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Service Code NDC 76204090001
Hospital Charge Code 4400816
Hospital Revenue Code 250
Min. Negotiated Rate $7.00
Max. Negotiated Rate $16.58
Rate for Payer: Aetna of NY Commercial $14.42
Rate for Payer: Aetna of NY Medicare $9.48
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $15.45
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $15.45
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $7.62
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $10.30
Rate for Payer: Cash Price $15.45
Rate for Payer: CDPHP Commercial $16.58
Rate for Payer: CDPHP Medicare $7.62
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $16.48
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $16.48
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $16.48
Rate for Payer: EmblemHealth Medicaid $16.48
Rate for Payer: EmblemHealth Medicare $7.00
Rate for Payer: EmblemHealth Select Care $14.83
Rate for Payer: Fidelis Medicare $7.85
Rate for Payer: Galaxy Health Commercial $13.39
Rate for Payer: Hamaspik Choice Medicare $7.62
Rate for Payer: Humana Medicare $7.62
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $14.42
Rate for Payer: Local 1199SEIU Medicare $9.48
Rate for Payer: MVP Health Care of NY Commercial $15.45
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $11.60
Rate for Payer: MVP Health Care of NY Medicare $8.00
Rate for Payer: United Healthcare Medicare $7.62
Rate for Payer: WellCare Medicare $11.33
Service Code NDC 76204090001
Hospital Charge Code 4400816
Hospital Revenue Code 250
Min. Negotiated Rate $11.33
Max. Negotiated Rate $13.39
Rate for Payer: Cash Price $15.45
Rate for Payer: Galaxy Health Commercial $13.39
Rate for Payer: WellCare Medicare $11.33
Service Code NDC 50383024105
Hospital Charge Code 4400428
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 50383024105
Hospital Charge Code 4400428
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 00904605161
Hospital Charge Code 4400429
Hospital Revenue Code 250
Min. Negotiated Rate $4.82
Max. Negotiated Rate $5.69
Rate for Payer: Cash Price $6.57
Rate for Payer: Galaxy Health Commercial $5.69
Rate for Payer: WellCare Medicare $4.82
Service Code NDC 00904605161
Hospital Charge Code 4400429
Hospital Revenue Code 250
Min. Negotiated Rate $2.98
Max. Negotiated Rate $7.05
Rate for Payer: Aetna of NY Commercial $6.13
Rate for Payer: Aetna of NY Medicare $4.03
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $6.57
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $6.57
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $3.24
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $4.38
Rate for Payer: Cash Price $6.57
Rate for Payer: CDPHP Commercial $7.05
Rate for Payer: CDPHP Medicare $3.24
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $7.01
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $7.01
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $7.01
Rate for Payer: EmblemHealth Medicaid $7.01
Rate for Payer: EmblemHealth Medicare $2.98
Rate for Payer: EmblemHealth Select Care $6.31
Rate for Payer: Fidelis Medicare $3.34
Rate for Payer: Galaxy Health Commercial $5.69
Rate for Payer: Hamaspik Choice Medicare $3.24
Rate for Payer: Humana Medicare $3.24
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $6.13
Rate for Payer: Local 1199SEIU Medicare $4.03
Rate for Payer: MVP Health Care of NY Commercial $6.57
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $4.93
Rate for Payer: MVP Health Care of NY Medicare $3.40
Rate for Payer: United Healthcare Medicare $3.24
Rate for Payer: WellCare Medicare $4.82
Service Code NDC 00904605261
Hospital Charge Code 4400430
Hospital Revenue Code 250
Min. Negotiated Rate $5.95
Max. Negotiated Rate $7.03
Rate for Payer: Cash Price $8.12
Rate for Payer: Galaxy Health Commercial $7.03
Rate for Payer: WellCare Medicare $5.95
Service Code NDC 00904605261
Hospital Charge Code 4400430
Hospital Revenue Code 250
Min. Negotiated Rate $3.68
Max. Negotiated Rate $8.71
Rate for Payer: Aetna of NY Commercial $7.57
Rate for Payer: Aetna of NY Medicare $4.98
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $8.12
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $8.12
