|
ANESTHESIA 165 MINS
|
Facility
OP
|
$484.00
|
|
| Hospital Charge Code |
4120014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$164.56 |
| Max. Negotiated Rate |
$389.62 |
| Rate for Payer: Aetna of NY Commercial |
$338.80
|
| Rate for Payer: Aetna of NY Medicare |
$222.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$363.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$363.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$179.08
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$242.00
|
| Rate for Payer: Cash Price |
$363.00
|
| Rate for Payer: CDPHP Commercial |
$389.62
|
| Rate for Payer: CDPHP Medicare |
$179.08
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$387.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$387.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$387.20
|
| Rate for Payer: EmblemHealth Medicaid |
$387.20
|
| Rate for Payer: EmblemHealth Medicare |
$164.56
|
| Rate for Payer: EmblemHealth Select Care |
$348.48
|
| Rate for Payer: Fidelis Medicare |
$184.45
|
| Rate for Payer: Galaxy Health Commercial |
$314.60
|
| Rate for Payer: Hamaspik Choice Medicare |
$179.08
|
| Rate for Payer: Humana Medicare |
$179.08
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$338.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$222.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$363.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$272.49
|
| Rate for Payer: MVP Health Care of NY Medicare |
$188.03
|
| Rate for Payer: United Healthcare Medicare |
$179.08
|
| Rate for Payer: WellCare Medicare |
$266.20
|
|
|
ANESTHESIA 180 MIN
|
Facility
OP
|
$517.00
|
|
| Hospital Charge Code |
4120008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$175.78 |
| Max. Negotiated Rate |
$416.18 |
| Rate for Payer: Aetna of NY Commercial |
$361.90
|
| Rate for Payer: Aetna of NY Medicare |
$237.82
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$387.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$387.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$191.29
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$258.50
|
| Rate for Payer: Cash Price |
$387.75
|
| Rate for Payer: CDPHP Commercial |
$416.18
|
| Rate for Payer: CDPHP Medicare |
$191.29
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$413.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$413.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$413.60
|
| Rate for Payer: EmblemHealth Medicaid |
$413.60
|
| Rate for Payer: EmblemHealth Medicare |
$175.78
|
| Rate for Payer: EmblemHealth Select Care |
$372.24
|
| Rate for Payer: Fidelis Medicare |
$197.03
|
| Rate for Payer: Galaxy Health Commercial |
$336.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$191.29
|
| Rate for Payer: Humana Medicare |
$191.29
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$361.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$237.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$387.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$291.07
|
| Rate for Payer: MVP Health Care of NY Medicare |
$200.85
|
| Rate for Payer: United Healthcare Medicare |
$191.29
|
| Rate for Payer: WellCare Medicare |
$284.35
|
|
|
ANESTHESIA 195 MINS
|
Facility
OP
|
$549.00
|
|
| Hospital Charge Code |
4120015
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$186.66 |
| Max. Negotiated Rate |
$441.94 |
| Rate for Payer: Aetna of NY Commercial |
$384.30
|
| Rate for Payer: Aetna of NY Medicare |
$252.54
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$411.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$411.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$203.13
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$274.50
|
| Rate for Payer: Cash Price |
$411.75
|
| Rate for Payer: CDPHP Commercial |
$441.94
|
| Rate for Payer: CDPHP Medicare |
$203.13
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$439.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$439.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$439.20
|
| Rate for Payer: EmblemHealth Medicaid |
$439.20
|
| Rate for Payer: EmblemHealth Medicare |
$186.66
|
| Rate for Payer: EmblemHealth Select Care |
$395.28
|
| Rate for Payer: Fidelis Medicare |
$209.22
|
| Rate for Payer: Galaxy Health Commercial |
$356.85
|
| Rate for Payer: Hamaspik Choice Medicare |
$203.13
|
| Rate for Payer: Humana Medicare |
$203.13
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$384.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$252.54
|
| Rate for Payer: MVP Health Care of NY Commercial |
$411.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$309.09
|
| Rate for Payer: MVP Health Care of NY Medicare |
$213.29
|
| Rate for Payer: United Healthcare Medicare |
$203.13
|
| Rate for Payer: WellCare Medicare |
$301.95
|
|
|
ANESTHESIA 210 MIN
|
Facility
OP
|
$581.00
|
|
| Hospital Charge Code |
