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Service Code HCPCS J1335
Hospital Charge Code 4400392
Hospital Revenue Code 636
Min. Negotiated Rate $11.90
Max. Negotiated Rate $152.75
Rate for Payer: Aetna of NY Commercial $129.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $11.90
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $11.90
Rate for Payer: Cash Price $176.25
Rate for Payer: Cash Price $176.25
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $11.90
Rate for Payer: EmblemHealth Select Care $11.90
Rate for Payer: Galaxy Health Commercial $152.75
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $129.25
Rate for Payer: WellCare Medicare $129.25
Service Code HCPCS J1335
Hospital Charge Code 4400392
Hospital Revenue Code 636
Min. Negotiated Rate $11.90
Max. Negotiated Rate $189.18
Rate for Payer: Aetna of NY Commercial $129.25
Rate for Payer: Aetna of NY Medicare $108.10
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $11.90
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $11.90
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $86.95
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $117.50
Rate for Payer: Cash Price $176.25
Rate for Payer: Cash Price $176.25
Rate for Payer: CDPHP Commercial $189.18
Rate for Payer: CDPHP Medicare $86.95
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $11.90
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $188.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $188.00
Rate for Payer: EmblemHealth Medicaid $188.00
Rate for Payer: EmblemHealth Medicare $79.90
Rate for Payer: EmblemHealth Select Care $11.90
Rate for Payer: Fidelis Medicare $89.56
Rate for Payer: Galaxy Health Commercial $152.75
Rate for Payer: Hamaspik Choice Medicare $86.95
Rate for Payer: Humana Medicare $86.95
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $129.25
Rate for Payer: Local 1199SEIU Medicare $108.10
Rate for Payer: MVP Health Care of NY Commercial $176.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $132.30
Rate for Payer: MVP Health Care of NY Medicare $91.30
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $21.98
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $11.90
Rate for Payer: United Healthcare Commercial $21.98
Rate for Payer: United Healthcare Medicare $86.95
Rate for Payer: WellCare Medicare $129.25
Service Code HCPCS 36415
Hospital Charge Code 4604032
Hospital Revenue Code 300
Min. Negotiated Rate $3.06
Max. Negotiated Rate $715.00
Rate for Payer: Aetna of NY Commercial $6.30
Rate for Payer: Aetna of NY Medicare $4.14
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $6.75
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $6.75
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan $16.09
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid $7.15
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $3.33
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $4.50
Rate for Payer: Cash Price $6.75
Rate for Payer: Cash Price $6.75
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan $7.15
Rate for Payer: CDPHP Commercial $7.24
Rate for Payer: CDPHP Essential Plan $16.09
Rate for Payer: CDPHP Medicare $3.33
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $5.40
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $8.58
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $7.15
Rate for Payer: EmblemHealth Medicaid $7.15
Rate for Payer: EmblemHealth Medicare $3.06
Rate for Payer: EmblemHealth Select Care $5.40
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid $16.09
Rate for Payer: Fidelis Medicare $3.43
Rate for Payer: Galaxy Health Commercial $5.85
Rate for Payer: Galaxy Health Workers Comp $10.51
Rate for Payer: Hamaspik Choice Medicaid $715.00
Rate for Payer: Hamaspik Choice Medicare $3.33
Rate for Payer: Humana Medicare $3.33
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $6.30
Rate for Payer: Local 1199SEIU Medicare $4.14
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid $715.00
Rate for Payer: MVP Health Care of NY Commercial $6.75
Rate for Payer: MVP Health Care of NY Essential Plan 1&2 $15.37
Rate for Payer: MVP Health Care of NY Essential Plan 3&4 $15.37
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $5.07
Rate for Payer: MVP Health Care of NY Medicare $3.50
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $6.75
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $7.15
Rate for Payer: United Healthcare Commercial $6.75
