|
CULTURE, THROAT
|
Facility
|
OP
|
$601.42
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3009479
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$300.71 |
| 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 |
$300.71
|
| 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 |
$156.37
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$90.21
|
| 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 |
$17.08
|
|
|
CULTURE, TISSUE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3000114
|
|
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, TISSUE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3000114
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE, TRANSFUSION REACTION
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87040
|
| Hospital Charge Code |
3000122
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE, TRANSFUSION REACTION
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87040
|
| Hospital Charge Code |
3000122
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.26 |
| Max. Negotiated Rate |
$195.00 |
| 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 |
$195.00
|
| 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 |
$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 |
$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 |
$11.08
|
|
|
CULTURE,TYPING;ID BY NUCLEIC A
|
Facility
|
IP
|
$141.00
|
|
|
Service Code
|
HCPCS 87149
|
| Hospital Charge Code |
38477157
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$21.15 |
| Max. Negotiated Rate |
$21.15 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.15
|
|
|
CULTURE,TYPING;ID BY NUCLEIC A
|
Facility
|
OP
|
$141.00
|
|
|
Service Code
|
HCPCS 87149
|
| Hospital Charge Code |
38477157
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$54.54
|
| Rate for Payer: Aetna Medicare Advantage |
$64.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$72.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$72.73
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$20.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$36.30
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$72.73
|
| Rate for Payer: Cigna Commercial |
$70.50
|
| Rate for Payer: Cigna Medicare Advantage |
$20.05
|
| Rate for Payer: Clover Medicare Advantage |
$19.05
|
| Rate for Payer: EmblemHealth Commercial |
$60.15
|
| Rate for Payer: Humana Medicare Advantage |
$20.65
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$20.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$36.66
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$21.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$16.04
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$20.05
|
| Rate for Payer: Wellcare Medicare Advantage |
$20.05
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$4.00
|
|
|
CULTURE TYPING IMM PER ANTISER
|
Facility
|
IP
|
$36.00
|
|
|
Service Code
|
HCPCS 87147
|
| Hospital Charge Code |
38477041
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$5.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.40
|
|
|
CULTURE TYPING IMM PER ANTISER
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
HCPCS 87147
|
| Hospital Charge Code |
38477041
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$14.09
|
| Rate for Payer: Aetna Medicare Advantage |
$16.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$18.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$18.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$5.18
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$18.79
|
| Rate for Payer: Cigna Commercial |
$18.00
|
| Rate for Payer: Cigna Medicare Advantage |
$5.18
|
| Rate for Payer: Clover Medicare Advantage |
$4.92
|
| Rate for Payer: EmblemHealth Commercial |
$15.54
|
| Rate for Payer: Humana Medicare Advantage |
$5.34
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$5.18
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.36
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$4.14
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$5.18
|
| Rate for Payer: Wellcare Medicare Advantage |
$5.18
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.02
|
|
|
CULTURE,TYPING;OTHER METHODS
|
Facility
|
IP
|
$37.00
|
|
|
Service Code
|
HCPCS 87158
|
| Hospital Charge Code |
38477042
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$5.55 |
| Max. Negotiated Rate |
$5.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.55
|
|
|
CULTURE,TYPING;OTHER METHODS
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
HCPCS 87158
|
| Hospital Charge Code |
38477042
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$21.05
|
| Rate for Payer: Aetna Medicare Advantage |
$25.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$28.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$28.08
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$7.74
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$4.95
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$28.08
|
| Rate for Payer: Cigna Commercial |
$18.50
|
| Rate for Payer: Cigna Medicare Advantage |
$7.74
|
| Rate for Payer: Clover Medicare Advantage |
$7.35
|
| Rate for Payer: EmblemHealth Commercial |
$23.22
|
| Rate for Payer: Humana Medicare Advantage |
$7.97
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$7.74
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$9.62
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$5.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.19
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$7.74
|
| Rate for Payer: Wellcare Medicare Advantage |
$7.74
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.05
|
|
|
CULTURE, URINE
|
Facility
|
IP
|
$550.62
|
|
|
Service Code
|
HCPCS 87086
|
| Hospital Charge Code |
3009461
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$82.59 |
| Max. Negotiated Rate |
$82.59 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.59
|
|
|
CULTURE, URINE
|
Facility
|
OP
|
$550.62
|
|
|
Service Code
|
HCPCS 87086
|
| Hospital Charge Code |
3009461
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$275.31 |
| Rate for Payer: Aetna Commercial |
$21.95
|
| Rate for Payer: Aetna Medicare Advantage |
$26.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.27
|
| Rate for Payer: Cigna Commercial |
$275.31
|
| Rate for Payer: Cigna Medicare Advantage |
$8.07
|
| Rate for Payer: Clover Medicare Advantage |
$7.67
|
| Rate for Payer: EmblemHealth Commercial |
