|
NALBUPHINE HYDROCHLORIDE INJ, PER 10 MG
|
Facility
|
OP
|
$10.82
|
|
|
Service Code
|
HCPCS J2300
|
| Hospital Charge Code |
4400536
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$8.71 |
| Rate for Payer: Aetna of NY Commercial |
$5.95
|
| Rate for Payer: Aetna of NY Medicare |
$4.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$2.82
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$2.82
|
| 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: 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 |
$2.82
|
| 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 |
$2.82
|
| 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 |
$5.95
|
| 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: Oxford Health Plans Freedom/Liberty/Metro |
$4.49
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$2.82
|
| Rate for Payer: United Healthcare Commercial |
$4.49
|
| Rate for Payer: United Healthcare Medicare |
$4.00
|
| Rate for Payer: WellCare Medicare |
$5.95
|
|
|
NALOXONE HYDROCHLORIDE INJ, PER 1 MG
|
Facility
|
IP
|
$61.16
|
|
|
Service Code
|
HCPCS J2310
|
| Hospital Charge Code |
4400539
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.06 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna of NY Commercial |
$33.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$8.06
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$8.06
|
| Rate for Payer: Cash Price |
$45.87
|
| Rate for Payer: Cash Price |
$45.87
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$8.06
|
| Rate for Payer: EmblemHealth Select Care |
$8.06
|
| Rate for Payer: Galaxy Health Commercial |
$39.75
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$33.64
|
| Rate for Payer: WellCare Medicare |
$33.64
|
|
|
NALOXONE HYDROCHLORIDE INJ, PER 1 MG
|
Facility
|
OP
|
$61.16
|
|
|
Service Code
|
HCPCS J2310
|
| Hospital Charge Code |
4400539
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.06 |
| Max. Negotiated Rate |
$2,020.00 |
| Rate for Payer: Aetna of NY Commercial |
$33.64
|
| Rate for Payer: Aetna of NY Medicare |
$28.13
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$8.06
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$8.06
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$45.45
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$20.20
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$22.63
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$30.58
|
| Rate for Payer: Cash Price |
$45.87
|
| Rate for Payer: Cash Price |
$45.87
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$20.20
|
| Rate for Payer: CDPHP Commercial |
$49.23
|
| Rate for Payer: CDPHP Essential Plan |
$45.45
|
| Rate for Payer: CDPHP Medicare |
$22.63
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$8.06
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$24.24
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$20.20
|
| Rate for Payer: EmblemHealth Medicaid |
$20.20
|
| Rate for Payer: EmblemHealth Medicare |
$20.79
|
| Rate for Payer: EmblemHealth Select Care |
$8.06
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$45.45
|
| Rate for Payer: Fidelis Medicare |
$23.31
|
| Rate for Payer: Galaxy Health Commercial |
$39.75
|
| Rate for Payer: Galaxy Health Workers Comp |
$29.69
|
| Rate for Payer: Hamaspik Choice Medicaid |
$2,020.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$22.63
|
| Rate for Payer: Humana Medicare |
$22.63
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$33.64
|
| Rate for Payer: Local 1199SEIU Medicare |
$28.13
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$2,020.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$45.87
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$43.43
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$43.43
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$34.43
|
| Rate for Payer: MVP Health Care of NY Medicare |
$23.76
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$15.59
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$20.20
|
| Rate for Payer: United Healthcare Commercial |
$15.59
|
| Rate for Payer: United Healthcare Medicare |
$22.63
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$21.21
|
| Rate for Payer: WellCare Medicare |
$33.64
|
|
|
NANO BITER STRAIGHT (AR-10913D-1)
|
Facility
|
IP
|
$817.00
|
|
| Hospital Charge Code |
4473025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$531.05 |
| Max. Negotiated Rate |
$531.05 |
| Rate for Payer: Cash Price |
$612.75
|
| Rate for Payer: Galaxy Health Commercial |
$531.05
|
|
|
NANO BITER STRAIGHT (AR-10913D-1)
|
Facility
|
OP
|
$817.00
|
|
| Hospital Charge Code |
4473025