Rate for Payer: United Healthcare Medicare $3.33
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid $7.51
Rate for Payer: WellCare Medicare $4.95
Service Code HCPCS 36415
Hospital Charge Code 4604032
Hospital Revenue Code 300
Min. Negotiated Rate $5.85
Max. Negotiated Rate $5.85
Rate for Payer: Cash Price $6.75
Rate for Payer: Galaxy Health Commercial $5.85
Hospital Charge Code 4472176
Hospital Revenue Code 270
Min. Negotiated Rate $23.40
Max. Negotiated Rate $23.40
Rate for Payer: Cash Price $27.00
Rate for Payer: Galaxy Health Commercial $23.40
Hospital Charge Code 4472176
Hospital Revenue Code 270
Min. Negotiated Rate $12.24
Max. Negotiated Rate $28.98
Rate for Payer: Aetna of NY Commercial $25.20
Rate for Payer: Aetna of NY Medicare $16.56
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $27.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $27.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $13.32
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $18.00
Rate for Payer: Cash Price $27.00
Rate for Payer: CDPHP Commercial $28.98
Rate for Payer: CDPHP Medicare $13.32
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $28.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $28.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $28.80
Rate for Payer: EmblemHealth Medicaid $28.80
Rate for Payer: EmblemHealth Medicare $12.24
Rate for Payer: EmblemHealth Select Care $25.92
Rate for Payer: Fidelis Medicare $13.72
Rate for Payer: Galaxy Health Commercial $23.40
Rate for Payer: Hamaspik Choice Medicare $13.32
Rate for Payer: Humana Medicare $13.32
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $25.20
Rate for Payer: Local 1199SEIU Medicare $16.56
Rate for Payer: MVP Health Care of NY Commercial $27.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $20.27
Rate for Payer: MVP Health Care of NY Medicare $13.99
Rate for Payer: United Healthcare Medicare $13.32
Rate for Payer: WellCare Medicare $19.80
Service Code NDC 24208091019
Hospital Charge Code 4401551
Hospital Revenue Code 250
Min. Negotiated Rate $20.35
Max. Negotiated Rate $24.05
Rate for Payer: Cash Price $27.75
Rate for Payer: Galaxy Health Commercial $24.05
Rate for Payer: WellCare Medicare $20.35
Service Code NDC 24208091019
Hospital Charge Code 4401551
Hospital Revenue Code 250
Min. Negotiated Rate $12.58
Max. Negotiated Rate $29.78
Rate for Payer: Aetna of NY Commercial $25.90
Rate for Payer: Aetna of NY Medicare $17.02
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $27.75
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $27.75
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $13.69
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $18.50
Rate for Payer: Cash Price $27.75
Rate for Payer: CDPHP Commercial $29.78
Rate for Payer: CDPHP Medicare $13.69
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $29.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $29.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $29.60
Rate for Payer: EmblemHealth Medicaid $29.60
Rate for Payer: EmblemHealth Medicare $12.58
Rate for Payer: EmblemHealth Select Care $26.64
Rate for Payer: Fidelis Medicare $14.10
Rate for Payer: Galaxy Health Commercial $24.05
Rate for Payer: Hamaspik Choice Medicare $13.69
Rate for Payer: Humana Medicare $13.69
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $25.90
Rate for Payer: Local 1199SEIU Medicare $17.02
Rate for Payer: MVP Health Care of NY Commercial $27.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $20.83
Rate for Payer: MVP Health Care of NY Medicare $14.37
Rate for Payer: United Healthcare Medicare $13.69
Rate for Payer: WellCare Medicare $20.35
Service Code NDC 24338012213
Hospital Charge Code 4400275
Hospital Revenue Code 250
Min. Negotiated Rate $7.70
Max. Negotiated Rate $18.24
Rate for Payer: Aetna of NY Commercial $15.86
Rate for Payer: Aetna of NY Medicare $10.42
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $17.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $17.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $8.38
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $11.33
Rate for Payer: Cash Price $17.00
Rate for Payer: CDPHP Commercial $18.24
Rate for Payer: CDPHP Medicare $8.38
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $18.13
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $18.13
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $18.13
Rate for Payer: EmblemHealth Medicaid $18.13
