|
CULTURE, CAMPYLOBACTER
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87046
|
| Hospital Charge Code |
39990244
|
|
Hospital Revenue Code
|
309
|
| 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
|
|
|
CULTURE, CAMPYLOBACTER
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87046
|
| Hospital Charge Code |
39990244
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE, CMV
|
Facility
|
IP
|
$213.00
|
|
|
Service Code
|
HCPCS 87252
|
| Hospital Charge Code |
38475010
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$31.95 |
| Max. Negotiated Rate |
$31.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.95
|
|
|
CULTURE, CMV
|
Facility
|
OP
|
$213.00
|
|
|
Service Code
|
HCPCS 87252
|
| Hospital Charge Code |
38475010
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$70.91
|
| Rate for Payer: Aetna Medicare Advantage |
$84.47
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$94.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$94.57
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$26.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$48.67
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$94.57
|
| Rate for Payer: Cigna Commercial |
$106.50
|
| Rate for Payer: Cigna Medicare Advantage |
$26.07
|
| Rate for Payer: Clover Medicare Advantage |
$24.77
|
| Rate for Payer: EmblemHealth Commercial |
$78.21
|
| Rate for Payer: Humana Medicare Advantage |
$26.85
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$26.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$55.38
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$31.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$20.86
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$26.07
|
| Rate for Payer: Wellcare Medicare Advantage |
$26.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$6.05
|
|
|
CULTURE, CSF
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3009941
|
|
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, CSF
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3009941
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE, EAR
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3030145
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE, EAR
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3030145
|
|
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 EAR EXTERNAL-SO
|
Facility
|
OP
|
$76.71
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40134477
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.18 |
| 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 |
$38.35
|
| 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 |
$19.94
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.51
|
| 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 |
$2.18
|
|
|
CULTURE EAR EXTERNAL-SO
|
Facility
|
IP
|
$76.71
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40134477
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.51 |
| Max. Negotiated Rate |
$11.51 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$11.51
|
|
|
CULTURE, EYE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3009453
|
|
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, EYE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3009453
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE EYE-SO
|
Facility
|
OP
|
$189.31
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40134480
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.38 |
| 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 |
$94.66
|
| 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 |
$49.22
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.40
|
| 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 |
$5.38
|
|
|
CULTURE EYE-SO
|
Facility
|
IP
|
$189.31
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40134480
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.40 |
| Max. Negotiated Rate |
$28.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$28.40
|
|
|
CULTURE,FUNG,HAIR,SK,NAIL
|
Facility
|
OP
|
$53.00
|
|
|
Service Code
|
HCPCS 87101
|
| Hospital Charge Code |
39900484
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.51 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$20.97
|
| Rate for Payer: Aetna Medicare Advantage |
$24.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7.71
|
| 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 |
$27.97
|
| Rate for Payer: Cigna Commercial |
$26.50
|
| Rate for Payer: Cigna Medicare Advantage |
$7.71
|
| Rate for Payer: Clover Medicare Advantage |
$7.32
|
| Rate for Payer: EmblemHealth Commercial |
$23.13
|
| Rate for Payer: Humana Medicare Advantage |
$7.94
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7.71
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$13.78
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.95
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$7.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.51
|
|
|
CULTURE,FUNG,HAIR,SK,NAIL
|
Facility
|
IP
|
$53.00
|
|
|
Service Code
|
HCPCS 87101
|
| Hospital Charge Code |
39900484
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$7.95 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$7.95
|
|
|
CULTURE, FUNGI ISOLATION SKIN
|
Facility
|
OP
|
$99.00
|
|
|
Service Code
|
HCPCS 87101
|
| Hospital Charge Code |
38475011
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$2.81 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$20.97
|
| Rate for Payer: Aetna Medicare Advantage |
$24.98
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$27.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$27.97
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7.71
|
| 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 |
$27.97
|
| Rate for Payer: Cigna Commercial |
$49.50
|
| Rate for Payer: Cigna Medicare Advantage |
$7.71
|
| Rate for Payer: Clover Medicare Advantage |
$7.32
|
| Rate for Payer: EmblemHealth Commercial |
$23.13
|
| Rate for Payer: Humana Medicare Advantage |
$7.94
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7.71
|
| 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 |
$6.17
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7.71
|
| Rate for Payer: Wellcare Medicare Advantage |
$7.71
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$2.81
|
|
|
CULTURE, FUNGI ISOLATION SKIN
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
HCPCS 87101
|
| Hospital Charge Code |
38475011
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$14.85 |
| Max. Negotiated Rate |
$14.85 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$14.85
|
|
|
CULTURE,FUNG,RESPIRIRATORY II
|
Facility
|
IP
|
$36.70
|
|
|
Service Code
|
HCPCS 87206
|
| Hospital Charge Code |
3990158B
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$5.50 |
| Max. Negotiated Rate |
$5.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.50
|
|
|
CULTURE,FUNG,RESPIRIRATORY II
|
Facility
|
OP
|
$36.70
|
|
|
Service Code
|
HCPCS 87206
|
| Hospital Charge Code |
3990158B
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$1.04 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$14.66
|
| Rate for Payer: Aetna Medicare Advantage |
$17.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.55
|
| Rate for Payer: Cigna Commercial |
$18.35
|
| Rate for Payer: Cigna Medicare Advantage |
$5.39
|
| Rate for Payer: Clover Medicare Advantage |
$5.12
|
| Rate for Payer: EmblemHealth Commercial |
$16.17
|
| Rate for Payer: Humana Medicare Advantage |
$5.55
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.39
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.54
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.04
|
|
|
CULTURE,FUNGUS,BLOOD
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87103
|
| Hospital Charge Code |
39900487
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$55.65
|
| Rate for Payer: Aetna Medicare Advantage |
$66.29
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.46
|
| 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 |
$74.22
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$20.46
|
| Rate for Payer: Clover Medicare Advantage |
$19.44
|
| Rate for Payer: EmblemHealth Commercial |
$61.38
|
| Rate for Payer: Humana Medicare Advantage |
$21.07
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.46
|
| 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 |
$16.37
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.46
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.46
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CULTURE,FUNGUS,BLOOD
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87103
|
| Hospital Charge Code |
39900487
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE,FUNGUS,MISC I
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87102
|
| Hospital Charge Code |
3990160A
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE,FUNGUS,MISC I
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87102
|
| Hospital Charge Code |
3990160A
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$22.88
|
| Rate for Payer: Aetna Medicare Advantage |
$27.25
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$30.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$30.51
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.41
|
| 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 |
$30.51
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$8.41
|
| Rate for Payer: Clover Medicare Advantage |
$7.99
|
| Rate for Payer: EmblemHealth Commercial |
$25.23
|
| Rate for Payer: Humana Medicare Advantage |
$8.66
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.41
|
| 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 |
$6.73
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.41
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.41
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CULTURE,FUNGUS,MISC II
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87206
|
| Hospital Charge Code |
3990160B
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.31 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$14.66
|
| Rate for Payer: Aetna Medicare Advantage |
$17.46
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$19.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$19.55
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.39
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$6.93
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$19.55
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.39
|
| Rate for Payer: Clover Medicare Advantage |
$5.12
|
| Rate for Payer: EmblemHealth Commercial |
$16.17
|
| Rate for Payer: Humana Medicare Advantage |
$5.55
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.39
|
| 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 |
$4.31
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.39
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.39
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
