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Service Code NDC 00904682461
Hospital Charge Code 4409117
Hospital Revenue Code 250
Min. Negotiated Rate $2.33
Max. Negotiated Rate $5.51
Rate for Payer: Aetna of NY Commercial $4.80
Rate for Payer: Aetna of NY Medicare $3.15
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $5.14
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $5.14
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $2.53
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $3.42
Rate for Payer: Cash Price $5.14
Rate for Payer: CDPHP Commercial $5.51
Rate for Payer: CDPHP Medicare $2.53
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $5.48
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $5.48
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $5.48
Rate for Payer: EmblemHealth Medicaid $5.48
Rate for Payer: EmblemHealth Medicare $2.33
Rate for Payer: EmblemHealth Select Care $4.93
Rate for Payer: Fidelis Medicare $2.61
Rate for Payer: Galaxy Health Commercial $4.45
Rate for Payer: Hamaspik Choice Medicare $2.53
Rate for Payer: Humana Medicare $2.53
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $4.80
Rate for Payer: Local 1199SEIU Medicare $3.15
Rate for Payer: MVP Health Care of NY Commercial $5.14
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $3.86
Rate for Payer: MVP Health Care of NY Medicare $2.66
Rate for Payer: United Healthcare Medicare $2.53
Rate for Payer: WellCare Medicare $3.77
Hospital Charge Code 4471503
Hospital Revenue Code 270
Min. Negotiated Rate $14.30
Max. Negotiated Rate $14.30
Rate for Payer: Cash Price $16.50
Rate for Payer: Galaxy Health Commercial $14.30
Hospital Charge Code 4471503
Hospital Revenue Code 270
Min. Negotiated Rate $7.48
Max. Negotiated Rate $17.71
Rate for Payer: Aetna of NY Commercial $15.40
Rate for Payer: Aetna of NY Medicare $10.12
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $16.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $16.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $8.14
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $11.00
Rate for Payer: Cash Price $16.50
Rate for Payer: CDPHP Commercial $17.71
Rate for Payer: CDPHP Medicare $8.14
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $17.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $17.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $17.60
Rate for Payer: EmblemHealth Medicaid $17.60
Rate for Payer: EmblemHealth Medicare $7.48
Rate for Payer: EmblemHealth Select Care $15.84
Rate for Payer: Fidelis Medicare $8.38
Rate for Payer: Galaxy Health Commercial $14.30
Rate for Payer: Hamaspik Choice Medicare $8.14
Rate for Payer: Humana Medicare $8.14
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $15.40
Rate for Payer: Local 1199SEIU Medicare $10.12
Rate for Payer: MVP Health Care of NY Commercial $16.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $12.39
Rate for Payer: MVP Health Care of NY Medicare $8.55
Rate for Payer: United Healthcare Medicare $8.14
Rate for Payer: WellCare Medicare $12.10
Service Code NDC 00115169701
Hospital Charge Code 4400364
Hospital Revenue Code 250
Min. Negotiated Rate $2.38
Max. Negotiated Rate $5.64
Rate for Payer: Aetna of NY Commercial $4.90
Rate for Payer: Aetna of NY Medicare $3.22
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $5.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $5.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $2.59
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $3.50
Rate for Payer: Cash Price $5.25
Rate for Payer: CDPHP Commercial $5.64
Rate for Payer: CDPHP Medicare $2.59
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $5.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $5.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $5.60
Rate for Payer: EmblemHealth Medicaid $5.60
Rate for Payer: EmblemHealth Medicare $2.38
Rate for Payer: EmblemHealth Select Care $5.04
Rate for Payer: Fidelis Medicare $2.67
Rate for Payer: Galaxy Health Commercial $4.55
Rate for Payer: Hamaspik Choice Medicare $2.59
Rate for Payer: Humana Medicare $2.59
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $4.90
Rate for Payer: Local 1199SEIU Medicare $3.22
Rate for Payer: MVP Health Care of NY Commercial $5.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $3.94
Rate for Payer: MVP Health Care of NY Medicare $2.72
Rate for Payer: United Healthcare Medicare $2.59
Rate for Payer: WellCare Medicare $3.85
Service Code NDC 00115169701
Hospital Charge Code 4400364
Hospital Revenue Code 250
Min. Negotiated Rate $3.85
Max. Negotiated Rate $4.55
Rate for Payer: Cash Price $5.25
Rate for Payer: Galaxy Health Commercial $4.55
Rate for Payer: WellCare Medicare $3.85
Service Code NDC 51672300302
Hospital Charge Code 4400363
