|
GLUCOSE BODY FLUID
|
Facility
|
IP
|
$15.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
4300382
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Galaxy Health Commercial |
$9.75
|
|
|
GLUCOSE CSF
|
Facility
|
IP
|
$12.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
4300383
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Galaxy Health Commercial |
$7.80
|
|
|
GLUCOSE CSF
|
Facility
|
OP
|
$12.00
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
4300383
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$9.60 |
| Rate for Payer: Aetna of NY Commercial |
$7.80
|
| Rate for Payer: Aetna of NY Medicare |
$5.52
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$4.80
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: CDPHP Medicare |
$4.44
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$7.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$9.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$9.60
|
| Rate for Payer: EmblemHealth Medicaid |
$9.60
|
| Rate for Payer: EmblemHealth Medicare |
$4.08
|
| Rate for Payer: EmblemHealth Select Care |
$7.20
|
| Rate for Payer: Fidelis Medicare |
$4.80
|
| Rate for Payer: Galaxy Health Commercial |
$7.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$4.80
|
| Rate for Payer: Humana Medicare |
$4.80
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$7.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$5.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$9.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$6.76
|
| Rate for Payer: MVP Health Care of NY Medicare |
$5.04
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$9.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1.80
|
| Rate for Payer: United Healthcare Commercial |
$9.00
|
| Rate for Payer: United Healthcare Medicare |
$4.80
|
| Rate for Payer: WellCare Medicare |
$6.60
|
|
|
GLUCOSE RANDOM
|
Facility
|
IP
|
$12.00
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
4300379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Galaxy Health Commercial |
$7.80
|
|
|
GLUCOSE RANDOM
|
Facility
|
OP
|
$12.00
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
4300379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.80 |
| Max. Negotiated Rate |
$9.60 |
| Rate for Payer: Aetna of NY Commercial |
$7.80
|
| Rate for Payer: Aetna of NY Medicare |
$5.52
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$4.80
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: CDPHP Medicare |
$4.44
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$7.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$9.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$9.60
|
| Rate for Payer: EmblemHealth Medicaid |
$9.60
|
| Rate for Payer: EmblemHealth Medicare |
$4.08
|
| Rate for Payer: EmblemHealth Select Care |
$7.20
|
| Rate for Payer: Fidelis Medicare |
$4.80
|
| Rate for Payer: Galaxy Health Commercial |
$7.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$4.80
|
| Rate for Payer: Humana Medicare |
$4.80
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$7.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$5.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$9.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$6.76
|
| Rate for Payer: MVP Health Care of NY Medicare |
$5.04
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$9.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1.80
|
| Rate for Payer: United Healthcare Commercial |
$9.00
|
| Rate for Payer: United Healthcare Medicare |
$4.80
|
| Rate for Payer: WellCare Medicare |
$6.60
|
|
|
GLYBURIDE 5MG TABS 100 EA
|
Facility
|
IP
|
$6.18
|
|
|
Service Code
|
NDC 51079087320
|
| Hospital Charge Code |
4400335
|
|
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
|
|
|
GLYBURIDE 5MG TABS 100 EA
|
Facility
|
OP
|
$6.18
|
|
|
Service Code
|
NDC 51079087320
|
| Hospital Charge Code |
4400335
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$4.94 |
| 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) Medicare |
$2.47
|
| Rate for Payer: Cash Price |
$4.64
|
| 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 |
$2.47
|
| Rate for Payer: Galaxy Health Commercial |
$4.02
|
| Rate for Payer: Hamaspik Choice Medicare |
$2.47
|
| Rate for Payer: Humana Medicare |
$2.47
|
| 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 |
$4.63
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$3.48
|
| Rate for Payer: MVP Health Care of NY Medicare |
$2.60
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$0.93
|
| Rate for Payer: United Healthcare Medicare |
$2.47
|
| Rate for Payer: WellCare Medicare |
$3.40
|
|
|
GLYCOPYROLLATE INJ
|
Facility
|
IP
|
$85.23
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
4408986
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$46.88 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna of NY Commercial |
$46.88
|
| Rate for Payer: Cash Price |
$63.92
|
| Rate for Payer: Galaxy Health Commercial |
$55.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$46.88
|
| Rate for Payer: WellCare Medicare |
$46.88
|
|
|
