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Hospital Charge Code 4451246
Hospital Revenue Code 270
Min. Negotiated Rate $41.60
Max. Negotiated Rate $41.60
Rate for Payer: Cash Price $48.00
Rate for Payer: Galaxy Health Commercial $41.60
Service Code HCPCS 96523
Hospital Charge Code 4451248
Hospital Revenue Code 260
Min. Negotiated Rate $58.28
Max. Negotiated Rate $140.88
Rate for Payer: Aetna of NY Commercial $122.50
Rate for Payer: Aetna of NY Medicare $80.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $131.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $131.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $64.75
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $87.50
Rate for Payer: Cash Price $131.25
Rate for Payer: Cash Price $131.25
Rate for Payer: CDPHP Commercial $140.88
Rate for Payer: CDPHP Medicare $64.75
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $140.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $140.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $140.00
Rate for Payer: EmblemHealth Medicaid $140.00
Rate for Payer: EmblemHealth Medicare $59.50
Rate for Payer: EmblemHealth Select Care $126.00
Rate for Payer: Fidelis Medicare $66.69
Rate for Payer: Galaxy Health Commercial $113.75
Rate for Payer: Hamaspik Choice Medicare $64.75
Rate for Payer: Humana Medicare $64.75
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $122.50
Rate for Payer: Local 1199SEIU Medicare $80.50
Rate for Payer: MVP Health Care of NY Commercial $131.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $98.52
Rate for Payer: MVP Health Care of NY Medicare $67.99
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $131.25
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $58.28
Rate for Payer: United Healthcare Commercial $131.25
Rate for Payer: United Healthcare Medicare $64.75
Rate for Payer: WellCare Medicare $96.25
Service Code HCPCS 96523
Hospital Charge Code 4451248
Hospital Revenue Code 260
Min. Negotiated Rate $113.75
Max. Negotiated Rate $113.75
Rate for Payer: Cash Price $131.25
Rate for Payer: Galaxy Health Commercial $113.75
Service Code HCPCS 96374
Hospital Charge Code 4450107
Hospital Revenue Code 260
Min. Negotiated Rate $325.00
Max. Negotiated Rate $325.00
Rate for Payer: Cash Price $375.00
Rate for Payer: Galaxy Health Commercial $325.00
Service Code HCPCS 96374
Hospital Charge Code 4450107
Hospital Revenue Code 260
Min. Negotiated Rate $170.00
Max. Negotiated Rate $402.50
Rate for Payer: Aetna of NY Commercial $350.00
Rate for Payer: Aetna of NY Medicare $230.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $320.44
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $400.55
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $185.00
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $250.00
Rate for Payer: Cash Price $375.00
Rate for Payer: Cash Price $375.00
Rate for Payer: Cash Price $375.00
Rate for Payer: CDPHP Commercial $402.50
Rate for Payer: CDPHP Medicare $185.00
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $400.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $400.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $400.00
Rate for Payer: EmblemHealth Medicaid $400.00
Rate for Payer: EmblemHealth Medicare $170.00
Rate for Payer: EmblemHealth Select Care $360.00
Rate for Payer: Fidelis Medicare $190.55
Rate for Payer: Galaxy Health Commercial $325.00
Rate for Payer: Hamaspik Choice Medicare $185.00
Rate for Payer: Humana Medicare $185.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $350.00
Rate for Payer: Local 1199SEIU Medicare $230.00
Rate for Payer: MVP Health Care of NY Commercial $375.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $281.50
Rate for Payer: MVP Health Care of NY Medicare $194.25
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $375.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $204.22
Rate for Payer: United Healthcare Commercial $375.00
Rate for Payer: United Healthcare Medicare $185.00
Rate for Payer: WellCare Medicare $275.00
Hospital Charge Code 4451236
Hospital Revenue Code 270
Min. Negotiated Rate $13.00
Max. Negotiated Rate $13.00
Rate for Payer: Cash Price $15.00
Rate for Payer: Galaxy Health Commercial $13.00
Hospital Charge Code 4451236
Hospital Revenue Code 270
Min. Negotiated Rate $6.80
Max. Negotiated Rate $16.10
Rate for Payer: Aetna of NY Commercial $14.00
Rate for Payer: Aetna of NY Medicare $9.20
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $15.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $15.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $7.40
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $10.00
Rate for Payer: Cash Price $15.00
Rate for Payer: CDPHP Commercial $16.10
Rate for Payer: CDPHP Medicare $7.40
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $16.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $16.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $16.00