Hospital Revenue Code 250
Min. Negotiated Rate $17.42
Max. Negotiated Rate $20.59
Rate for Payer: Cash Price $23.75
Rate for Payer: Galaxy Health Commercial $20.59
Rate for Payer: WellCare Medicare $17.42
Service Code NDC 51672300302
Hospital Charge Code 4400363
Hospital Revenue Code 250
Min. Negotiated Rate $10.77
Max. Negotiated Rate $25.49
Rate for Payer: Aetna of NY Commercial $22.17
Rate for Payer: Aetna of NY Medicare $14.57
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $23.75
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $23.75
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $11.72
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $15.84
Rate for Payer: Cash Price $23.75
Rate for Payer: CDPHP Commercial $25.49
Rate for Payer: CDPHP Medicare $11.72
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $25.34
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $25.34
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $25.34
Rate for Payer: EmblemHealth Medicaid $25.34
Rate for Payer: EmblemHealth Medicare $10.77
Rate for Payer: EmblemHealth Select Care $22.80
Rate for Payer: Fidelis Medicare $12.07
Rate for Payer: Galaxy Health Commercial $20.59
Rate for Payer: Hamaspik Choice Medicare $11.72
Rate for Payer: Humana Medicare $11.72
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $22.17
Rate for Payer: Local 1199SEIU Medicare $14.57
Rate for Payer: MVP Health Care of NY Commercial $23.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $17.83
Rate for Payer: MVP Health Care of NY Medicare $12.30
Rate for Payer: United Healthcare Medicare $11.72
Rate for Payer: WellCare Medicare $17.42
Service Code NDC 00713050312
Hospital Charge Code 4400063
Hospital Revenue Code 250
Min. Negotiated Rate $23.81
Max. Negotiated Rate $56.38
Rate for Payer: Aetna of NY Commercial $49.03
Rate for Payer: Aetna of NY Medicare $32.22
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $52.53
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $52.53
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $25.91
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $35.02
Rate for Payer: Cash Price $52.53
Rate for Payer: CDPHP Commercial $56.38
Rate for Payer: CDPHP Medicare $25.91
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $56.03
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $56.03
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $56.03
Rate for Payer: EmblemHealth Medicaid $56.03
Rate for Payer: EmblemHealth Medicare $23.81
Rate for Payer: EmblemHealth Select Care $50.43
Rate for Payer: Fidelis Medicare $26.69
Rate for Payer: Galaxy Health Commercial $45.53
Rate for Payer: Hamaspik Choice Medicare $25.91
Rate for Payer: Humana Medicare $25.91
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $49.03
Rate for Payer: Local 1199SEIU Medicare $32.22
Rate for Payer: MVP Health Care of NY Commercial $52.53
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $39.43
Rate for Payer: MVP Health Care of NY Medicare $27.21
Rate for Payer: United Healthcare Medicare $25.91
Rate for Payer: WellCare Medicare $38.52
Service Code NDC 00713050312
Hospital Charge Code 4400063
Hospital Revenue Code 250
Min. Negotiated Rate $38.52
Max. Negotiated Rate $45.53
Rate for Payer: Cash Price $52.53
Rate for Payer: Galaxy Health Commercial $45.53
Rate for Payer: WellCare Medicare $38.52
Service Code HCPCS J1720
Hospital Charge Code 4400712
Hospital Revenue Code 636
Min. Negotiated Rate $11.82
Max. Negotiated Rate $28.89
Rate for Payer: Aetna of NY Commercial $19.12
Rate for Payer: Aetna of NY Medicare $15.99
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $18.46
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $18.46
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $12.86
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $17.38
Rate for Payer: Cash Price $26.07
Rate for Payer: Cash Price $26.07
Rate for Payer: CDPHP Commercial $27.98
Rate for Payer: CDPHP Medicare $12.86
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $18.46
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $27.81
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $27.81
Rate for Payer: EmblemHealth Medicaid $27.81
Rate for Payer: EmblemHealth Medicare $11.82
Rate for Payer: EmblemHealth Select Care $18.46
Rate for Payer: Fidelis Medicare $13.25
Rate for Payer: Galaxy Health Commercial $22.59
Rate for Payer: Hamaspik Choice Medicare $12.86
Rate for Payer: Humana Medicare $12.86
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $19.12
Rate for Payer: Local 1199SEIU Medicare $15.99
Rate for Payer: MVP Health Care of NY Commercial $26.07
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $19.57
Rate for Payer: MVP Health Care of NY Medicare $13.50