Rate for Payer: EmblemHealth Medicare $7.70
Rate for Payer: EmblemHealth Select Care $16.32
Rate for Payer: Fidelis Medicare $8.64
Rate for Payer: Galaxy Health Commercial $14.73
Rate for Payer: Hamaspik Choice Medicare $8.38
Rate for Payer: Humana Medicare $8.38
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $15.86
Rate for Payer: Local 1199SEIU Medicare $10.42
Rate for Payer: MVP Health Care of NY Commercial $17.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $12.76
Rate for Payer: MVP Health Care of NY Medicare $8.80
Rate for Payer: United Healthcare Medicare $8.38
Rate for Payer: WellCare Medicare $12.46
Service Code NDC 24338012213
Hospital Charge Code 4400275
Hospital Revenue Code 250
Min. Negotiated Rate $12.46
Max. Negotiated Rate $14.73
Rate for Payer: Cash Price $17.00
Rate for Payer: Galaxy Health Commercial $14.73
Rate for Payer: WellCare Medicare $12.46
Service Code NDC 24208091055
Hospital Charge Code 4400277
Hospital Revenue Code 250
Min. Negotiated Rate $19.96
Max. Negotiated Rate $47.26
Rate for Payer: Aetna of NY Commercial $41.10
Rate for Payer: Aetna of NY Medicare $27.01
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $44.03
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $44.03
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $21.72
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $29.36
Rate for Payer: Cash Price $44.03
Rate for Payer: CDPHP Commercial $47.26
Rate for Payer: CDPHP Medicare $21.72
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $46.97
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $46.97
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $46.97
Rate for Payer: EmblemHealth Medicaid $46.97
Rate for Payer: EmblemHealth Medicare $19.96
Rate for Payer: EmblemHealth Select Care $42.27
Rate for Payer: Fidelis Medicare $22.37
Rate for Payer: Galaxy Health Commercial $38.16
Rate for Payer: Hamaspik Choice Medicare $21.72
Rate for Payer: Humana Medicare $21.72
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $41.10
Rate for Payer: Local 1199SEIU Medicare $27.01
Rate for Payer: MVP Health Care of NY Commercial $44.03
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $33.05
Rate for Payer: MVP Health Care of NY Medicare $22.81
Rate for Payer: United Healthcare Medicare $21.72
Rate for Payer: WellCare Medicare $32.29
Service Code NDC 24208091055
Hospital Charge Code 4400277
Hospital Revenue Code 250
Min. Negotiated Rate $32.29
Max. Negotiated Rate $38.16
Rate for Payer: Cash Price $44.03
Rate for Payer: Galaxy Health Commercial $38.16
Rate for Payer: WellCare Medicare $32.29
Service Code HCPCS J1364
Hospital Charge Code 4400276
Hospital Revenue Code 636
Min. Negotiated Rate $77.85
Max. Negotiated Rate $146.25
Rate for Payer: Aetna of NY Commercial $123.75
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $77.85
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $77.85
Rate for Payer: Cash Price $168.75
Rate for Payer: Cash Price $168.75
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $77.85
Rate for Payer: EmblemHealth Select Care $77.85
Rate for Payer: Galaxy Health Commercial $146.25
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $123.75
Rate for Payer: WellCare Medicare $123.75
Service Code HCPCS J1364
Hospital Charge Code 4400276
Hospital Revenue Code 636
Min. Negotiated Rate $76.50
Max. Negotiated Rate $181.12
Rate for Payer: Aetna of NY Commercial $123.75
Rate for Payer: Aetna of NY Medicare $103.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $77.85
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $77.85
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $83.25
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $112.50
Rate for Payer: Cash Price $168.75
Rate for Payer: Cash Price $168.75
Rate for Payer: CDPHP Commercial $181.12
Rate for Payer: CDPHP Medicare $83.25
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $77.85
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $180.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $180.00
Rate for Payer: EmblemHealth Medicaid $180.00
Rate for Payer: EmblemHealth Medicare $76.50
Rate for Payer: EmblemHealth Select Care $77.85
Rate for Payer: Fidelis Medicare $85.75
Rate for Payer: Galaxy Health Commercial $146.25
Rate for Payer: Hamaspik Choice Medicare $83.25
Rate for Payer: Humana Medicare $83.25
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $123.75
Rate for Payer: Local 1199SEIU Medicare $103.50