Rate for Payer: EmblemHealth Medicaid $16.00
Rate for Payer: EmblemHealth Medicare $6.80
Rate for Payer: EmblemHealth Select Care $14.40
Rate for Payer: Fidelis Medicare $7.62
Rate for Payer: Galaxy Health Commercial $13.00
Rate for Payer: Hamaspik Choice Medicare $7.40
Rate for Payer: Humana Medicare $7.40
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $14.00
Rate for Payer: Local 1199SEIU Medicare $9.20
Rate for Payer: MVP Health Care of NY Commercial $15.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $11.26
Rate for Payer: MVP Health Care of NY Medicare $7.77
Rate for Payer: United Healthcare Medicare $7.40
Rate for Payer: WellCare Medicare $11.00
Service Code HCPCS 96375
Hospital Charge Code 4451234
Hospital Revenue Code 260
Min. Negotiated Rate $45.26
Max. Negotiated Rate $400.55
Rate for Payer: Aetna of NY Commercial $95.20
Rate for Payer: Aetna of NY Medicare $62.56
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $320.44
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $400.55
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $50.32
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $68.00
Rate for Payer: Cash Price $102.00
Rate for Payer: Cash Price $102.00
Rate for Payer: Cash Price $102.00
Rate for Payer: CDPHP Commercial $109.48
Rate for Payer: CDPHP Medicare $50.32
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $108.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $108.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $108.80
Rate for Payer: EmblemHealth Medicaid $108.80
Rate for Payer: EmblemHealth Medicare $46.24
Rate for Payer: EmblemHealth Select Care $97.92
Rate for Payer: Fidelis Medicare $51.83
Rate for Payer: Galaxy Health Commercial $88.40
Rate for Payer: Hamaspik Choice Medicare $50.32
Rate for Payer: Humana Medicare $50.32
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $95.20
Rate for Payer: Local 1199SEIU Medicare $62.56
Rate for Payer: MVP Health Care of NY Commercial $102.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $76.57
Rate for Payer: MVP Health Care of NY Medicare $52.84
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $102.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $45.26
Rate for Payer: United Healthcare Commercial $102.00
Rate for Payer: United Healthcare Medicare $50.32
Rate for Payer: WellCare Medicare $74.80
Service Code HCPCS 96375
Hospital Charge Code 4451234
Hospital Revenue Code 260
Min. Negotiated Rate $88.40
Max. Negotiated Rate $88.40
Rate for Payer: Cash Price $102.00
Rate for Payer: Galaxy Health Commercial $88.40
Service Code HCPCS 96375
Hospital Charge Code 4451244
Hospital Revenue Code 260
Min. Negotiated Rate $45.26
Max. Negotiated Rate $400.55
Rate for Payer: Aetna of NY Commercial $95.20
Rate for Payer: Aetna of NY Medicare $62.56
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $320.44
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $400.55
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $50.32
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $68.00
Rate for Payer: Cash Price $102.00
Rate for Payer: Cash Price $102.00
Rate for Payer: Cash Price $102.00
Rate for Payer: CDPHP Commercial $109.48
Rate for Payer: CDPHP Medicare $50.32
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $108.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $108.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $108.80
Rate for Payer: EmblemHealth Medicaid $108.80
Rate for Payer: EmblemHealth Medicare $46.24
Rate for Payer: EmblemHealth Select Care $97.92
Rate for Payer: Fidelis Medicare $51.83
Rate for Payer: Galaxy Health Commercial $88.40
Rate for Payer: Hamaspik Choice Medicare $50.32
Rate for Payer: Humana Medicare $50.32
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $95.20
Rate for Payer: Local 1199SEIU Medicare $62.56
Rate for Payer: MVP Health Care of NY Commercial $102.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $76.57
Rate for Payer: MVP Health Care of NY Medicare $52.84
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $102.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $45.26
Rate for Payer: United Healthcare Commercial $102.00
Rate for Payer: United Healthcare Medicare $50.32
Rate for Payer: WellCare Medicare $74.80
Service Code HCPCS 96375
Hospital Charge Code 4451244
Hospital Revenue Code 260
Min. Negotiated Rate $88.40
Max. Negotiated Rate $88.40
Rate for Payer: Cash Price $102.00
Rate for Payer: Galaxy Health Commercial $88.40
Hospital Charge Code 4472144
Hospital Revenue Code 270
Min. Negotiated Rate $18.20
Max. Negotiated Rate $18.20
Rate for Payer: Cash Price $21.00
Rate for Payer: Galaxy Health Commercial $18.20
Hospital Charge Code 4472144
Hospital Revenue Code 270
Min. Negotiated Rate $9.52
Max. Negotiated Rate $22.54
Rate for Payer: Aetna of NY Commercial $19.60
Rate for Payer: Aetna of NY Medicare $12.88