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $28.89
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $18.46
Rate for Payer: United Healthcare Commercial $28.89
Rate for Payer: United Healthcare Medicare $12.86
Rate for Payer: WellCare Medicare $19.12
Service Code HCPCS J1720
Hospital Charge Code 4400712
Hospital Revenue Code 636
Min. Negotiated Rate $18.46
Max. Negotiated Rate $22.59
Rate for Payer: Aetna of NY Commercial $19.12
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $18.46
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $18.46
Rate for Payer: Cash Price $26.07
Rate for Payer: Cash Price $26.07
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $18.46
Rate for Payer: EmblemHealth Select Care $18.46
Rate for Payer: Galaxy Health Commercial $22.59
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $19.12
Rate for Payer: WellCare Medicare $19.12
Service Code HCPCS J1170
Hospital Charge Code 4401577
Hospital Revenue Code 636
Min. Negotiated Rate $4.76
Max. Negotiated Rate $91.77
Rate for Payer: Aetna of NY Commercial $62.70
Rate for Payer: Aetna of NY Medicare $52.44
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $42.18
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $57.00
Rate for Payer: Cash Price $85.50
Rate for Payer: Cash Price $85.50
Rate for Payer: CDPHP Commercial $91.77
Rate for Payer: CDPHP Medicare $42.18
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.76
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $91.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $91.20
Rate for Payer: EmblemHealth Medicaid $91.20
Rate for Payer: EmblemHealth Medicare $38.76
Rate for Payer: EmblemHealth Select Care $4.76
Rate for Payer: Fidelis Medicare $43.45
Rate for Payer: Galaxy Health Commercial $74.10
Rate for Payer: Hamaspik Choice Medicare $42.18
Rate for Payer: Humana Medicare $42.18
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $62.70
Rate for Payer: Local 1199SEIU Medicare $52.44
Rate for Payer: MVP Health Care of NY Commercial $85.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $64.18
Rate for Payer: MVP Health Care of NY Medicare $44.29
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $7.18
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $4.76
Rate for Payer: United Healthcare Commercial $7.18
Rate for Payer: United Healthcare Medicare $42.18
Rate for Payer: WellCare Medicare $62.70
Service Code HCPCS J1170
Hospital Charge Code 4401577
Hospital Revenue Code 636
Min. Negotiated Rate $4.76
Max. Negotiated Rate $74.10
Rate for Payer: Aetna of NY Commercial $62.70
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.76
Rate for Payer: Cash Price $85.50
Rate for Payer: Cash Price $85.50
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.76
Rate for Payer: EmblemHealth Select Care $4.76
Rate for Payer: Galaxy Health Commercial $74.10
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $62.70
Rate for Payer: WellCare Medicare $62.70
Service Code HCPCS J1170
Hospital Charge Code 4401934
Hospital Revenue Code 636
Min. Negotiated Rate $3.23
Max. Negotiated Rate $7.65
Rate for Payer: Aetna of NY Commercial $5.22
Rate for Payer: Aetna of NY Medicare $4.37
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $3.52
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $4.75
Rate for Payer: Cash Price $7.13
Rate for Payer: Cash Price $7.13
Rate for Payer: CDPHP Commercial $7.65
Rate for Payer: CDPHP Medicare $3.52
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.76
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $7.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $7.60
Rate for Payer: EmblemHealth Medicaid $7.60
Rate for Payer: EmblemHealth Medicare $3.23
Rate for Payer: EmblemHealth Select Care $4.76
Rate for Payer: Fidelis Medicare $3.62
Rate for Payer: Galaxy Health Commercial $6.18
Rate for Payer: Hamaspik Choice Medicare $3.52
Rate for Payer: Humana Medicare $3.52
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $5.22
Rate for Payer: Local 1199SEIU Medicare $4.37
Rate for Payer: MVP Health Care of NY Commercial $7.12
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $5.35
Rate for Payer: MVP Health Care of NY Medicare $3.69
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $7.18
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $4.76
Rate for Payer: United Healthcare Commercial $7.18
Rate for Payer: United Healthcare Medicare $3.52
Rate for Payer: WellCare Medicare $5.22
Service Code HCPCS J1170
Hospital Charge Code 4401934
Hospital Revenue Code 636
Min. Negotiated Rate $4.76
Max. Negotiated Rate $6.18
Rate for Payer: Aetna of NY Commercial $5.22
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.76
Rate for Payer: Cash Price $7.13
Rate for Payer: Cash Price $7.13