4120009
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$197.54 |
| Max. Negotiated Rate |
$467.70 |
| Rate for Payer: Aetna of NY Commercial |
$406.70
|
| Rate for Payer: Aetna of NY Medicare |
$267.26
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$435.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$435.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$214.97
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$290.50
|
| Rate for Payer: Cash Price |
$435.75
|
| Rate for Payer: CDPHP Commercial |
$467.70
|
| Rate for Payer: CDPHP Medicare |
$214.97
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$464.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$464.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$464.80
|
| Rate for Payer: EmblemHealth Medicaid |
$464.80
|
| Rate for Payer: EmblemHealth Medicare |
$197.54
|
| Rate for Payer: EmblemHealth Select Care |
$418.32
|
| Rate for Payer: Fidelis Medicare |
$221.42
|
| Rate for Payer: Galaxy Health Commercial |
$377.65
|
| Rate for Payer: Hamaspik Choice Medicare |
$214.97
|
| Rate for Payer: Humana Medicare |
$214.97
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$406.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$267.26
|
| Rate for Payer: MVP Health Care of NY Commercial |
$435.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$327.10
|
| Rate for Payer: MVP Health Care of NY Medicare |
$225.72
|
| Rate for Payer: United Healthcare Medicare |
$214.97
|
| Rate for Payer: WellCare Medicare |
$319.55
|
|
|
ANESTHESIA 225 MINS
|
Facility
OP
|
$613.00
|
|
| Hospital Charge Code |
4120020
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$208.42 |
| Max. Negotiated Rate |
$493.46 |
| Rate for Payer: Aetna of NY Commercial |
$429.10
|
| Rate for Payer: Aetna of NY Medicare |
$281.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$459.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$459.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$226.81
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$306.50
|
| Rate for Payer: Cash Price |
$459.75
|
| Rate for Payer: CDPHP Commercial |
$493.46
|
| Rate for Payer: CDPHP Medicare |
$226.81
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$490.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$490.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$490.40
|
| Rate for Payer: EmblemHealth Medicaid |
$490.40
|
| Rate for Payer: EmblemHealth Medicare |
$208.42
|
| Rate for Payer: EmblemHealth Select Care |
$441.36
|
| Rate for Payer: Fidelis Medicare |
$233.61
|
| Rate for Payer: Galaxy Health Commercial |
$398.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$226.81
|
| Rate for Payer: Humana Medicare |
$226.81
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$429.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$281.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$459.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$345.12
|
| Rate for Payer: MVP Health Care of NY Medicare |
$238.15
|
| Rate for Payer: United Healthcare Medicare |
$226.81
|
| Rate for Payer: WellCare Medicare |
$337.15
|
|
|
ANESTHESIA 240 MIN
|
Facility
OP
|
$645.00
|
|
| Hospital Charge Code |
4120017
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$219.30 |
| Max. Negotiated Rate |
$519.22 |
| Rate for Payer: Aetna of NY Commercial |
$451.50
|
| Rate for Payer: Aetna of NY Medicare |
$296.70
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$483.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$483.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$238.65
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$322.50
|
| Rate for Payer: Cash Price |
$483.75
|
| Rate for Payer: CDPHP Commercial |
$519.22
|
| Rate for Payer: CDPHP Medicare |
$238.65
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$516.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$516.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$516.00
|
| Rate for Payer: EmblemHealth Medicaid |
$516.00
|
| Rate for Payer: EmblemHealth Medicare |
$219.30
|
| Rate for Payer: EmblemHealth Select Care |
$464.40
|
| Rate for Payer: Fidelis Medicare |
$245.81
|
| Rate for Payer: Galaxy Health Commercial |
$419.25
|
| Rate for Payer: Hamaspik Choice Medicare |
$238.65
|
| Rate for Payer: Humana Medicare |
$238.65
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$451.50
|
| Rate for Payer: Local 1199SEIU Medicare |
$296.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$483.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$363.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$250.58
|
| Rate for Payer: United Healthcare Medicare |
$238.65
|
| Rate for Payer: WellCare Medicare |
$354.75
|
|
|
ANESTHESIA 255 MINS
|
Facility
OP
|
$684.00
|
|
| Hospital Charge Code |
4120021
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$232.56 |