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $4.00
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $5.41
Rate for Payer: Cash Price $8.12
Rate for Payer: CDPHP Commercial $8.71
Rate for Payer: CDPHP Medicare $4.00
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $8.66
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $8.66
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $8.66
Rate for Payer: EmblemHealth Medicaid $8.66
Rate for Payer: EmblemHealth Medicare $3.68
Rate for Payer: EmblemHealth Select Care $7.79
Rate for Payer: Fidelis Medicare $4.12
Rate for Payer: Galaxy Health Commercial $7.03
Rate for Payer: Hamaspik Choice Medicare $4.00
Rate for Payer: Humana Medicare $4.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $7.57
Rate for Payer: Local 1199SEIU Medicare $4.98
Rate for Payer: MVP Health Care of NY Commercial $8.12
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $6.09
Rate for Payer: MVP Health Care of NY Medicare $4.20
Rate for Payer: United Healthcare Medicare $4.00
Rate for Payer: WellCare Medicare $5.95
Service Code HCPCS J1953
Hospital Charge Code 4400431
Hospital Revenue Code 636
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.31
Rate for Payer: Aetna of NY Commercial $0.26
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $0.07
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $0.07
Rate for Payer: Cash Price $0.36
Rate for Payer: Cash Price $0.36
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $0.07
Rate for Payer: EmblemHealth Select Care $0.07
Rate for Payer: Galaxy Health Commercial $0.31
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $0.26
Rate for Payer: WellCare Medicare $0.26
Service Code HCPCS J1953
Hospital Charge Code 4400431
Hospital Revenue Code 636
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.39
Rate for Payer: Aetna of NY Commercial $0.26
Rate for Payer: Aetna of NY Medicare $0.22
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $0.07
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $0.07
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $0.18
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $0.24
Rate for Payer: Cash Price $0.36
Rate for Payer: Cash Price $0.36
Rate for Payer: CDPHP Commercial $0.39
Rate for Payer: CDPHP Medicare $0.18
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $0.07
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $0.38
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $0.38
Rate for Payer: EmblemHealth Medicaid $0.38
Rate for Payer: EmblemHealth Medicare $0.16
Rate for Payer: EmblemHealth Select Care $0.07
Rate for Payer: Fidelis Medicare $0.18
Rate for Payer: Galaxy Health Commercial $0.31
Rate for Payer: Hamaspik Choice Medicare $0.18
Rate for Payer: Humana Medicare $0.18
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $0.26
Rate for Payer: Local 1199SEIU Medicare $0.22
Rate for Payer: MVP Health Care of NY Commercial $0.36
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $0.27
Rate for Payer: MVP Health Care of NY Medicare $0.19
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $0.12
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $0.07
Rate for Payer: United Healthcare Commercial $0.12
Rate for Payer: United Healthcare Medicare $0.18
Rate for Payer: WellCare Medicare $0.26
Service Code NDC 70954013910
Hospital Charge Code 4401558
Hospital Revenue Code 250
Min. Negotiated Rate $77.00
Max. Negotiated Rate $91.00
Rate for Payer: Cash Price $105.00
Rate for Payer: Galaxy Health Commercial $91.00
Rate for Payer: WellCare Medicare $77.00
Service Code NDC 70954013910
Hospital Charge Code 4401558
Hospital Revenue Code 250
Min. Negotiated Rate $47.60
Max. Negotiated Rate $112.70
Rate for Payer: Aetna of NY Commercial $98.00
Rate for Payer: Aetna of NY Medicare $64.40
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $105.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $105.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $51.80
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $70.00
Rate for Payer: Cash Price $105.00
Rate for Payer: CDPHP Commercial $112.70
Rate for Payer: CDPHP Medicare $51.80
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $112.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $112.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $112.00
