|
CULT SKINGRFT T/ARM/LEG
|
Facility
|
OP
|
$10,771.05
|
|
|
Service Code
|
HCPCS 15150
|
| Hospital Charge Code |
1600000277
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$305.90 |
| Max. Negotiated Rate |
$8,891.84 |
| Rate for Payer: UnitedHealthcare Community & State |
$340.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$2,451.23
|
| Rate for Payer: Wellcare Medicare Advantage |
$2,451.23
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$305.90
|
| Rate for Payer: Aetna Commercial |
$6,667.35
|
| Rate for Payer: Aetna Medicare Advantage |
$7,941.99
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$8,891.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$8,891.84
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$2,451.23
|
| 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 |
$8,891.84
|
| Rate for Payer: Cigna Commercial |
$4,913.48
|
| Rate for Payer: Cigna Medicare Advantage |
$2,451.23
|
| Rate for Payer: Clover Medicare Advantage |
$2,328.67
|
| Rate for Payer: EmblemHealth Commercial |
$7,353.69
|
| Rate for Payer: Humana Medicare Advantage |
$2,524.77
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$2,451.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2,800.47
|
| Rate for Payer: Oxford Commercial |
$5,018.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1,615.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,347.00
|
|
|
CULTURE,AEROBIC
|
Facility
|
OP
|
$59.20
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
39900264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$23.45
|
| Rate for Payer: Aetna Medicare Advantage |
$27.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.27
|
| Rate for Payer: Cigna Commercial |
$29.60
|
| Rate for Payer: Cigna Medicare Advantage |
$8.62
|
| Rate for Payer: Clover Medicare Advantage |
$8.19
|
| Rate for Payer: EmblemHealth Commercial |
$25.86
|
| Rate for Payer: Humana Medicare Advantage |
$8.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$15.39
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.68
|
|
|
CULTURE,AEROBIC
|
Facility
|
IP
|
$59.20
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
39900264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.88 |
| Max. Negotiated Rate |
$8.88 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$8.88
|
|
|
CULTURE AEROBIC BACTERIA-SO
|
Facility
|
IP
|
$98.99
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
401387070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.85 |
| Max. Negotiated Rate |
$14.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.85
|
|
|
CULTURE AEROBIC BACTERIA-SO
|
Facility
|
OP
|
$98.99
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
401387070
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.81 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$23.45
|
| Rate for Payer: Aetna Medicare Advantage |
$27.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.27
|
| Rate for Payer: Cigna Commercial |
$49.49
|
| Rate for Payer: Cigna Medicare Advantage |
$8.62
|
| Rate for Payer: Clover Medicare Advantage |
$8.19
|
| Rate for Payer: EmblemHealth Commercial |
$25.86
|
| Rate for Payer: Humana Medicare Advantage |
$8.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.62
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$25.74
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.85
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.81
|
|
|
CULTURE AEROBIC IDENTIFY
|
Facility
|
IP
|
$138.14
|
|
|
Service Code
|
HCPCS 87077
|
| Hospital Charge Code |
401387077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.72 |
| Max. Negotiated Rate |
$20.72 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.72
|
|
|
CULTURE AEROBIC IDENTIFY
|
Facility
|
OP
|
$138.14
|
|
|
Service Code
|
HCPCS 87077
|
| Hospital Charge Code |
401387077
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.92 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$21.98
|
| Rate for Payer: Aetna Medicare Advantage |
$26.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.31
|
| Rate for Payer: Cigna Commercial |
$69.07
|
| Rate for Payer: Cigna Medicare Advantage |
$8.08
|
| Rate for Payer: Clover Medicare Advantage |
$7.68
|
| Rate for Payer: EmblemHealth Commercial |
$24.24
|
| Rate for Payer: Humana Medicare Advantage |
$8.32
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.08
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$35.92
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$20.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.08
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.08
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$3.92
|
|
|
CULTURE ANAEROBIC
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87075
|
| Hospital Charge Code |
3009511
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE ANAEROBIC
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87075
|
| Hospital Charge Code |
3009511
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$25.76
|
| Rate for Payer: Aetna Medicare Advantage |
$30.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.35
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$9.47
|
| Rate for Payer: Clover Medicare Advantage |
$9.00
|
| Rate for Payer: EmblemHealth Commercial |
$28.41
|
| Rate for Payer: Humana Medicare Advantage |
$9.75
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.47
|
| 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 |
$7.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CULTURE BACTERIA XCPT BLOOD-SO
|
Facility
|
OP
|
$63.93
|
|
|
Service Code
|
HCPCS 87075
|
| Hospital Charge Code |
40134446B
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$25.76
|
| Rate for Payer: Aetna Medicare Advantage |
$30.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.35
|
| Rate for Payer: Cigna Commercial |
$31.96
|
| Rate for Payer: Cigna Medicare Advantage |
$9.47
|
| Rate for Payer: Clover Medicare Advantage |
$9.00
|
| Rate for Payer: EmblemHealth Commercial |
$28.41
|
| Rate for Payer: Humana Medicare Advantage |
$9.75
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$16.62
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.82
|
|
|
CULTURE BACTERIA XCPT BLOOD-SO
|
Facility
|
OP
|
$103.94
|
|
|
Service Code
|
HCPCS 87075
|
| Hospital Charge Code |
40134469A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$25.76
|
| Rate for Payer: Aetna Medicare Advantage |
$30.68
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.35
|
| Rate for Payer: Cigna Commercial |
$51.97
|
| Rate for Payer: Cigna Medicare Advantage |
$9.47
|
| Rate for Payer: Clover Medicare Advantage |
$9.00
|
| Rate for Payer: EmblemHealth Commercial |
$28.41
|
| Rate for Payer: Humana Medicare Advantage |
$9.75
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.47
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$27.02
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$7.58
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.47
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.47
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.95
|
|
|
CULTURE BACTERIA XCPT BLOOD-SO
|
Facility