| Max. Negotiated Rate |
$550.62 |
| Rate for Payer: Aetna of NY Commercial |
$478.80
|
| Rate for Payer: Aetna of NY Medicare |
$314.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$513.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$253.08
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$342.00
|
| Rate for Payer: Cash Price |
$513.00
|
| Rate for Payer: CDPHP Commercial |
$550.62
|
| Rate for Payer: CDPHP Medicare |
$253.08
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$547.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$547.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$547.20
|
| Rate for Payer: EmblemHealth Medicaid |
$547.20
|
| Rate for Payer: EmblemHealth Medicare |
$232.56
|
| Rate for Payer: EmblemHealth Select Care |
$492.48
|
| Rate for Payer: Fidelis Medicare |
$260.67
|
| Rate for Payer: Galaxy Health Commercial |
$444.60
|
| Rate for Payer: Hamaspik Choice Medicare |
$253.08
|
| Rate for Payer: Humana Medicare |
$253.08
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$478.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$314.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$513.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$385.09
|
| Rate for Payer: MVP Health Care of NY Medicare |
$265.73
|
| Rate for Payer: United Healthcare Medicare |
$253.08
|
| Rate for Payer: WellCare Medicare |
$376.20
|
|
|
ANESTHESIA 270 MIN
|
Facility
OP
|
$722.00
|
|
| Hospital Charge Code |
4120018
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$245.48 |
| Max. Negotiated Rate |
$581.21 |
| Rate for Payer: Aetna of NY Commercial |
$505.40
|
| Rate for Payer: Aetna of NY Medicare |
$332.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$541.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$541.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$267.14
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$361.00
|
| Rate for Payer: Cash Price |
$541.50
|
| Rate for Payer: CDPHP Commercial |
$581.21
|
| Rate for Payer: CDPHP Medicare |
$267.14
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$577.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$577.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$577.60
|
| Rate for Payer: EmblemHealth Medicaid |
$577.60
|
| Rate for Payer: EmblemHealth Medicare |
$245.48
|
| Rate for Payer: EmblemHealth Select Care |
$519.84
|
| Rate for Payer: Fidelis Medicare |
$275.15
|
| Rate for Payer: Galaxy Health Commercial |
$469.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$267.14
|
| Rate for Payer: Humana Medicare |
$267.14
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$505.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$332.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$541.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$406.49
|
| Rate for Payer: MVP Health Care of NY Medicare |
$280.50
|
| Rate for Payer: United Healthcare Medicare |
$267.14
|
| Rate for Payer: WellCare Medicare |
$397.10
|
|
|
ANESTHESIA 285 MINS
|
Facility
OP
|
$762.00
|
|
| Hospital Charge Code |
4120022
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$259.08 |
| Max. Negotiated Rate |
$613.41 |
| Rate for Payer: Aetna of NY Commercial |
$533.40
|
| Rate for Payer: Aetna of NY Medicare |
$350.52
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$571.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$571.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$281.94
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$381.00
|
| Rate for Payer: Cash Price |
$571.50
|
| Rate for Payer: CDPHP Commercial |
$613.41
|
| Rate for Payer: CDPHP Medicare |
$281.94
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$609.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$609.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$609.60
|
| Rate for Payer: EmblemHealth Medicaid |
$609.60
|
| Rate for Payer: EmblemHealth Medicare |
$259.08
|
| Rate for Payer: EmblemHealth Select Care |
$548.64
|
| Rate for Payer: Fidelis Medicare |
$290.40
|
| Rate for Payer: Galaxy Health Commercial |
$495.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$281.94
|
| Rate for Payer: Humana Medicare |
$281.94
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$533.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$350.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$571.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$429.01
|
| Rate for Payer: MVP Health Care of NY Medicare |
$296.04
|
| Rate for Payer: United Healthcare Medicare |
$281.94
|
| Rate for Payer: WellCare Medicare |
$419.10
|
|
|
ANESTHESIA 300 MIN
|
Facility
OP
|
$802.00
|
|
| Hospital Charge Code |
4120019
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$272.68 |
| Max. Negotiated Rate |
$645.61 |
| Rate for Payer: Aetna of NY Commercial |
$561.40
|
| Rate for Payer: Aetna of NY Medicare |
$368.92