GLYCOPYROLLATE INJ
|
Facility
|
OP
|
$85.23
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
4408986
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$68.18 |
| Rate for Payer: Aetna of NY Medicare |
$39.21
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$34.09
|
| Rate for Payer: Cash Price |
$63.92
|
| Rate for Payer: CDPHP Medicare |
$31.54
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$68.18
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$68.18
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$68.18
|
| Rate for Payer: EmblemHealth Medicaid |
$68.18
|
| Rate for Payer: EmblemHealth Medicare |
$28.98
|
| Rate for Payer: EmblemHealth Select Care |
$61.37
|
| Rate for Payer: Fidelis Medicare |
$34.09
|
| Rate for Payer: Galaxy Health Commercial |
$55.40
|
| Rate for Payer: Hamaspik Choice Medicare |
$34.09
|
| Rate for Payer: Humana Medicare |
$34.09
|
| Rate for Payer: Local 1199SEIU Medicare |
$39.21
|
| Rate for Payer: MVP Health Care of NY Commercial |
$63.92
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$47.98
|
| Rate for Payer: MVP Health Care of NY Medicare |
$35.80
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$12.78
|
| Rate for Payer: United Healthcare Medicare |
$34.09
|
| Rate for Payer: WellCare Medicare |
$46.88
|
|
|
GLYCOSYLATED HEMOGLOBIN
|
Facility
|
IP
|
$56.00
|
|
|
Service Code
|
HCPCS 83036
|
| Hospital Charge Code |
4300385
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$36.40 |
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Galaxy Health Commercial |
$36.40
|
|
|
GLYCOSYLATED HEMOGLOBIN
|
Facility
|
OP
|
$56.00
|
|
|
Service Code
|
HCPCS 83036
|
| Hospital Charge Code |
4300385
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$44.80 |
| Rate for Payer: Aetna of NY Commercial |
$36.40
|
| Rate for Payer: Aetna of NY Medicare |
$25.76
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$22.40
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: CDPHP Medicare |
$20.72
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$33.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$44.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$44.80
|
| Rate for Payer: EmblemHealth Medicaid |
$44.80
|
| Rate for Payer: EmblemHealth Medicare |
$19.04
|
| Rate for Payer: EmblemHealth Select Care |
$33.60
|
| Rate for Payer: Fidelis Medicare |
$22.40
|
| Rate for Payer: Galaxy Health Commercial |
$36.40
|
| Rate for Payer: Hamaspik Choice Medicare |
$22.40
|
| Rate for Payer: Humana Medicare |
$22.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$36.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$25.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$42.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$31.53
|
| Rate for Payer: MVP Health Care of NY Medicare |
$23.52
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$42.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.40
|
| Rate for Payer: United Healthcare Commercial |
$42.00
|
| Rate for Payer: United Healthcare Medicare |
$22.40
|
| Rate for Payer: WellCare Medicare |
$30.80
|
|
|
GPS III APPLICATOR KIT
|
Facility
|
IP
|
$130.81
|
|
| Hospital Charge Code |
4471612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$85.03 |
| Max. Negotiated Rate |
$85.03 |
| Rate for Payer: Cash Price |
$98.11
|
| Rate for Payer: Galaxy Health Commercial |
$85.03
|
|
|
GPS III APPLICATOR KIT
|
Facility
|
OP
|
$130.81
|
|
| Hospital Charge Code |
4471612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.62 |
| Max. Negotiated Rate |
$104.65 |
| Rate for Payer: Aetna of NY Commercial |
$91.57
|
| Rate for Payer: Aetna of NY Medicare |
$60.17
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$52.32
|
| Rate for Payer: Cash Price |
$98.11
|
| Rate for Payer: CDPHP Medicare |
$48.40
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$104.65
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$104.65
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$104.65
|
| Rate for Payer: EmblemHealth Medicaid |
$104.65
|
| Rate for Payer: EmblemHealth Medicare |
$44.48
|
| Rate for Payer: EmblemHealth Select Care |
$94.18
|
| Rate for Payer: Fidelis Medicare |
$52.32
|
| Rate for Payer: Galaxy Health Commercial |
$85.03
|
| Rate for Payer: Hamaspik Choice Medicare |
$52.32
|
| Rate for Payer: Humana Medicare |
$52.32
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$91.57
|
| Rate for Payer: Local 1199SEIU Medicare |
$60.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$98.11
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$73.65
|
| Rate for Payer: MVP Health Care of NY Medicare |
$54.94
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$19.62
|
| Rate for Payer: United Healthcare Medicare |
$52.32
|
| Rate for Payer: WellCare Medicare |
$71.95
|
|
|
GPS III SYSTEM
|
Facility
|
IP
|
$2,150.64
|
|
| Hospital Charge Code |
4471613
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,397.92 |
| Max. Negotiated Rate |
$1,397.92 |
| Rate for Payer: Cash Price |
$1,612.98
|
| Rate for Payer: Galaxy Health Commercial |
$1,397.92
|
|
|
GPS III SYSTEM
|