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $21.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $21.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $10.36
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $14.00
Rate for Payer: Cash Price $21.00
Rate for Payer: CDPHP Commercial $22.54
Rate for Payer: CDPHP Medicare $10.36
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $22.40
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $22.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $22.40
Rate for Payer: EmblemHealth Medicaid $22.40
Rate for Payer: EmblemHealth Medicare $9.52
Rate for Payer: EmblemHealth Select Care $20.16
Rate for Payer: Fidelis Medicare $10.67
Rate for Payer: Galaxy Health Commercial $18.20
Rate for Payer: Hamaspik Choice Medicare $10.36
Rate for Payer: Humana Medicare $10.36
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $19.60
Rate for Payer: Local 1199SEIU Medicare $12.88
Rate for Payer: MVP Health Care of NY Commercial $21.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $15.76
Rate for Payer: MVP Health Care of NY Medicare $10.88
Rate for Payer: United Healthcare Medicare $10.36
Rate for Payer: WellCare Medicare $15.40
Hospital Charge Code 4472184
Hospital Revenue Code 270
Min. Negotiated Rate $15.98
Max. Negotiated Rate $37.84
Rate for Payer: Aetna of NY Commercial $32.90
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 CBP/EPO/PPO/HMO/Network Access $37.60
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: EmblemHealth Select Care $33.84
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 $32.90
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: United Healthcare Medicare $17.39
Rate for Payer: WellCare Medicare $25.85
Hospital Charge Code 4472184
Hospital Revenue Code 270
Min. Negotiated Rate $30.55
Max. Negotiated Rate $30.55
Rate for Payer: Cash Price $35.25
Rate for Payer: Galaxy Health Commercial $30.55
Service Code HCPCS 96366
Hospital Charge Code 4450106
Hospital Revenue Code 260
Min. Negotiated Rate $88.40
Max. Negotiated Rate $88.40
Rate for Payer: Cash Price $102.00
Rate for Payer: Galaxy Health Commercial $88.40
Service Code HCPCS 96366
Hospital Charge Code 4450106
Hospital Revenue Code 260
Min. Negotiated Rate $46.24
Max. Negotiated Rate $23,767.00
Rate for Payer: Aetna of NY Commercial $95.20
Rate for Payer: Aetna of NY Medicare $62.56
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $320.44
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $400.55
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan $534.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid $237.67
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $50.32
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $68.00
Rate for Payer: Cash Price $102.00
Rate for Payer: Cash Price $102.00
Rate for Payer: Cash Price $102.00
Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan $237.67
Rate for Payer: CDPHP Commercial $109.48
Rate for Payer: CDPHP Essential Plan $534.76
Rate for Payer: CDPHP Medicare $50.32
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $108.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $285.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $237.67
Rate for Payer: EmblemHealth Medicaid $237.67
Rate for Payer: EmblemHealth Medicare $46.24
Rate for Payer: EmblemHealth Select Care $97.92
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid $534.76
Rate for Payer: Fidelis Medicare $51.83
Rate for Payer: Galaxy Health Commercial $88.40
Rate for Payer: Galaxy Health Workers Comp $349.37
Rate for Payer: Hamaspik Choice Medicaid $23,767.00
Rate for Payer: Hamaspik Choice Medicare $50.32
Rate for Payer: Humana Medicare $50.32
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $95.20
Rate for Payer: Local 1199SEIU Medicare $62.56
Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid $23,767.00
Rate for Payer: MVP Health Care of NY Commercial $102.00
Rate for Payer: MVP Health Care of NY Essential Plan 1&2 $510.99
Rate for Payer: MVP Health Care of NY Essential Plan 3&4 $510.99
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $76.57
Rate for Payer: MVP Health Care of NY Medicare $52.84
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $102.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $237.67
Rate for Payer: United Healthcare Commercial $102.00
Rate for Payer: United Healthcare Medicare $50.32
Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid $249.55
Rate for Payer: WellCare Medicare $74.80
Service Code HCPCS 96365
Hospital Charge Code 4451242
Hospital Revenue Code 260
Min. Negotiated Rate $35.35
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 $320.44
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $400.55
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: Cash Price $459.75
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: Oxford Health Plans Freedom/Liberty/Metro $459.75
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $35.35
Rate for Payer: United Healthcare Commercial $459.75