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$601.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$601.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$296.74
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$401.00
|
| Rate for Payer: Cash Price |
$601.50
|
| Rate for Payer: CDPHP Commercial |
$645.61
|
| Rate for Payer: CDPHP Medicare |
$296.74
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$641.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$641.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$641.60
|
| Rate for Payer: EmblemHealth Medicaid |
$641.60
|
| Rate for Payer: EmblemHealth Medicare |
$272.68
|
| Rate for Payer: EmblemHealth Select Care |
$577.44
|
| Rate for Payer: Fidelis Medicare |
$305.64
|
| Rate for Payer: Galaxy Health Commercial |
$521.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$296.74
|
| Rate for Payer: Humana Medicare |
$296.74
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$561.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$368.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$601.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$451.53
|
| Rate for Payer: MVP Health Care of NY Medicare |
$311.58
|
| Rate for Payer: United Healthcare Medicare |
$296.74
|
| Rate for Payer: WellCare Medicare |
$441.10
|
|
|
ANESTHESIA 30 MINUTES
|
Facility
OP
|
$107.00
|
|
| Hospital Charge Code |
4120003
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$36.38 |
| Max. Negotiated Rate |
$86.14 |
| Rate for Payer: Aetna of NY Commercial |
$74.90
|
| Rate for Payer: Aetna of NY Medicare |
$49.22
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$80.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$80.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$39.59
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$53.50
|
| Rate for Payer: Cash Price |
$80.25
|
| Rate for Payer: CDPHP Commercial |
$86.14
|
| Rate for Payer: CDPHP Medicare |
$39.59
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$85.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$85.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$85.60
|
| Rate for Payer: EmblemHealth Medicaid |
$85.60
|
| Rate for Payer: EmblemHealth Medicare |
$36.38
|
| Rate for Payer: EmblemHealth Select Care |
$77.04
|
| Rate for Payer: Fidelis Medicare |
$40.78
|
| Rate for Payer: Galaxy Health Commercial |
$69.55
|
| Rate for Payer: Hamaspik Choice Medicare |
$39.59
|
| Rate for Payer: Humana Medicare |
$39.59
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$74.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$49.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$80.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$60.24
|
| Rate for Payer: MVP Health Care of NY Medicare |
$41.57
|
| Rate for Payer: United Healthcare Medicare |
$39.59
|
| Rate for Payer: WellCare Medicare |
$58.85
|
|
|
ANESTHESIA 45 MINS
|
Facility
OP
|
$161.00
|
|
| Hospital Charge Code |
4120010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$54.74 |
| Max. Negotiated Rate |
$129.60 |
| Rate for Payer: Aetna of NY Commercial |
$112.70
|
| Rate for Payer: Aetna of NY Medicare |
$74.06
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$120.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$120.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$59.57
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$80.50
|
| Rate for Payer: Cash Price |
$120.75
|
| Rate for Payer: CDPHP Commercial |
$129.60
|
| Rate for Payer: CDPHP Medicare |
$59.57
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$128.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$128.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$128.80
|
| Rate for Payer: EmblemHealth Medicaid |
$128.80
|
| Rate for Payer: EmblemHealth Medicare |
$54.74
|
| Rate for Payer: EmblemHealth Select Care |
$115.92
|
| Rate for Payer: Fidelis Medicare |
$61.36
|
| Rate for Payer: Galaxy Health Commercial |
$104.65
|
| Rate for Payer: Hamaspik Choice Medicare |
$59.57
|
| Rate for Payer: Humana Medicare |
$59.57
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$112.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$74.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$120.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$90.64
|
| Rate for Payer: MVP Health Care of NY Medicare |
$62.55
|
| Rate for Payer: United Healthcare Medicare |
$59.57
|
| Rate for Payer: WellCare Medicare |
$88.55
|
|
|
ANESTHESIA 60 MINUTES
|
Facility
OP
|
$217.00
|
|
| Hospital Charge Code |
4120004
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$73.78 |
| Max. Negotiated Rate |
$174.68 |
| Rate for Payer: Aetna of NY Commercial |
$151.90
|
| Rate for Payer: Aetna of NY Medicare |
$99.82
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$162.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$162.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$80.29