$24.21
|
| Rate for Payer: Humana Medicare Advantage |
$8.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$143.16
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$82.59
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.07
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$15.64
|
|
|
CULTURE, URINE, BLADDER
|
Facility
|
IP
|
$399.41
|
|
|
Service Code
|
HCPCS 87086
|
| Hospital Charge Code |
3009487
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.91 |
| Max. Negotiated Rate |
$59.91 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.91
|
|
|
CULTURE, URINE, BLADDER
|
Facility
|
OP
|
$399.41
|
|
|
Service Code
|
HCPCS 87086
|
| Hospital Charge Code |
3009487
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$199.71 |
| Rate for Payer: Aetna Commercial |
$21.95
|
| Rate for Payer: Aetna Medicare Advantage |
$26.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.27
|
| Rate for Payer: Cigna Commercial |
$199.71
|
| Rate for Payer: Cigna Medicare Advantage |
$8.07
|
| Rate for Payer: Clover Medicare Advantage |
$7.67
|
| Rate for Payer: EmblemHealth Commercial |
$24.21
|
| Rate for Payer: Humana Medicare Advantage |
$8.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$103.85
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$59.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.07
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.34
|
|
|
CULTURE URINE ROUTINE-SO
|
Facility
|
IP
|
$66.83
|
|
|
Service Code
|
HCPCS 87086
|
| Hospital Charge Code |
401387086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.02 |
| Max. Negotiated Rate |
$10.02 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.02
|
|
|
CULTURE URINE ROUTINE-SO
|
Facility
|
OP
|
$66.83
|
|
|
Service Code
|
HCPCS 87086
|
| Hospital Charge Code |
401387086
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$156.00 |
| Rate for Payer: Aetna Commercial |
$21.95
|
| Rate for Payer: Aetna Medicare Advantage |
$26.15
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$29.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$29.27
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$8.07
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$9.90
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$29.27
|
| Rate for Payer: Cigna Commercial |
$33.41
|
| Rate for Payer: Cigna Medicare Advantage |
$8.07
|
| Rate for Payer: Clover Medicare Advantage |
$7.67
|
| Rate for Payer: EmblemHealth Commercial |
$24.21
|
| Rate for Payer: Humana Medicare Advantage |
$8.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$8.07
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$17.38
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$10.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$156.00
|
| Rate for Payer: UnitedHealthcare Community & State |
$6.46
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$8.07
|
| Rate for Payer: Wellcare Medicare Advantage |
$8.07
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$1.90
|
|
|
CULTURE, VARICELLA ZOSTER
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 86171
|
| Hospital Charge Code |
3006806
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.42 |
| Max. Negotiated Rate |
$195.00 |
| Rate for Payer: Aetna Commercial |
$27.23
|
| Rate for Payer: Aetna Medicare Advantage |
$32.43
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$36.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$36.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage |
$10.01
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health |
$7.42
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$36.31
|
| Rate for Payer: Cigna Commercial |
$195.00
|
| Rate for Payer: Cigna Medicare Advantage |
$10.01
|
| Rate for Payer: Clover Medicare Advantage |
$9.51
|
| Rate for Payer: EmblemHealth Commercial |
$30.03
|
| Rate for Payer: Humana Medicare Advantage |
$10.31
|
| Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage |
$10.01
|
| 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 |
$8.01
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.01
|
| Rate for Payer: Wellcare Medicare Advantage |
$10.01
|
| Rate for Payer: Wellpoint Medicaid Managed Care |
$11.08
|
|
|
CULTURE, VARICELLA ZOSTER
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 86171
|
| Hospital Charge Code |
3006806
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE,VIRAL,FLD,TISSUE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
HCPCS 87252
|
| Hospital Charge Code |
39900496
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$58.50
|
|
|
CULTURE,VIRAL,FLD,TISSUE
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
HCPCS 87252
|
| Hospital Charge Code |
39900496
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$195.00 |
| 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 |
$195.00
|
| 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 |
$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 |
$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 |
$11.08
|
|
|
CULTURE,VIRUS
|
Facility
|
OP
|
$179.15
|
|
|
Service Code
|
HCPCS 87252
|
| Hospital Charge Code |
39900276
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$5.09 |
| 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 |
$89.58
|
| 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 |
$46.58
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.87
|
| 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 |
$5.09
|
|
|
CULTURE,VIRUS
|
Facility
|
IP
|
$179.15
|
|
|
Service Code
|
HCPCS 87252
|
| Hospital Charge Code |
39900276
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$26.87 |
| Max. Negotiated Rate |
$26.87 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$26.87
|
|
|
CULTURE, WOUND
|
Facility
|
OP
|
$770.30
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3000148
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$385.15 |
| 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 |
$385.15
|
| 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 |
$200.28
|
| Rate for Payer: Oxford Commercial |
$156.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.55
|
| 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 |
$21.88
|
|
|
CULTURE, WOUND
|
Facility
|
IP
|
$770.30
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
3000148
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$115.55 |
| Max. Negotiated Rate |
$115.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$115.55
|
|