Rate for Payer: EmblemHealth Medicaid $112.00
Rate for Payer: EmblemHealth Medicare $47.60
Rate for Payer: EmblemHealth Select Care $100.80
Rate for Payer: Fidelis Medicare $53.35
Rate for Payer: Galaxy Health Commercial $91.00
Rate for Payer: Hamaspik Choice Medicare $51.80
Rate for Payer: Humana Medicare $51.80
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $98.00
Rate for Payer: Local 1199SEIU Medicare $64.40
Rate for Payer: MVP Health Care of NY Commercial $105.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $78.82
Rate for Payer: MVP Health Care of NY Medicare $54.39
Rate for Payer: United Healthcare Medicare $51.80
Rate for Payer: WellCare Medicare $77.00
Service Code NDC 00904635161
Hospital Charge Code 4400424
Hospital Revenue Code 250
Min. Negotiated Rate $9.11
Max. Negotiated Rate $21.56
Rate for Payer: Aetna of NY Commercial $18.75
Rate for Payer: Aetna of NY Medicare $12.32
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $20.08
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $20.08
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $9.91
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $13.39
Rate for Payer: Cash Price $20.09
Rate for Payer: CDPHP Commercial $21.56
Rate for Payer: CDPHP Medicare $9.91
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $21.42
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $21.42
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $21.42
Rate for Payer: EmblemHealth Medicaid $21.42
Rate for Payer: EmblemHealth Medicare $9.11
Rate for Payer: EmblemHealth Select Care $19.28
Rate for Payer: Fidelis Medicare $10.21
Rate for Payer: Galaxy Health Commercial $17.41
Rate for Payer: Hamaspik Choice Medicare $9.91
Rate for Payer: Humana Medicare $9.91
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $18.75
Rate for Payer: Local 1199SEIU Medicare $12.32
Rate for Payer: MVP Health Care of NY Commercial $20.08
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $15.08
Rate for Payer: MVP Health Care of NY Medicare $10.40
Rate for Payer: United Healthcare Medicare $9.91
Rate for Payer: WellCare Medicare $14.73
Service Code NDC 00904635161
Hospital Charge Code 4400424
Hospital Revenue Code 250
Min. Negotiated Rate $14.73
Max. Negotiated Rate $17.41
Rate for Payer: Cash Price $20.09
Rate for Payer: Galaxy Health Commercial $17.41
Rate for Payer: WellCare Medicare $14.73
Service Code NDC 00904635261
Hospital Charge Code 4400425
Hospital Revenue Code 250
Min. Negotiated Rate $32.15
Max. Negotiated Rate $37.99
Rate for Payer: Cash Price $43.84
Rate for Payer: Galaxy Health Commercial $37.99
Rate for Payer: WellCare Medicare $32.15
Service Code NDC 00904635261
Hospital Charge Code 4400425
Hospital Revenue Code 250
Min. Negotiated Rate $19.87
Max. Negotiated Rate $47.05
Rate for Payer: Aetna of NY Commercial $40.92
Rate for Payer: Aetna of NY Medicare $26.89
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $43.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $43.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $21.63
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $29.22
Rate for Payer: Cash Price $43.84
Rate for Payer: CDPHP Commercial $47.05
Rate for Payer: CDPHP Medicare $21.63
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $46.76
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $46.76
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $46.76
Rate for Payer: EmblemHealth Medicaid $46.76
Rate for Payer: EmblemHealth Medicare $19.87
Rate for Payer: EmblemHealth Select Care $42.08
Rate for Payer: Fidelis Medicare $22.28
Rate for Payer: Galaxy Health Commercial $37.99
Rate for Payer: Hamaspik Choice Medicare $21.63
Rate for Payer: Humana Medicare $21.63
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $40.92
Rate for Payer: Local 1199SEIU Medicare $26.89
Rate for Payer: MVP Health Care of NY Commercial $43.84
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $32.91
Rate for Payer: MVP Health Care of NY Medicare $22.71
Rate for Payer: United Healthcare Medicare $21.63
Rate for Payer: WellCare Medicare $32.15
Service Code HCPCS J1956
Hospital Charge Code 4450009