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$108.50
|
| Rate for Payer: Cash Price |
$162.75
|
| Rate for Payer: CDPHP Commercial |
$174.68
|
| Rate for Payer: CDPHP Medicare |
$80.29
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$173.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$173.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$173.60
|
| Rate for Payer: EmblemHealth Medicaid |
$173.60
|
| Rate for Payer: EmblemHealth Medicare |
$73.78
|
| Rate for Payer: EmblemHealth Select Care |
$156.24
|
| Rate for Payer: Fidelis Medicare |
$82.70
|
| Rate for Payer: Galaxy Health Commercial |
$141.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$80.29
|
| Rate for Payer: Humana Medicare |
$80.29
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$151.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$99.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$162.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$122.17
|
| Rate for Payer: MVP Health Care of NY Medicare |
$84.30
|
| Rate for Payer: United Healthcare Medicare |
$80.29
|
| Rate for Payer: WellCare Medicare |
$119.35
|
|
|
ANESTHESIA 75 MINS
|
Facility
OP
|
$269.00
|
|
| Hospital Charge Code |
4120011
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$91.46 |
| Max. Negotiated Rate |
$216.54 |
| Rate for Payer: Aetna of NY Commercial |
$188.30
|
| Rate for Payer: Aetna of NY Medicare |
$123.74
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$201.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$201.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$99.53
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$134.50
|
| Rate for Payer: Cash Price |
$201.75
|
| Rate for Payer: CDPHP Commercial |
$216.54
|
| Rate for Payer: CDPHP Medicare |
$99.53
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$215.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$215.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$215.20
|
| Rate for Payer: EmblemHealth Medicaid |
$215.20
|
| Rate for Payer: EmblemHealth Medicare |
$91.46
|
| Rate for Payer: EmblemHealth Select Care |
$193.68
|
| Rate for Payer: Fidelis Medicare |
$102.52
|
| Rate for Payer: Galaxy Health Commercial |
$174.85
|
| Rate for Payer: Hamaspik Choice Medicare |
$99.53
|
| Rate for Payer: Humana Medicare |
$99.53
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$188.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$123.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$201.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$151.45
|
| Rate for Payer: MVP Health Care of NY Medicare |
$104.51
|
| Rate for Payer: United Healthcare Medicare |
$99.53
|
| Rate for Payer: WellCare Medicare |
$147.95
|
|
|
ANESTHESIA 90 MIN
|
Facility
OP
|
$322.00
|
|
| Hospital Charge Code |
4120005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$109.48 |
| Max. Negotiated Rate |
$259.21 |
| Rate for Payer: Aetna of NY Commercial |
$225.40
|
| Rate for Payer: Aetna of NY Medicare |
$148.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$241.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$241.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$119.14
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$161.00
|
| Rate for Payer: Cash Price |
$241.50
|
| Rate for Payer: CDPHP Commercial |
$259.21
|
| Rate for Payer: CDPHP Medicare |
$119.14
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$257.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$257.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$257.60
|
| Rate for Payer: EmblemHealth Medicaid |
$257.60
|
| Rate for Payer: EmblemHealth Medicare |
$109.48
|
| Rate for Payer: EmblemHealth Select Care |
$231.84
|
| Rate for Payer: Fidelis Medicare |
$122.71
|
| Rate for Payer: Galaxy Health Commercial |
$209.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$119.14
|
| Rate for Payer: Humana Medicare |
$119.14
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$225.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$148.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$241.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$181.29
|
| Rate for Payer: MVP Health Care of NY Medicare |
$125.10
|
| Rate for Payer: United Healthcare Medicare |
$119.14
|
| Rate for Payer: WellCare Medicare |
$177.10
|
|
|
ANGLED TOMCAT 4.5MM 3805451
|
Facility
OP
|
$205.00
|
|
| Hospital Charge Code |
4479299
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$69.70 |
| Max. Negotiated Rate |
$165.02 |
| Rate for Payer: Aetna of NY Commercial |
$143.50
|
| Rate for Payer: Aetna of NY Medicare |
$94.30
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$153.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$153.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$75.85
