|
BIPOLAR PROBE 10FR.
|
Facility
OP
|
$523.00
|
|
| Hospital Charge Code |
4471734
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$177.82 |
| Max. Negotiated Rate |
$421.02 |
| Rate for Payer: Aetna of NY Commercial |
$366.10
|
| Rate for Payer: Aetna of NY Medicare |
$240.58
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$392.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$392.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$193.51
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$261.50
|
| Rate for Payer: Cash Price |
$392.25
|
| Rate for Payer: CDPHP Commercial |
$421.02
|
| Rate for Payer: CDPHP Medicare |
$193.51
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$418.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$418.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$418.40
|
| Rate for Payer: EmblemHealth Medicaid |
$418.40
|
| Rate for Payer: EmblemHealth Medicare |
$177.82
|
| Rate for Payer: EmblemHealth Select Care |
$376.56
|
| Rate for Payer: Fidelis Medicare |
$199.32
|
| Rate for Payer: Galaxy Health Commercial |
$339.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$193.51
|
| Rate for Payer: Humana Medicare |
$193.51
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$366.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$240.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$392.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$294.45
|
| Rate for Payer: MVP Health Care of NY Medicare |
$203.19
|
| Rate for Payer: United Healthcare Medicare |
$193.51
|
| Rate for Payer: WellCare Medicare |
$287.65
|
|
|
BIPOLAR PROBE 7FR.
|
Facility
OP
|
$578.00
|
|
| Hospital Charge Code |
4471735
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$196.52 |
| Max. Negotiated Rate |
$465.29 |
| Rate for Payer: Aetna of NY Commercial |
$404.60
|
| Rate for Payer: Aetna of NY Medicare |
$265.88
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$433.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$433.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$213.86
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$289.00
|
| Rate for Payer: Cash Price |
$433.50
|
| Rate for Payer: CDPHP Commercial |
$465.29
|
| Rate for Payer: CDPHP Medicare |
$213.86
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$462.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$462.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$462.40
|
| Rate for Payer: EmblemHealth Medicaid |
$462.40
|
| Rate for Payer: EmblemHealth Medicare |
$196.52
|
| Rate for Payer: EmblemHealth Select Care |
$416.16
|
| Rate for Payer: Fidelis Medicare |
$220.28
|
| Rate for Payer: Galaxy Health Commercial |
$375.70
|
| Rate for Payer: Hamaspik Choice Medicare |
$213.86
|
| Rate for Payer: Humana Medicare |
$213.86
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$404.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$265.88
|
| Rate for Payer: MVP Health Care of NY Commercial |
$433.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$325.41
|
| Rate for Payer: MVP Health Care of NY Medicare |
$224.55
|
| Rate for Payer: United Healthcare Medicare |
$213.86
|
| Rate for Payer: WellCare Medicare |
$317.90
|
|
|
BISACODYL 10MG SUPP 12 EA
|
Facility
OP
|
$6.18
|
|
| Hospital Charge Code |
4400105
|
|
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
|
|
|
BISACODYL 5MG TABS 100 EA
|
Facility
OP
|
$6.18
|
|
| Hospital Charge Code |
4400106
|
|
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
|
|
|
BISOPROLOL 5 MG TABLET
|
Facility
OP
|
$15.95
|
|
| