Code
|
HCPCS 87328
|
| Hospital Charge Code |
38475104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.06 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$37.59
|
| Rate for Payer: Aetna Medicare Advantage |
$44.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$50.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$50.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$13.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$12.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$50.13
|
| Rate for Payer: Cigna Commercial |
$89.00
|
| Rate for Payer: Cigna Medicare Advantage |
$13.82
|
| Rate for Payer: Clover Medicare Advantage |
$13.13
|
| Rate for Payer: EmblemHealth Commercial |
$41.46
|
| Rate for Payer: Humana Medicare Advantage |
$14.23
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$13.82
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$46.28
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.70
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$11.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$13.82
|
| Rate for Payer: Wellcare Medicare Advantage |
$13.82
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$5.06
|
|
|
CRYPTOSPORIDIUM AG,STOOL
|
Facility
|
OP
|
$75.65
|
|
|
Service Code
|
HCPCS 87272
|
| Hospital Charge Code |
39900280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.15 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$32.59
|
| Rate for Payer: Aetna Medicare Advantage |
$38.82
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$43.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$11.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$10.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$43.46
|
| Rate for Payer: Cigna Commercial |
$37.83
|
| Rate for Payer: Cigna Medicare Advantage |
$11.98
|
| Rate for Payer: Clover Medicare Advantage |
$11.38
|
| Rate for Payer: EmblemHealth Commercial |
$35.94
|
| Rate for Payer: Humana Medicare Advantage |
$12.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$11.98
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$19.67
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.35
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$9.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellcare Medicare Advantage |
$11.98
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.15
|
|
|
CRYPTOSPORIDIUM AG,STOOL
|
Facility
|
IP
|
$75.65
|
|
|
Service Code
|
HCPCS 87272
|
| Hospital Charge Code |
39900280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.35 |
| Max. Negotiated Rate |
$11.35 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.35
|
|
|
CRYPTOSPORIDIUM AG,STOOL I
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87015
|
| Hospital Charge Code |
3990127A
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$5.34 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$18.17
|
| Rate for Payer: Aetna Medicare Advantage |
$21.64
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$24.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$24.23
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$6.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$24.23
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6.68
|
| Rate for Payer: Clover Medicare Advantage |
$6.35
|
| Rate for Payer: EmblemHealth Commercial |
$20.04
|
| Rate for Payer: Humana Medicare Advantage |
$6.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$6.68
|
| 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 |
$5.34
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$6.68
|
| Rate for Payer: Wellcare Medicare Advantage |
$6.68
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