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.76
Rate for Payer: EmblemHealth Select Care $4.76
Rate for Payer: Galaxy Health Commercial $6.18
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $5.22
Rate for Payer: WellCare Medicare $5.22
Service Code NDC 42858030125
Hospital Charge Code 4400367
Hospital Revenue Code 250
Min. Negotiated Rate $3.40
Max. Negotiated Rate $4.02
Rate for Payer: Cash Price $4.64
Rate for Payer: Galaxy Health Commercial $4.02
Rate for Payer: WellCare Medicare $3.40
Service Code NDC 42858030125
Hospital Charge Code 4400367
Hospital Revenue Code 250
Min. Negotiated Rate $2.10
Max. Negotiated Rate $4.97
Rate for Payer: Aetna of NY Commercial $4.33
Rate for Payer: Aetna of NY Medicare $2.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.64
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.64
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $2.29
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $3.09
Rate for Payer: Cash Price $4.64
Rate for Payer: CDPHP Commercial $4.97
Rate for Payer: CDPHP Medicare $2.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.94
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $4.94
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $4.94
Rate for Payer: EmblemHealth Medicaid $4.94
Rate for Payer: EmblemHealth Medicare $2.10
Rate for Payer: EmblemHealth Select Care $4.45
Rate for Payer: Fidelis Medicare $2.36
Rate for Payer: Galaxy Health Commercial $4.02
Rate for Payer: Hamaspik Choice Medicare $2.29
Rate for Payer: Humana Medicare $2.29
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $4.33
Rate for Payer: Local 1199SEIU Medicare $2.84
Rate for Payer: MVP Health Care of NY Commercial $4.64
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $3.48
Rate for Payer: MVP Health Care of NY Medicare $2.40
Rate for Payer: United Healthcare Medicare $2.29
Rate for Payer: WellCare Medicare $3.40
Service Code HCPCS J1170
Hospital Charge Code 4400368
Hospital Revenue Code 636
Min. Negotiated Rate $2.10
Max. Negotiated Rate $7.18
Rate for Payer: Aetna of NY Commercial $3.40
Rate for Payer: Aetna of NY Medicare $2.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $2.29
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $3.09
Rate for Payer: Cash Price $4.64
Rate for Payer: Cash Price $4.64
Rate for Payer: CDPHP Commercial $4.97
Rate for Payer: CDPHP Medicare $2.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.76
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $4.94
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $4.94
Rate for Payer: EmblemHealth Medicaid $4.94
Rate for Payer: EmblemHealth Medicare $2.10
Rate for Payer: EmblemHealth Select Care $4.76
Rate for Payer: Fidelis Medicare $2.36
Rate for Payer: Galaxy Health Commercial $4.02
Rate for Payer: Hamaspik Choice Medicare $2.29
Rate for Payer: Humana Medicare $2.29
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $3.40
Rate for Payer: Local 1199SEIU Medicare $2.84
Rate for Payer: MVP Health Care of NY Commercial $4.64
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $3.48
Rate for Payer: MVP Health Care of NY Medicare $2.40
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $7.18
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $4.76
Rate for Payer: United Healthcare Commercial $7.18
Rate for Payer: United Healthcare Medicare $2.29
Rate for Payer: WellCare Medicare $3.40
Service Code HCPCS J1170
Hospital Charge Code 4400368
Hospital Revenue Code 636
Min. Negotiated Rate $3.40
Max. Negotiated Rate $4.76
Rate for Payer: Aetna of NY Commercial $3.40
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.76
Rate for Payer: Cash Price $4.64
Rate for Payer: Cash Price $4.64
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.76
Rate for Payer: EmblemHealth Select Care $4.76
Rate for Payer: Galaxy Health Commercial $4.02
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $3.40
Rate for Payer: WellCare Medicare $3.40
Service Code NDC 43598072101
Hospital Charge Code 4409026
Hospital Revenue Code 250
Min. Negotiated Rate $5.10
Max. Negotiated Rate $12.08
Rate for Payer: Aetna of NY Commercial $10.50
Rate for Payer: Aetna of NY Medicare $6.90
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $11.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $11.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $5.55
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $7.50
Rate for Payer: Cash Price $11.25
Rate for Payer: CDPHP Commercial $12.08
Rate for Payer: CDPHP Medicare $5.55
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $12.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $12.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $12.00
Rate for Payer: EmblemHealth Medicaid $12.00
Rate for Payer: EmblemHealth Medicare $5.10