Facility
|
OP
|
$2,150.64
|
|
| Hospital Charge Code |
4471613
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$322.60 |
| Max. Negotiated Rate |
$1,720.51 |
| Rate for Payer: Aetna of NY Commercial |
$1,505.45
|
| Rate for Payer: Aetna of NY Medicare |
$989.29
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$860.26
|
| Rate for Payer: Cash Price |
$1,612.98
|
| Rate for Payer: CDPHP Medicare |
$795.74
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,720.51
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,720.51
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,720.51
|
| Rate for Payer: EmblemHealth Medicaid |
$1,720.51
|
| Rate for Payer: EmblemHealth Medicare |
$731.22
|
| Rate for Payer: EmblemHealth Select Care |
$1,548.46
|
| Rate for Payer: Fidelis Medicare |
$860.26
|
| Rate for Payer: Galaxy Health Commercial |
$1,397.92
|
| Rate for Payer: Hamaspik Choice Medicare |
$860.26
|
| Rate for Payer: Humana Medicare |
$860.26
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,505.45
|
| Rate for Payer: Local 1199SEIU Medicare |
$989.29
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,612.98
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$1,210.81
|
| Rate for Payer: MVP Health Care of NY Medicare |
$903.27
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$322.60
|
| Rate for Payer: United Healthcare Medicare |
$860.26
|
| Rate for Payer: WellCare Medicare |
$1,182.85
|
|
|
GROSS & MICRO LAB ONLY(TISSUE PATHOLOGY)
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS 88305 TC
|
| Hospital Charge Code |
4301144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$104.00 |
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Galaxy Health Commercial |
$104.00
|
|
|
GROSS & MICRO LAB ONLY(TISSUE PATHOLOGY)
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS 88305 TC
|
| Hospital Charge Code |
4301144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$128.00 |
| Rate for Payer: Aetna of NY Commercial |
$104.00
|
| Rate for Payer: Aetna of NY Medicare |
$73.60
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$64.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: CDPHP Medicare |
$59.20
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$96.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$128.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$128.00
|
| Rate for Payer: EmblemHealth Medicaid |
$128.00
|
| Rate for Payer: EmblemHealth Medicare |
$54.40
|
| Rate for Payer: EmblemHealth Select Care |
$96.00
|
| Rate for Payer: Fidelis Medicare |
$64.00
|
| Rate for Payer: Galaxy Health Commercial |
$104.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$64.00
|
| Rate for Payer: Humana Medicare |
$64.00
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$104.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$73.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$120.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$90.08
|
| Rate for Payer: MVP Health Care of NY Medicare |
$67.20
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$120.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$24.00
|
| Rate for Payer: United Healthcare Commercial |
$120.00
|
| Rate for Payer: United Healthcare Medicare |
$64.00
|
| Rate for Payer: WellCare Medicare |
$88.00
|
|
|
GROUNDING PADS
|
Facility
|
IP
|
$43.26
|
|
| Hospital Charge Code |
4479217
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$28.12 |
| Rate for Payer: Cash Price |
$32.44
|
| Rate for Payer: Galaxy Health Commercial |
$28.12
|
|
|
GROUNDING PADS
|
Facility
|
OP
|
$43.26
|
|
| Hospital Charge Code |
4479217
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.49 |
| Max. Negotiated Rate |
$34.61 |
| Rate for Payer: Aetna of NY Commercial |
$30.28
|
| Rate for Payer: Aetna of NY Medicare |
$19.90
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$17.30
|
| Rate for Payer: Cash Price |
$32.44
|
| Rate for Payer: CDPHP Medicare |
$16.01
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$34.61
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$34.61
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$34.61
|
| Rate for Payer: EmblemHealth Medicaid |
$34.61
|
| Rate for Payer: EmblemHealth Medicare |
$14.71
|
| Rate for Payer: EmblemHealth Select Care |
$31.15
|
| Rate for Payer: Fidelis Medicare |
$17.30
|
| Rate for Payer: Galaxy Health Commercial |
$28.12
|
| Rate for Payer: Hamaspik Choice Medicare |
$17.30
|
| Rate for Payer: Humana Medicare |
$17.30
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$30.28
|
| Rate for Payer: Local 1199SEIU Medicare |
$19.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$32.45
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$24.36
|
| Rate for Payer: MVP Health Care of NY Medicare |
$18.17
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$6.49
|
| Rate for Payer: United Healthcare Medicare |
$17.30
|
| Rate for Payer: WellCare Medicare |
$23.79
|
|
|
GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
HCPCS 97552 GP
|
| Hospital Charge Code |
4650465
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$187.00 |