Rate for Payer: United Healthcare Medicare $226.81
Rate for Payer: WellCare Medicare $337.15
Service Code HCPCS 96365
Hospital Charge Code 4451242
Hospital Revenue Code 260
Min. Negotiated Rate $398.45
Max. Negotiated Rate $398.45
Rate for Payer: Cash Price $459.75
Rate for Payer: Galaxy Health Commercial $398.45
Hospital Charge Code 4472094
Hospital Revenue Code 270
Min. Negotiated Rate $27.30
Max. Negotiated Rate $27.30
Rate for Payer: Cash Price $31.50
Rate for Payer: Galaxy Health Commercial $27.30
Hospital Charge Code 4472094
Hospital Revenue Code 270
Min. Negotiated Rate $14.28
Max. Negotiated Rate $33.81
Rate for Payer: Aetna of NY Commercial $29.40
Rate for Payer: Aetna of NY Medicare $19.32
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $31.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $31.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $15.54
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $21.00
Rate for Payer: Cash Price $31.50
Rate for Payer: CDPHP Commercial $33.81
Rate for Payer: CDPHP Medicare $15.54
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $33.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $33.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $33.60
Rate for Payer: EmblemHealth Medicaid $33.60
Rate for Payer: EmblemHealth Medicare $14.28
Rate for Payer: EmblemHealth Select Care $30.24
Rate for Payer: Fidelis Medicare $16.01
Rate for Payer: Galaxy Health Commercial $27.30
Rate for Payer: Hamaspik Choice Medicare $15.54
Rate for Payer: Humana Medicare $15.54
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $29.40
Rate for Payer: Local 1199SEIU Medicare $19.32
Rate for Payer: MVP Health Care of NY Commercial $31.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $23.65
Rate for Payer: MVP Health Care of NY Medicare $16.32
Rate for Payer: United Healthcare Medicare $15.54
Rate for Payer: WellCare Medicare $23.10
Service Code NDC 00832121101
Hospital Charge Code 4401422
Hospital Revenue Code 250
Min. Negotiated Rate $2.04
Max. Negotiated Rate $4.83
Rate for Payer: Aetna of NY Commercial $4.20
Rate for Payer: Aetna of NY Medicare $2.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $2.22
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $3.00
Rate for Payer: Cash Price $4.50
Rate for Payer: CDPHP Commercial $4.83
Rate for Payer: CDPHP Medicare $2.22
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $4.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $4.80
Rate for Payer: EmblemHealth Medicaid $4.80
Rate for Payer: EmblemHealth Medicare $2.04
Rate for Payer: EmblemHealth Select Care $4.32
Rate for Payer: Fidelis Medicare $2.29
Rate for Payer: Galaxy Health Commercial $3.90
Rate for Payer: Hamaspik Choice Medicare $2.22
Rate for Payer: Humana Medicare $2.22
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $4.20
Rate for Payer: Local 1199SEIU Medicare $2.76
Rate for Payer: MVP Health Care of NY Commercial $4.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $3.38
Rate for Payer: MVP Health Care of NY Medicare $2.33
Rate for Payer: United Healthcare Medicare $2.22
Rate for Payer: WellCare Medicare $3.30
Service Code NDC 00832121101
Hospital Charge Code 4401422
Hospital Revenue Code 250
Min. Negotiated Rate $3.30
Max. Negotiated Rate $3.90
Rate for Payer: Cash Price $4.50
Rate for Payer: Galaxy Health Commercial $3.90
Rate for Payer: WellCare Medicare $3.30
Service Code NDC 00832121301
Hospital Charge Code 4401420
Hospital Revenue Code 250
Min. Negotiated Rate $2.04
Max. Negotiated Rate $4.83
Rate for Payer: Aetna of NY Commercial $4.20
Rate for Payer: Aetna of NY Medicare $2.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $2.22
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $3.00
Rate for Payer: Cash Price $4.50
Rate for Payer: CDPHP Commercial $4.83
Rate for Payer: CDPHP Medicare $2.22
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.80
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $4.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $4.80
Rate for Payer: EmblemHealth Medicaid $4.80
Rate for Payer: EmblemHealth Medicare $2.04
Rate for Payer: EmblemHealth Select Care $4.32
Rate for Payer: Fidelis Medicare $2.29
Rate for Payer: Galaxy Health Commercial $3.90
Rate for Payer: Hamaspik Choice Medicare $2.22
Rate for Payer: Humana Medicare $2.22
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $4.20
Rate for Payer: Local 1199SEIU Medicare $2.76
Rate for Payer: MVP Health Care of NY Commercial $4.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $3.38
Rate for Payer: MVP Health Care of NY Medicare $2.33
Rate for Payer: United Healthcare Medicare $2.22
Rate for Payer: WellCare Medicare $3.30
Service Code NDC 00832121301
Hospital Charge Code 4401420
Hospital Revenue Code 250
Min. Negotiated Rate $3.30
Max. Negotiated Rate $3.90
Rate for Payer: Cash Price $4.50
Rate for Payer: Galaxy Health Commercial $3.90
Rate for Payer: WellCare Medicare $3.30