Rate for Payer: MVP Health Care of NY Commercial $168.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $126.68
Rate for Payer: MVP Health Care of NY Medicare $87.41
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $144.09
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $77.85
Rate for Payer: United Healthcare Commercial $144.09
Rate for Payer: United Healthcare Medicare $83.25
Rate for Payer: WellCare Medicare $123.75
Service Code NDC 00904642661
Hospital Charge Code 4400435
Hospital Revenue Code 250
Min. Negotiated Rate $4.64
Max. Negotiated Rate $10.99
Rate for Payer: Aetna of NY Commercial $9.56
Rate for Payer: Aetna of NY Medicare $6.28
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $10.24
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $10.24
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $5.05
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $6.82
Rate for Payer: Cash Price $10.24
Rate for Payer: CDPHP Commercial $10.99
Rate for Payer: CDPHP Medicare $5.05
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $10.92
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $10.92
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $10.92
Rate for Payer: EmblemHealth Medicaid $10.92
Rate for Payer: EmblemHealth Medicare $4.64
Rate for Payer: EmblemHealth Select Care $9.83
Rate for Payer: Fidelis Medicare $5.20
Rate for Payer: Galaxy Health Commercial $8.87
Rate for Payer: Hamaspik Choice Medicare $5.05
Rate for Payer: Humana Medicare $5.05
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $9.56
Rate for Payer: Local 1199SEIU Medicare $6.28
Rate for Payer: MVP Health Care of NY Commercial $10.24
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $7.68
Rate for Payer: MVP Health Care of NY Medicare $5.30
Rate for Payer: United Healthcare Medicare $5.05
Rate for Payer: WellCare Medicare $7.51
Service Code NDC 00904642661
Hospital Charge Code 4400435
Hospital Revenue Code 250
Min. Negotiated Rate $7.51
Max. Negotiated Rate $8.87
Rate for Payer: Cash Price $10.24
Rate for Payer: Galaxy Health Commercial $8.87
Rate for Payer: WellCare Medicare $7.51
Service Code NDC 67457018200
Hospital Charge Code 4400112
Hospital Revenue Code 250
Min. Negotiated Rate $14.87
Max. Negotiated Rate $17.58
Rate for Payer: Cash Price $20.28
Rate for Payer: Galaxy Health Commercial $17.58
Rate for Payer: WellCare Medicare $14.87
Service Code NDC 67457018200
Hospital Charge Code 4400112
Hospital Revenue Code 250
Min. Negotiated Rate $9.19
Max. Negotiated Rate $21.77
Rate for Payer: Aetna of NY Commercial $18.93
Rate for Payer: Aetna of NY Medicare $12.44
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $20.28
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $20.28
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $10.00
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $13.52
Rate for Payer: Cash Price $20.28
Rate for Payer: CDPHP Commercial $21.77
Rate for Payer: CDPHP Medicare $10.00
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $21.63
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $21.63
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $21.63
Rate for Payer: EmblemHealth Medicaid $21.63
Rate for Payer: EmblemHealth Medicare $9.19
Rate for Payer: EmblemHealth Select Care $19.47
Rate for Payer: Fidelis Medicare $10.30
Rate for Payer: Galaxy Health Commercial $17.58
Rate for Payer: Hamaspik Choice Medicare $10.00
Rate for Payer: Humana Medicare $10.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $18.93
Rate for Payer: Local 1199SEIU Medicare $12.44
Rate for Payer: MVP Health Care of NY Commercial $20.28
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $15.22
Rate for Payer: MVP Health Care of NY Medicare $10.51
Rate for Payer: United Healthcare Medicare $10.00
Rate for Payer: WellCare Medicare $14.87
Service Code CPT 43235
Hospital Revenue Code 490
Min. Negotiated Rate $863.69
Max. Negotiated Rate $2,521.93
Rate for Payer: Aetna of NY Commercial $1,857.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $2,017.33
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $2,521.93
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $897.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $1,857.00
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $1,775.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $863.69
Rate for Payer: United Healthcare Commercial $1,775.00
Service Code CPT 43239