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$102.50
|
| Rate for Payer: Cash Price |
$153.75
|
| Rate for Payer: CDPHP Commercial |
$165.02
|
| Rate for Payer: CDPHP Medicare |
$75.85
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$164.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$164.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$164.00
|
| Rate for Payer: EmblemHealth Medicaid |
$164.00
|
| Rate for Payer: EmblemHealth Medicare |
$69.70
|
| Rate for Payer: EmblemHealth Select Care |
$147.60
|
| Rate for Payer: Fidelis Medicare |
$78.13
|
| Rate for Payer: Galaxy Health Commercial |
$133.25
|
| Rate for Payer: Hamaspik Choice Medicare |
$75.85
|
| Rate for Payer: Humana Medicare |
$75.85
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$143.50
|
| Rate for Payer: Local 1199SEIU Medicare |
$94.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$153.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$115.42
|
| Rate for Payer: MVP Health Care of NY Medicare |
$79.64
|
| Rate for Payer: United Healthcare Medicare |
$75.85
|
| Rate for Payer: WellCare Medicare |
$112.75
|
|
|
ANORO ELLIPTA 62.5-25 MCG INH 14 ea, 14 eaches
|
Facility
OP
|
$363.00
|
|
| Hospital Charge Code |
4401425
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$123.42 |
| Max. Negotiated Rate |
$292.22 |
| Rate for Payer: Aetna of NY Commercial |
$254.10
|
| Rate for Payer: Aetna of NY Medicare |
$166.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$272.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$272.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$134.31
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$181.50
|
| Rate for Payer: Cash Price |
$272.25
|
| Rate for Payer: CDPHP Commercial |
$292.22
|
| Rate for Payer: CDPHP Medicare |
$134.31
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$290.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$290.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$290.40
|
| Rate for Payer: EmblemHealth Medicaid |
$290.40
|
| Rate for Payer: EmblemHealth Medicare |
$123.42
|
| Rate for Payer: EmblemHealth Select Care |
$261.36
|
| Rate for Payer: Fidelis Medicare |
$138.34
|
| Rate for Payer: Galaxy Health Commercial |
$235.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$134.31
|
| Rate for Payer: Humana Medicare |
$134.31
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$254.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$166.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$272.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$204.37
|
| Rate for Payer: MVP Health Care of NY Medicare |
$141.03
|
| Rate for Payer: United Healthcare Medicare |
$134.31
|
| Rate for Payer: WellCare Medicare |
$199.65
|
|
|
ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO
|
Facility
OP
|
$14,232.00
|
|
|
Service Code
|
HCPCS 57240
|
| Hospital Charge Code |
4002041
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$1,307.00 |
| Max. Negotiated Rate |
$11,456.76 |
| Rate for Payer: Aetna of NY Commercial |
$1,857.00
|
| Rate for Payer: Aetna of NY Medicare |
$6,546.72
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$2,320.09
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$2,899.59
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$5,265.84
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$1,307.00
|
| Rate for Payer: Cash Price |
$10,674.00
|
| Rate for Payer: Cash Price |
$10,674.00
|
| Rate for Payer: Cash Price |
$10,674.00
|
| Rate for Payer: CDPHP Commercial |
$11,456.76
|
| Rate for Payer: CDPHP Medicare |
$5,265.84
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$11,385.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$11,385.60
|
| Rate for Payer: EmblemHealth Medicaid |
$11,385.60
|
| Rate for Payer: EmblemHealth Medicare |
$4,838.88
|
| Rate for Payer: Fidelis Medicare |
$5,423.82
|
| Rate for Payer: Galaxy Health Commercial |
$9,250.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$5,265.84
|
| Rate for Payer: Humana Medicare |
$5,265.84
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,857.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$6,546.72
|
| Rate for Payer: Multiplan Commercial |
$11,385.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$10,674.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$8,012.62
|
| Rate for Payer: MVP Health Care of NY Medicare |
$5,529.13
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$1,775.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$4,739.10
|
| Rate for Payer: United Healthcare Commercial |
$2,036.00
|
| Rate for Payer: United Healthcare Medicare |
$5,265.84
|
| Rate for Payer: WellCare Medicare |
$7,827.60
|
|
|
ANTIBIOTIC SENSITIVITY
|
Facility
OP
|
$34.00
|
|
|
Service Code
|
HCPCS 87186
|
| Hospital Charge Code |
4304866
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$27.37 |