|
IP
|
$63.93
|
|
|
Service Code
|
HCPCS 87075
|
| Hospital Charge Code |
40134446B
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$9.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.59
|
|
|
CULTURE BACTERIA XCPT BLOOD-SO
|
Facility
|
IP
|
$103.94
|
|
|
Service Code
|
HCPCS 87075
|
| Hospital Charge Code |
40134469A
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$15.59 |
| Max. Negotiated Rate |
$15.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$15.59
|
|
|
CULTURE, BLOOD
|
Facility
|
IP
|
$667.56
|
|
|
Service Code
|
HCPCS 87040
|
| Hospital Charge Code |
3008851
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$100.13 |
| Max. Negotiated Rate |
$100.13 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.13
|
|
|
CULTURE, BLOOD
|
Facility
|
OP
|
$667.56
|
|
|
Service Code
|
HCPCS 87040
|
| Hospital Charge Code |
3008851
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.26 |
| Max. Negotiated Rate |
$333.78 |
| Rate for Payer: Aetna Commercial |
$28.07
|
| Rate for Payer: Aetna Medicare Advantage |
$33.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.44
|
| Rate for Payer: Cigna Commercial |
$333.78
|
| Rate for Payer: Cigna Medicare Advantage |
$10.32
|
| Rate for Payer: Clover Medicare Advantage |
$9.80
|
| Rate for Payer: EmblemHealth Commercial |
$30.96
|
| Rate for Payer: Humana Medicare Advantage |
$10.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.32
|
| 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 |
$100.13
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.96
|
|
|
CULTURE,BLOOD
|
Facility
|
OP
|
$70.95
|
|
|
Service Code
|
HCPCS 87040
|
| Hospital Charge Code |
39900263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.01 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$28.07
|
| Rate for Payer: Aetna Medicare Advantage |
$33.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$37.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$37.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.32
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$37.44
|
| Rate for Payer: Cigna Commercial |
$35.48
|
| Rate for Payer: Cigna Medicare Advantage |
$10.32
|
| Rate for Payer: Clover Medicare Advantage |
$9.80
|
| Rate for Payer: EmblemHealth Commercial |
$30.96
|
| Rate for Payer: Humana Medicare Advantage |
$10.63
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$18.45
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$8.26
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.32
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.32
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.01
|
|
|
CULTURE,BLOOD
|
Facility
|
IP
|
$70.95
|
|
|
Service Code
|
HCPCS 87040
|
| Hospital Charge Code |
39900263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.64 |
| Max. Negotiated Rate |
$10.64 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.64
|
|
|
CULTURE, BODY FLUID
|
Facility
|
IP
|
$667.59
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3009503
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$100.14 |
| Max. Negotiated Rate |
$100.14 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$100.14
|
|
|
CULTURE, BODY FLUID
|
Facility
|
OP
|
$667.59
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3009503
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$333.80 |
| Rate for Payer: Aetna Commercial |
$23.45
|
| Rate for Payer: Aetna Medicare Advantage |
$27.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.27
|
| Rate for Payer: Cigna Commercial |
$333.80
|
| Rate for Payer: Cigna Medicare Advantage |
$8.62
|
| Rate for Payer: Clover Medicare Advantage |
$8.19
|
| Rate for Payer: EmblemHealth Commercial |
$25.86
|
| Rate for Payer: Humana Medicare Advantage |
$8.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.62
|
| 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 |
$6.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$18.96
|
|
|
CULTURE, BRONCHIAL WASHING
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3009966
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$23.45
|
| Rate for Payer: Aetna Medicare Advantage |
$27.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$31.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$31.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.62
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$14.85
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$31.27
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.62
|
| Rate for Payer: Clover Medicare Advantage |
$8.19
|
| Rate for Payer: EmblemHealth Commercial |
$25.86
|
| Rate for Payer: Humana Medicare Advantage |
$8.88
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.62
|
| 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 |
$6.90
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CULTURE, BRONCHIAL WASHING
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3009966
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
Culture, Campylobacter
|
Facility
|
OP
|
$82.91
|
|
|
Service Code
|
HCPCS 4475
|
| Hospital Charge Code |
3000075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$31.51
|
| Rate for Payer: Aetna Medicare Advantage |
$24.87
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$21.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$21.14
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$21.14
|
| Rate for Payer: Cigna Commercial |
$41.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$21.56
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$2.62
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.35
|
|
|
Culture, Campylobacter
|
Facility
|
IP
|
$82.91
|
|
|
Service Code
|
HCPCS 4475
|
| Hospital Charge Code |
3000075
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.44 |
| Max. Negotiated Rate |
$12.44 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$12.44
|
|
|
CULTURE CAMPYLOBACTER
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87046
|
| Hospital Charge Code |
401187046B
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE CAMPYLOBACTER
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87046
|
| Hospital Charge Code |
401187046B
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.55 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$25.68
|
| Rate for Payer: Aetna Medicare Advantage |
$30.59
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$34.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$34.24
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$9.44
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$8.81
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$34.24
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$9.44
|
| Rate for Payer: Clover Medicare Advantage |
$8.97
|
| Rate for Payer: EmblemHealth Commercial |
$28.32
|
| Rate for Payer: Humana Medicare Advantage |
$9.72
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$9.44
|
| 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 |
$7.55
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$9.44
|
| Rate for Payer: Wellcare Medicare Advantage |
$9.44
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