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.78 |
| Max. Negotiated Rate |
$657.68 |
| Rate for Payer: Aetna of NY Commercial |
$571.90
|
| Rate for Payer: Aetna of NY Medicare |
$375.82
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$612.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$612.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$302.29
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$408.50
|
| Rate for Payer: Cash Price |
$612.75
|
| Rate for Payer: CDPHP Commercial |
$657.68
|
| Rate for Payer: CDPHP Medicare |
$302.29
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$653.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$653.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$653.60
|
| Rate for Payer: EmblemHealth Medicaid |
$653.60
|
| Rate for Payer: EmblemHealth Medicare |
$277.78
|
| Rate for Payer: EmblemHealth Select Care |
$588.24
|
| Rate for Payer: Fidelis Medicare |
$311.36
|
| Rate for Payer: Galaxy Health Commercial |
$531.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$302.29
|
| Rate for Payer: Humana Medicare |
$302.29
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$571.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$375.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$612.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$459.97
|
| Rate for Payer: MVP Health Care of NY Medicare |
$317.40
|
| Rate for Payer: United Healthcare Medicare |
$302.29
|
| Rate for Payer: WellCare Medicare |
$449.35
|
|
|
NANO BITER UP (AR-10922D-1)
|
Facility
|
OP
|
$817.00
|
|
| Hospital Charge Code |
4473024
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.78 |
| Max. Negotiated Rate |
$657.68 |
| Rate for Payer: Aetna of NY Commercial |
$571.90
|
| Rate for Payer: Aetna of NY Medicare |
$375.82
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$612.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$612.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$302.29
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$408.50
|
| Rate for Payer: Cash Price |
$612.75
|
| Rate for Payer: CDPHP Commercial |
$657.68
|
| Rate for Payer: CDPHP Medicare |
$302.29
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$653.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$653.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$653.60
|
| Rate for Payer: EmblemHealth Medicaid |
$653.60
|
| Rate for Payer: EmblemHealth Medicare |
$277.78
|
| Rate for Payer: EmblemHealth Select Care |
$588.24
|
| Rate for Payer: Fidelis Medicare |
$311.36
|
| Rate for Payer: Galaxy Health Commercial |
$531.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$302.29
|
| Rate for Payer: Humana Medicare |
$302.29
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$571.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$375.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$612.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$459.97
|
| Rate for Payer: MVP Health Care of NY Medicare |
$317.40
|
| Rate for Payer: United Healthcare Medicare |
$302.29
|
| Rate for Payer: WellCare Medicare |
$449.35
|
|
|
NANO BITER UP (AR-10922D-1)
|
Facility
|
IP
|
$817.00
|
|
| Hospital Charge Code |
4473024
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$531.05 |
| Max. Negotiated Rate |
$531.05 |
| Rate for Payer: Cash Price |
$612.75
|
| Rate for Payer: Galaxy Health Commercial |
$531.05
|
|
|
NANO SABRE SHAVER (AR-9280NSR)
|
Facility
|
OP
|
$311.00
|
|
| Hospital Charge Code |
4473029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.74 |
| Max. Negotiated Rate |
$250.36 |
| Rate for Payer: Aetna of NY Commercial |
$217.70
|
| Rate for Payer: Aetna of NY Medicare |
$143.06
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$233.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$233.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$115.07
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$155.50
|
| Rate for Payer: Cash Price |
$233.25
|
| Rate for Payer: CDPHP Commercial |
$250.36
|
| Rate for Payer: CDPHP Medicare |
$115.07
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$248.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$248.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$248.80
|
| Rate for Payer: EmblemHealth Medicaid |
$248.80
|
| Rate for Payer: EmblemHealth Medicare |
$105.74
|
| Rate for Payer: EmblemHealth Select Care |
$223.92
|
| Rate for Payer: Fidelis Medicare |
$118.52
|
| Rate for Payer: Galaxy Health Commercial |
$202.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$115.07
|
| Rate for Payer: Humana Medicare |
$115.07