| Rate for Payer: Aetna of NY Commercial |
$22.10
|
| Rate for Payer: Aetna of NY Medicare |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$12.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$17.00
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: CDPHP Commercial |
$27.37
|
| Rate for Payer: CDPHP Medicare |
$12.58
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.20
|
| Rate for Payer: EmblemHealth Medicaid |
$27.20
|
| Rate for Payer: EmblemHealth Medicare |
$11.56
|
| Rate for Payer: Fidelis Medicare |
$12.96
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$19.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.21
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$25.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$6.66
|
| Rate for Payer: United Healthcare Commercial |
$25.50
|
| Rate for Payer: United Healthcare Medicare |
$12.58
|
| Rate for Payer: WellCare Medicare |
$18.70
|
|
|
ANTIBIOTIC SENSITIVITY
|
Facility
OP
|
$34.00
|
|
|
Service Code
|
HCPCS 87186
|
| Hospital Charge Code |
4301136
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$27.37 |
| Rate for Payer: Aetna of NY Commercial |
$22.10
|
| Rate for Payer: Aetna of NY Medicare |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$12.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$17.00
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: CDPHP Commercial |
$27.37
|
| Rate for Payer: CDPHP Medicare |
$12.58
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.20
|
| Rate for Payer: EmblemHealth Medicaid |
$27.20
|
| Rate for Payer: EmblemHealth Medicare |
$11.56
|
| Rate for Payer: Fidelis Medicare |
$12.96
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$19.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.21
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$25.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$6.66
|
| Rate for Payer: United Healthcare Commercial |
$25.50
|
| Rate for Payer: United Healthcare Medicare |
$12.58
|
| Rate for Payer: WellCare Medicare |
$18.70
|
|
|
ANTIBIOTIC SENSITIVITY
|
Facility
OP
|
$34.00
|
|
|
Service Code
|
HCPCS 87186
|
| Hospital Charge Code |
4301087
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$27.37 |
| Rate for Payer: Aetna of NY Commercial |
$22.10
|
| Rate for Payer: Aetna of NY Medicare |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$12.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$17.00
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: CDPHP Commercial |
$27.37
|
| Rate for Payer: CDPHP Medicare |
$12.58
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.20
|
| Rate for Payer: EmblemHealth Medicaid |
$27.20
|
| Rate for Payer: EmblemHealth Medicare |
$11.56
|
| Rate for Payer: Fidelis Medicare |
$12.96
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$19.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.21
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$25.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$6.66
|
| Rate for Payer: United Healthcare Commercial |
$25.50
|
| Rate for Payer: United Healthcare Medicare |
$12.58
|
| Rate for Payer: WellCare Medicare |
$18.70
|
|
|
ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA
|
Facility
OP
|
$57.00
|
|
|
Service Code
|
HCPCS 86665
|
| Hospital Charge Code |
4302023
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.14 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna of NY Commercial |
$37.05
|
| Rate for Payer: Aetna of NY Medicare |
$26.22
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$42.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$42.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$21.09
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$28.50
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: CDPHP Commercial |
$45.88
|
| Rate for Payer: CDPHP Medicare |
$21.09
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$45.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$45.60
|
| Rate for Payer: EmblemHealth Medicaid |
$45.60
|
| Rate for Payer: EmblemHealth Medicare |
$19.38
|
| Rate for Payer: Fidelis Medicare |
$21.72
|
| Rate for Payer: Galaxy Health Commercial |
$37.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$21.09
|
| Rate for Payer: Humana Medicare |
$21.09
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$37.05
|
| Rate for Payer: Local 1199SEIU Medicare |
$26.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$42.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$32.09
|
| Rate for Payer: MVP Health Care of NY Medicare |
$22.14
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$42.75
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$18.14
|
| Rate for Payer: United Healthcare Commercial |
$42.75
|
| Rate for Payer: United Healthcare Medicare |
$21.09
|
| Rate for Payer: WellCare Medicare |
$31.35
|
|
|
ANTIBODY PROTOZOA NES
|