Rate for Payer: EmblemHealth Select Care $10.80
Rate for Payer: Fidelis Medicare $5.72
Rate for Payer: Galaxy Health Commercial $9.75
Rate for Payer: Hamaspik Choice Medicare $5.55
Rate for Payer: Humana Medicare $5.55
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $10.50
Rate for Payer: Local 1199SEIU Medicare $6.90
Rate for Payer: MVP Health Care of NY Commercial $11.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $8.44
Rate for Payer: MVP Health Care of NY Medicare $5.83
Rate for Payer: United Healthcare Medicare $5.55
Rate for Payer: WellCare Medicare $8.25
Service Code NDC 43598072101
Hospital Charge Code 4409026
Hospital Revenue Code 250
Min. Negotiated Rate $8.25
Max. Negotiated Rate $9.75
Rate for Payer: Cash Price $11.25
Rate for Payer: Galaxy Health Commercial $9.75
Rate for Payer: WellCare Medicare $8.25
Service Code NDC 49884072401
Hospital Charge Code 4409208
Hospital Revenue Code 250
Min. Negotiated Rate $2.10
Max. Negotiated Rate $4.97
Rate for Payer: Aetna of NY Commercial $4.33
Rate for Payer: Aetna of NY Medicare $2.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.64
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.64
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $2.29
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $3.09
Rate for Payer: Cash Price $4.64
Rate for Payer: CDPHP Commercial $4.97
Rate for Payer: CDPHP Medicare $2.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.94
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $4.94
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $4.94
Rate for Payer: EmblemHealth Medicaid $4.94
Rate for Payer: EmblemHealth Medicare $2.10
Rate for Payer: EmblemHealth Select Care $4.45
Rate for Payer: Fidelis Medicare $2.36
Rate for Payer: Galaxy Health Commercial $4.02
Rate for Payer: Hamaspik Choice Medicare $2.29
Rate for Payer: Humana Medicare $2.29
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $4.33
Rate for Payer: Local 1199SEIU Medicare $2.84
Rate for Payer: MVP Health Care of NY Commercial $4.64
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $3.48
Rate for Payer: MVP Health Care of NY Medicare $2.40
Rate for Payer: United Healthcare Medicare $2.29
Rate for Payer: WellCare Medicare $3.40
Service Code NDC 49884072401
Hospital Charge Code 4409208
Hospital Revenue Code 250
Min. Negotiated Rate $3.40
Max. Negotiated Rate $4.02
Rate for Payer: Cash Price $4.64
Rate for Payer: Galaxy Health Commercial $4.02
Rate for Payer: WellCare Medicare $3.40
Service Code HCPCS J3410
Hospital Charge Code 4400372
Hospital Revenue Code 636
Min. Negotiated Rate $5.60
Max. Negotiated Rate $22.47
Rate for Payer: Aetna of NY Commercial $9.06
Rate for Payer: Aetna of NY Medicare $7.58
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $13.87
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $13.87
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $6.10
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $8.24
Rate for Payer: Cash Price $12.36
Rate for Payer: Cash Price $12.36
Rate for Payer: CDPHP Commercial $13.27
Rate for Payer: CDPHP Medicare $6.10
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $13.87
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $13.18
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $13.18
Rate for Payer: EmblemHealth Medicaid $13.18
Rate for Payer: EmblemHealth Medicare $5.60
Rate for Payer: EmblemHealth Select Care $13.87
Rate for Payer: Fidelis Medicare $6.28
Rate for Payer: Galaxy Health Commercial $10.71
Rate for Payer: Hamaspik Choice Medicare $6.10
Rate for Payer: Humana Medicare $6.10
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $9.06
Rate for Payer: Local 1199SEIU Medicare $7.58
Rate for Payer: MVP Health Care of NY Commercial $12.36
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $9.28
Rate for Payer: MVP Health Care of NY Medicare $6.40
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $22.47
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $13.87
Rate for Payer: United Healthcare Commercial $22.47
Rate for Payer: United Healthcare Medicare $6.10
Rate for Payer: WellCare Medicare $9.06
Service Code HCPCS J3410
Hospital Charge Code 4400372
Hospital Revenue Code 636
Min. Negotiated Rate $9.06
Max. Negotiated Rate $13.87
Rate for Payer: Aetna of NY Commercial $9.06
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $13.87
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $13.87
Rate for Payer: Cash Price $12.36
Rate for Payer: Cash Price $12.36
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $13.87
Rate for Payer: EmblemHealth Select Care $13.87
Rate for Payer: Galaxy Health Commercial $10.71
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $9.06
Rate for Payer: WellCare Medicare $9.06