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$217.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$143.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$233.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$175.09
|
| Rate for Payer: MVP Health Care of NY Medicare |
$120.82
|
| Rate for Payer: United Healthcare Medicare |
$115.07
|
| Rate for Payer: WellCare Medicare |
$171.05
|
|
|
NANO SABRE SHAVER (AR-9280NSR)
|
Facility
|
IP
|
$311.00
|
|
| Hospital Charge Code |
4473029
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.15 |
| Max. Negotiated Rate |
$202.15 |
| Rate for Payer: Cash Price |
$233.25
|
| Rate for Payer: Galaxy Health Commercial |
$202.15
|
|
|
NANO SCISSOR (AR-10915D-1)
|
Facility
|
IP
|
$817.00
|
|
| Hospital Charge Code |
4473026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$531.05 |
| Max. Negotiated Rate |
$531.05 |
| Rate for Payer: Cash Price |
$612.75
|
| Rate for Payer: Galaxy Health Commercial |
$531.05
|
|
|
NANO SCISSOR (AR-10915D-1)
|
Facility
|
OP
|
$817.00
|
|
| Hospital Charge Code |
4473026
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$277.78 |
| Max. Negotiated Rate |
$657.68 |
| Rate for Payer: Aetna of NY Commercial |
$571.90
|
| Rate for Payer: Aetna of NY Medicare |
$375.82
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$612.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$612.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$302.29
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$408.50
|
| Rate for Payer: Cash Price |
$612.75
|
| Rate for Payer: CDPHP Commercial |
$657.68
|
| Rate for Payer: CDPHP Medicare |
$302.29
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$653.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$653.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$653.60
|
| Rate for Payer: EmblemHealth Medicaid |
$653.60
|
| Rate for Payer: EmblemHealth Medicare |
$277.78
|
| Rate for Payer: EmblemHealth Select Care |
$588.24
|
| Rate for Payer: Fidelis Medicare |
$311.36
|
| Rate for Payer: Galaxy Health Commercial |
$531.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$302.29
|
| Rate for Payer: Humana Medicare |
$302.29
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$571.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$375.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$612.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$459.97
|
| Rate for Payer: MVP Health Care of NY Medicare |
$317.40
|
| Rate for Payer: United Healthcare Medicare |
$302.29
|
| Rate for Payer: WellCare Medicare |
$449.35
|
|
|
NANOSCOPE HANDPIECE (AR-3210-0040)
|
Facility
|
OP
|
$200.00
|
|
| Hospital Charge Code |
4473027
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.00 |
| Max. Negotiated Rate |
$161.00 |
| Rate for Payer: Aetna of NY Commercial |
$140.00
|
| Rate for Payer: Aetna of NY Medicare |
$92.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$150.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$74.00
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$100.00
|
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: CDPHP Commercial |
$161.00
|
| Rate for Payer: CDPHP Medicare |
$74.00
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$160.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$160.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$160.00
|
| Rate for Payer: EmblemHealth Medicaid |
$160.00
|
| Rate for Payer: EmblemHealth Medicare |
$68.00
|
| Rate for Payer: EmblemHealth Select Care |
$144.00
|
| Rate for Payer: Fidelis Medicare |
$76.22
|
| Rate for Payer: Galaxy Health Commercial |
$130.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$74.00
|
| Rate for Payer: Humana Medicare |
$74.00
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$140.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$92.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$150.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$112.60
|
| Rate for Payer: MVP Health Care of NY Medicare |
$77.70
|
| Rate for Payer: United Healthcare Medicare |
$74.00
|
| Rate for Payer: WellCare Medicare |
$110.00
|
|
|
NANOSCOPE HANDPIECE (AR-3210-0040)
|
Facility
|
IP
|
$200.00
|
|
| Hospital Charge Code |
4473027
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$130.00 |
| Rate for Payer: Cash Price |
$150.00
|
| Rate for Payer: Galaxy Health Commercial |
$130.00
|
|
|
NAPROXEN 500MG TABS 10X10EA
|
Facility
|
IP
|
$6.18
|
|
|
Service Code
|
NDC 63739040310
|
| Hospital Charge Code |
4400542
|
|
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
|
|
|
NAPROXEN 500MG TABS 10X10EA
|
Facility
|
OP
|
$6.18
|
|
|
Service Code
|
NDC 63739040310
|
| Hospital Charge Code |