Hospital Revenue Code 636
Min. Negotiated Rate $0.96
Max. Negotiated Rate $20.52
Rate for Payer: Aetna of NY Commercial $14.02
Rate for Payer: Aetna of NY Medicare $11.73
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $0.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $0.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $9.43
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $12.74
Rate for Payer: Cash Price $19.12
Rate for Payer: Cash Price $19.12
Rate for Payer: CDPHP Commercial $20.52
Rate for Payer: CDPHP Medicare $9.43
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $0.96
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $20.39
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $20.39
Rate for Payer: EmblemHealth Medicaid $20.39
Rate for Payer: EmblemHealth Medicare $8.67
Rate for Payer: EmblemHealth Select Care $0.96
Rate for Payer: Fidelis Medicare $9.71
Rate for Payer: Galaxy Health Commercial $16.57
Rate for Payer: Hamaspik Choice Medicare $9.43
Rate for Payer: Humana Medicare $9.43
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $14.02
Rate for Payer: Local 1199SEIU Medicare $11.73
Rate for Payer: MVP Health Care of NY Commercial $19.12
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $14.35
Rate for Payer: MVP Health Care of NY Medicare $9.90
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $1.52
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $0.96
Rate for Payer: United Healthcare Commercial $1.52
Rate for Payer: United Healthcare Medicare $9.43
Rate for Payer: WellCare Medicare $14.02
Service Code HCPCS J1956
Hospital Charge Code 4450008
Hospital Revenue Code 636
Min. Negotiated Rate $0.96
Max. Negotiated Rate $17.41
Rate for Payer: Aetna of NY Commercial $14.73
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $0.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $0.96
Rate for Payer: Cash Price $20.09
Rate for Payer: Cash Price $20.09
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $0.96
Rate for Payer: EmblemHealth Select Care $0.96
Rate for Payer: Galaxy Health Commercial $17.41
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $14.73
Rate for Payer: WellCare Medicare $14.73
Service Code HCPCS J1956
Hospital Charge Code 4450009
Hospital Revenue Code 636
Min. Negotiated Rate $0.96
Max. Negotiated Rate $16.57
Rate for Payer: Aetna of NY Commercial $14.02
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $0.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $0.96
Rate for Payer: Cash Price $19.12
Rate for Payer: Cash Price $19.12
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $0.96
Rate for Payer: EmblemHealth Select Care $0.96
Rate for Payer: Galaxy Health Commercial $16.57
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $14.02
Rate for Payer: WellCare Medicare $14.02
Service Code HCPCS J1956
Hospital Charge Code 4450008
Hospital Revenue Code 636
Min. Negotiated Rate $0.96
Max. Negotiated Rate $21.56
Rate for Payer: Aetna of NY Commercial $14.73
Rate for Payer: Aetna of NY Medicare $12.32
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $0.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $0.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $9.91
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $13.39
Rate for Payer: Cash Price $20.09
Rate for Payer: Cash Price $20.09
Rate for Payer: CDPHP Commercial $21.56
Rate for Payer: CDPHP Medicare $9.91
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $0.96
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $21.42
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $21.42
Rate for Payer: EmblemHealth Medicaid $21.42
Rate for Payer: EmblemHealth Medicare $9.11
Rate for Payer: EmblemHealth Select Care $0.96
Rate for Payer: Fidelis Medicare $10.21
Rate for Payer: Galaxy Health Commercial $17.41
Rate for Payer: Hamaspik Choice Medicare $9.91
Rate for Payer: Humana Medicare $9.91
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $14.73
Rate for Payer: Local 1199SEIU Medicare $12.32
Rate for Payer: MVP Health Care of NY Commercial $20.08
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $15.08
Rate for Payer: MVP Health Care of NY Medicare $10.40
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $1.52