| Rate for Payer: Aetna of NY Commercial |
$115.00
|
| Rate for Payer: Aetna of NY Medicare |
$33.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$28.80
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: CDPHP Medicare |
$26.64
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$57.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$57.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$57.60
|
| Rate for Payer: EmblemHealth Medicaid |
$57.60
|
| Rate for Payer: EmblemHealth Medicare |
$24.48
|
| Rate for Payer: EmblemHealth Select Care |
$51.84
|
| Rate for Payer: Fidelis Medicare |
$28.80
|
| Rate for Payer: Galaxy Health Commercial |
$46.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$28.80
|
| Rate for Payer: Humana Medicare |
$28.80
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$115.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$33.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$187.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$141.00
|
| Rate for Payer: MVP Health Care of NY Medicare |
$30.24
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$161.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$10.80
|
| Rate for Payer: United Healthcare Commercial |
$161.00
|
| Rate for Payer: United Healthcare Medicare |
$28.80
|
| Rate for Payer: WellCare Medicare |
$39.60
|
|
|
GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
HCPCS 97552 GN
|
| Hospital Charge Code |
4670317
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Galaxy Health Commercial |
$46.80
|
|
|
GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
HCPCS 97552 GO
|
| Hospital Charge Code |
4690271
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$187.00 |
| Rate for Payer: Aetna of NY Commercial |
$115.00
|
| Rate for Payer: Aetna of NY Medicare |
$33.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$28.80
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: CDPHP Medicare |
$26.64
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$57.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$57.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$57.60
|
| Rate for Payer: EmblemHealth Medicaid |
$57.60
|
| Rate for Payer: EmblemHealth Medicare |
$24.48
|
| Rate for Payer: EmblemHealth Select Care |
$51.84
|
| Rate for Payer: Fidelis Medicare |
$28.80
|
| Rate for Payer: Galaxy Health Commercial |
$46.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$28.80
|
| Rate for Payer: Humana Medicare |
$28.80
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$115.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$33.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$187.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$141.00
|
| Rate for Payer: MVP Health Care of NY Medicare |
$30.24
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$161.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$10.80
|
| Rate for Payer: United Healthcare Commercial |
$161.00
|
| Rate for Payer: United Healthcare Medicare |
$28.80
|
| Rate for Payer: WellCare Medicare |
$39.60
|
|
|
GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
HCPCS 97552 GP
|
| Hospital Charge Code |
4650465
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Galaxy Health Commercial |
$46.80
|
|
|
GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE
|
Facility
|
IP
|
$72.00
|
|
|
Service Code
|
HCPCS 97552 GO
|
| Hospital Charge Code |
4690271
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Galaxy Health Commercial |
$46.80
|
|
|
GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
HCPCS 97552 GN
|
| Hospital Charge Code |
4670317
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$187.00 |
| Rate for Payer: Aetna of NY Commercial |
$115.00
|
| Rate for Payer: Aetna of NY Medicare |
$33.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$28.80
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: Cash Price |
$54.00
|
| Rate for Payer: CDPHP Medicare |
$26.64
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$57.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$57.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$57.60
|
| Rate for Payer: EmblemHealth Medicaid |
$57.60
|
| Rate for Payer: EmblemHealth Medicare |
$24.48
|
| Rate for Payer: EmblemHealth Select Care |
$51.84
|
| Rate for Payer: Fidelis Medicare |
$28.80
|
| Rate for Payer: Galaxy Health Commercial |
$46.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$28.80
|
| Rate for Payer: Humana Medicare |
$28.80
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$115.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$33.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$187.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$141.00
|
| Rate for Payer: MVP Health Care of NY Medicare |
$30.24
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$161.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$10.80
|
| Rate for Payer: United Healthcare Commercial |
$161.00
|
| Rate for Payer: United Healthcare Medicare |
$28.80
|
| Rate for Payer: WellCare Medicare |
$39.60
|
|