4400542
|
|
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
|
|
|
NASOPHARYNGE AIRWAY 6.0
|
Facility
|
OP
|
$10.00
|
|
| Hospital Charge Code |
4471216
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of NY Commercial |
$7.00
|
| Rate for Payer: Aetna of NY Medicare |
$4.60
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$7.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$7.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$3.70
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$5.00
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: CDPHP Commercial |
$8.05
|
| Rate for Payer: CDPHP Medicare |
$3.70
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$8.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$8.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$8.00
|
| Rate for Payer: EmblemHealth Medicaid |
$8.00
|
| Rate for Payer: EmblemHealth Medicare |
$3.40
|
| Rate for Payer: EmblemHealth Select Care |
$7.20
|
| Rate for Payer: Fidelis Medicare |
$3.81
|
| Rate for Payer: Galaxy Health Commercial |
$6.50
|
| Rate for Payer: Hamaspik Choice Medicare |
$3.70
|
| Rate for Payer: Humana Medicare |
$3.70
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$7.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$4.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$7.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$5.63
|
| Rate for Payer: MVP Health Care of NY Medicare |
$3.88
|
| Rate for Payer: United Healthcare Medicare |
$3.70
|
| Rate for Payer: WellCare Medicare |
$5.50
|
|
|
NASOPHARYNGE AIRWAY 6.0
|
Facility
|
IP
|
$10.00
|
|
| Hospital Charge Code |
4471216
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Galaxy Health Commercial |
$6.50
|
|
|
NASOPHARYNGE AIRWAY 7.0
|
Facility
|
IP
|
$11.00
|
|
| Hospital Charge Code |
4471217
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.15 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Cash Price |
$8.25
|
| Rate for Payer: Galaxy Health Commercial |
$7.15
|
|
|
NASOPHARYNGE AIRWAY 7.0
|
Facility
|
OP
|
$11.00
|
|
| Hospital Charge Code |
4471217
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$8.86 |
| Rate for Payer: Aetna of NY Commercial |
$7.70
|
| Rate for Payer: Aetna of NY Medicare |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$8.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$8.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$4.07
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$5.50
|
| Rate for Payer: Cash Price |
$8.25
|
| Rate for Payer: CDPHP Commercial |
$8.86
|
| Rate for Payer: CDPHP Medicare |
$4.07
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$8.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$8.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$8.80
|
| Rate for Payer: EmblemHealth Medicaid |
$8.80
|
| Rate for Payer: EmblemHealth Medicare |
$3.74
|
| Rate for Payer: EmblemHealth Select Care |
$7.92
|
| Rate for Payer: Fidelis Medicare |
$4.19
|
| Rate for Payer: Galaxy Health Commercial |
$7.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$4.07
|
| Rate for Payer: Humana Medicare |
$4.07
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$7.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$5.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$8.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$6.19
|
| Rate for Payer: MVP Health Care of NY Medicare |
$4.27
|
| Rate for Payer: United Healthcare Medicare |
$4.07
|
| Rate for Payer: WellCare Medicare |
$6.05
|
|
|
NASOPHARYNGE AIRWAY 8.0
|
Facility
|
OP
|
$10.00
|
|
| Hospital Charge Code |
4471219
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of NY Commercial |
$7.00
|
| Rate for Payer: Aetna of NY Medicare |
$4.60
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$7.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$7.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$3.70
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$5.00
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: CDPHP Commercial |
$8.05
|
| Rate for Payer: CDPHP Medicare |
$3.70
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$8.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$8.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$8.00
|
| Rate for Payer: EmblemHealth Medicaid |
$8.00
|
| Rate for Payer: EmblemHealth Medicare |
$3.40
|
| Rate for Payer: EmblemHealth Select Care |
$7.20
|
| Rate for Payer: Fidelis Medicare |
$3.81
|
| Rate for Payer: Galaxy Health Commercial |
$6.50
|
| Rate for Payer: Hamaspik Choice Medicare |
$3.70
|
| Rate for Payer: Humana Medicare |
$3.70