Facility
OP
|
$47.00
|
|
|
Service Code
|
HCPCS 86753
|
| Hospital Charge Code |
4302018
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$37.84 |
| Rate for Payer: Aetna of NY Commercial |
$30.55
|
| Rate for Payer: Aetna of NY Medicare |
$21.62
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$35.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$35.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$17.39
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$23.50
|
| Rate for Payer: Cash Price |
$35.25
|
| Rate for Payer: CDPHP Commercial |
$37.84
|
| Rate for Payer: CDPHP Medicare |
$17.39
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$37.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$37.60
|
| Rate for Payer: EmblemHealth Medicaid |
$37.60
|
| Rate for Payer: EmblemHealth Medicare |
$15.98
|
| Rate for Payer: Fidelis Medicare |
$17.91
|
| Rate for Payer: Galaxy Health Commercial |
$30.55
|
| Rate for Payer: Hamaspik Choice Medicare |
$17.39
|
| Rate for Payer: Humana Medicare |
$17.39
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$30.55
|
| Rate for Payer: Local 1199SEIU Medicare |
$21.62
|
| Rate for Payer: MVP Health Care of NY Commercial |
$35.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$26.46
|
| Rate for Payer: MVP Health Care of NY Medicare |
$18.26
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$35.25
|
| Rate for Payer: United Healthcare Commercial |
$35.25
|
| Rate for Payer: United Healthcare Medicare |
$17.39
|
| Rate for Payer: WellCare Medicare |
$25.85
|
|
|
ANTIBODY; RICKETTSIA
|
Facility
OP
|
$68.00
|
|
|
Service Code
|
HCPCS 86757
|
| Hospital Charge Code |
4302009
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.35 |
| Max. Negotiated Rate |
$54.74 |
| Rate for Payer: Aetna of NY Commercial |
$44.20
|
| Rate for Payer: Aetna of NY Medicare |
$31.28
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$51.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$25.16
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$34.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: Cash Price |
$51.00
|
| Rate for Payer: CDPHP Commercial |
$54.74
|
| Rate for Payer: CDPHP Medicare |
$25.16
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$54.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$54.40
|
| Rate for Payer: EmblemHealth Medicaid |
$54.40
|
| Rate for Payer: EmblemHealth Medicare |
$23.12
|
| Rate for Payer: Fidelis Medicare |
$25.91
|
| Rate for Payer: Galaxy Health Commercial |
$44.20
|
| Rate for Payer: Hamaspik Choice Medicare |
$25.16
|
| Rate for Payer: Humana Medicare |
$25.16
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$44.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$31.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$51.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$38.28
|
| Rate for Payer: MVP Health Care of NY Medicare |
$26.42
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$51.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$19.35
|
| Rate for Payer: United Healthcare Commercial |
$51.00
|
| Rate for Payer: United Healthcare Medicare |
$25.16
|
| Rate for Payer: WellCare Medicare |
$37.40
|
|
|
ANTIBODY SCREEN
|
Facility
OP
|
$155.00
|
|
|
Service Code
|
HCPCS 86850
|
| Hospital Charge Code |
4300064
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$124.78 |
| Rate for Payer: Aetna of NY Commercial |
$100.75
|
| Rate for Payer: Aetna of NY Medicare |
$71.30
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$116.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$116.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$57.35
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$77.50
|
| Rate for Payer: Cash Price |
$116.25
|
| Rate for Payer: Cash Price |
$116.25
|
| Rate for Payer: CDPHP Commercial |
$124.78
|
| Rate for Payer: CDPHP Medicare |
$57.35
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$124.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$124.00
|
| Rate for Payer: EmblemHealth Medicaid |
$124.00
|
| Rate for Payer: EmblemHealth Medicare |
$52.70
|
| Rate for Payer: Fidelis Medicare |
$59.07
|
| Rate for Payer: Galaxy Health Commercial |
$100.75
|
| Rate for Payer: Hamaspik Choice Medicare |
$57.35
|
| Rate for Payer: Humana Medicare |
$57.35
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$100.75
|
| Rate for Payer: Local 1199SEIU Medicare |
$71.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$116.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$87.26
|
| Rate for Payer: MVP Health Care of NY Medicare |
$60.22
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$116.25
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$5.61
|
| Rate for Payer: United Healthcare Commercial |
$116.25
|
| Rate for Payer: United Healthcare Medicare |
$57.35
|
| Rate for Payer: WellCare Medicare |
$85.25
|
|