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $0.96
Rate for Payer: United Healthcare Commercial $1.52
Rate for Payer: United Healthcare Medicare $9.91
Rate for Payer: WellCare Medicare $14.73
Service Code HCPCS J1956
Hospital Charge Code 4450010
Hospital Revenue Code 636
Min. Negotiated Rate $0.96
Max. Negotiated Rate $13.06
Rate for Payer: Aetna of NY Commercial $8.92
Rate for Payer: Aetna of NY Medicare $7.46
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $0.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $0.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $6.00
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $8.11
Rate for Payer: Cash Price $12.17
Rate for Payer: Cash Price $12.17
Rate for Payer: CDPHP Commercial $13.06
Rate for Payer: CDPHP Medicare $6.00
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $0.96
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $12.98
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $12.98
Rate for Payer: EmblemHealth Medicaid $12.98
Rate for Payer: EmblemHealth Medicare $5.51
Rate for Payer: EmblemHealth Select Care $0.96
Rate for Payer: Fidelis Medicare $6.18
Rate for Payer: Galaxy Health Commercial $10.54
Rate for Payer: Hamaspik Choice Medicare $6.00
Rate for Payer: Humana Medicare $6.00
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $8.92
Rate for Payer: Local 1199SEIU Medicare $7.46
Rate for Payer: MVP Health Care of NY Commercial $12.16
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $9.13
Rate for Payer: MVP Health Care of NY Medicare $6.30
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $1.52
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $0.96
Rate for Payer: United Healthcare Commercial $1.52
Rate for Payer: United Healthcare Medicare $6.00
Rate for Payer: WellCare Medicare $8.92
Service Code HCPCS J1956
Hospital Charge Code 4450010
Hospital Revenue Code 636
Min. Negotiated Rate $0.96
Max. Negotiated Rate $10.54
Rate for Payer: Aetna of NY Commercial $8.92
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $0.96
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $0.96
Rate for Payer: Cash Price $12.17
Rate for Payer: Cash Price $12.17
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $0.96
Rate for Payer: EmblemHealth Select Care $0.96
Rate for Payer: Galaxy Health Commercial $10.54
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $8.92
Rate for Payer: WellCare Medicare $8.92
Service Code NDC 51079044201
Hospital Charge Code 4400853
Hospital Revenue Code 250
Min. Negotiated Rate $5.78
Max. Negotiated Rate $13.68
Rate for Payer: Aetna of NY Commercial $11.90
Rate for Payer: Aetna of NY Medicare $7.82
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $12.75
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $12.75
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $6.29
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $8.50
Rate for Payer: Cash Price $12.75
Rate for Payer: CDPHP Commercial $13.68
Rate for Payer: CDPHP Medicare $6.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $13.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $13.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $13.60
Rate for Payer: EmblemHealth Medicaid $13.60
Rate for Payer: EmblemHealth Medicare $5.78
Rate for Payer: EmblemHealth Select Care $12.24
Rate for Payer: Fidelis Medicare $6.48
Rate for Payer: Galaxy Health Commercial $11.05
Rate for Payer: Hamaspik Choice Medicare $6.29
Rate for Payer: Humana Medicare $6.29
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $11.90
Rate for Payer: Local 1199SEIU Medicare $7.82
Rate for Payer: MVP Health Care of NY Commercial $12.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $9.57
Rate for Payer: MVP Health Care of NY Medicare $6.60
Rate for Payer: United Healthcare Medicare $6.29
Rate for Payer: WellCare Medicare $9.35
Service Code NDC 51079044201
Hospital Charge Code 4400853
Hospital Revenue Code 250
Min. Negotiated Rate $9.35
Max. Negotiated Rate $11.05
Rate for Payer: Cash Price $12.75
Rate for Payer: Galaxy Health Commercial $11.05
Rate for Payer: WellCare Medicare $9.35
Service Code NDC 00378181177
Hospital Charge Code 4401306
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