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$7.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$4.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$7.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$5.63
|
| Rate for Payer: MVP Health Care of NY Medicare |
$3.88
|
| Rate for Payer: United Healthcare Medicare |
$3.70
|
| Rate for Payer: WellCare Medicare |
$5.50
|
|
|
NASOPHARYNGE AIRWAY 8.0
|
Facility
|
IP
|
$10.00
|
|
| Hospital Charge Code |
4471219
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Galaxy Health Commercial |
$6.50
|
|
|
NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$443.00
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
4301126
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$287.95 |
| Max. Negotiated Rate |
$287.95 |
| Rate for Payer: Cash Price |
$332.25
|
| Rate for Payer: Galaxy Health Commercial |
$287.95
|
|
|
NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$443.00
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
4301126
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.41 |
| Max. Negotiated Rate |
$356.62 |
| Rate for Payer: Aetna of NY Commercial |
$287.95
|
| Rate for Payer: Aetna of NY Medicare |
$203.78
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$332.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$332.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$163.91
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$221.50
|
| Rate for Payer: Cash Price |
$332.25
|
| Rate for Payer: Cash Price |
$332.25
|
| Rate for Payer: CDPHP Commercial |
$356.62
|
| Rate for Payer: CDPHP Medicare |
$163.91
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$265.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$354.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$354.40
|
| Rate for Payer: EmblemHealth Medicaid |
$354.40
|
| Rate for Payer: EmblemHealth Medicare |
$150.62
|
| Rate for Payer: EmblemHealth Select Care |
$265.80
|
| Rate for Payer: Fidelis Medicare |
$168.83
|
| Rate for Payer: Galaxy Health Commercial |
$287.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$163.91
|
| Rate for Payer: Humana Medicare |
$163.91
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$287.95
|
| Rate for Payer: Local 1199SEIU Medicare |
$203.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$332.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$249.41
|
| Rate for Payer: MVP Health Care of NY Medicare |
$172.11
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$332.25
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$34.41
|
| Rate for Payer: United Healthcare Commercial |
$332.25
|
| Rate for Payer: United Healthcare Medicare |
$163.91
|
| Rate for Payer: WellCare Medicare |
$243.65
|
|
|
N-AUTOM URINALYS WO MICRO
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
HCPCS 81002
|
| Hospital Charge Code |
4300810
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$16.90 |
| Rate for Payer: Aetna of NY Commercial |
$13.65
|
| Rate for Payer: Aetna of NY Medicare |
$9.66
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$7.77
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$10.50
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: CDPHP Commercial |
$16.90
|
| Rate for Payer: CDPHP Medicare |
$7.77
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$12.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$16.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$16.80
|
| Rate for Payer: EmblemHealth Medicaid |
$16.80
|
| Rate for Payer: EmblemHealth Medicare |
$7.14
|
| Rate for Payer: EmblemHealth Select Care |
$12.60
|
| Rate for Payer: Fidelis Medicare |
$8.00
|
| Rate for Payer: Galaxy Health Commercial |
$13.65
|
| Rate for Payer: Hamaspik Choice Medicare |
$7.77
|
| Rate for Payer: Humana Medicare |
$7.77
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$13.65
|
| Rate for Payer: Local 1199SEIU Medicare |
$9.66
|
| Rate for Payer: MVP Health Care of NY Commercial |
$15.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$11.82
|
| Rate for Payer: MVP Health Care of NY Medicare |
$8.16
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$15.75
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$2.02
|
| Rate for Payer: United Healthcare Commercial |
$15.75
|
| Rate for Payer: United Healthcare Medicare |
$7.77
|
| Rate for Payer: WellCare Medicare |
$11.55
|
|
|
N-AUTOM URINALYS WO MICRO
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
HCPCS 81002
|
| Hospital Charge Code |
4300810
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.65 |
| Max. Negotiated Rate |
$13.65 |
| Rate for Payer: Cash Price |
$15.75
|
| Rate for Payer: Galaxy Health Commercial |
$13.65
|
|