Hospital Revenue Code 490
Min. Negotiated Rate $863.69
Max. Negotiated Rate $2,521.93
Rate for Payer: Aetna of NY Commercial $1,857.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $2,017.33
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $2,521.93
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $897.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $1,857.00
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $1,775.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $863.69
Rate for Payer: United Healthcare Commercial $1,775.00
Service Code HCPCS 85651
Hospital Charge Code 4300310
Hospital Revenue Code 305
Min. Negotiated Rate $2.02
Max. Negotiated Rate $16.10
Rate for Payer: Aetna of NY Commercial $13.00
Rate for Payer: Aetna of NY Medicare $9.20
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $15.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $15.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $7.40
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $10.00
Rate for Payer: Cash Price $15.00
Rate for Payer: Cash Price $15.00
Rate for Payer: CDPHP Commercial $16.10
Rate for Payer: CDPHP Medicare $7.40
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $12.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $16.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $16.00
Rate for Payer: EmblemHealth Medicaid $16.00
Rate for Payer: EmblemHealth Medicare $6.80
Rate for Payer: EmblemHealth Select Care $12.00
Rate for Payer: Fidelis Medicare $7.62
Rate for Payer: Galaxy Health Commercial $13.00
Rate for Payer: Hamaspik Choice Medicare $7.40
Rate for Payer: Humana Medicare $7.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $13.00
Rate for Payer: Local 1199SEIU Medicare $9.20
Rate for Payer: MVP Health Care of NY Commercial $15.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $11.26
Rate for Payer: MVP Health Care of NY Medicare $7.77
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $15.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $2.02
Rate for Payer: United Healthcare Commercial $15.00
Rate for Payer: United Healthcare Medicare $7.40
Rate for Payer: WellCare Medicare $11.00
Service Code HCPCS 85651
Hospital Charge Code 4300310
Hospital Revenue Code 305
Min. Negotiated Rate $13.00
Max. Negotiated Rate $13.00
Rate for Payer: Cash Price $15.00
Rate for Payer: Galaxy Health Commercial $13.00
Service Code HCPCS G0480
Hospital Charge Code 4300314
Hospital Revenue Code 301
Min. Negotiated Rate $15.15
Max. Negotiated Rate $289.80
Rate for Payer: Aetna of NY Commercial $234.00
Rate for Payer: Aetna of NY Medicare $165.60
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $270.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $270.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $133.20
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $180.00
Rate for Payer: Cash Price $270.00
Rate for Payer: Cash Price $270.00
Rate for Payer: CDPHP Commercial $289.80
Rate for Payer: CDPHP Medicare $133.20
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $216.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $288.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $288.00
Rate for Payer: EmblemHealth Medicaid $288.00
Rate for Payer: EmblemHealth Medicare $122.40
Rate for Payer: EmblemHealth Select Care $216.00
Rate for Payer: Fidelis Medicare $137.20
Rate for Payer: Galaxy Health Commercial $234.00
Rate for Payer: Hamaspik Choice Medicare $133.20
Rate for Payer: Humana Medicare $133.20
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $234.00
Rate for Payer: Local 1199SEIU Medicare $165.60
Rate for Payer: MVP Health Care of NY Commercial $270.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $202.68
Rate for Payer: MVP Health Care of NY Medicare $139.86
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $270.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $15.15
Rate for Payer: United Healthcare Commercial $270.00
Rate for Payer: United Healthcare Medicare $133.20
Rate for Payer: WellCare Medicare $198.00
Service Code HCPCS G0480
Hospital Charge Code 4300314
Hospital Revenue Code 301
Min. Negotiated Rate $234.00
Max. Negotiated Rate $234.00
Rate for Payer: Cash Price $270.00
Rate for Payer: Galaxy Health Commercial $234.00
Hospital Charge Code 4472213
Hospital Revenue Code 270
Min. Negotiated Rate $8.45
Max. Negotiated Rate $8.45
Rate for Payer: Cash Price $9.75
Rate for Payer: Galaxy Health Commercial $8.45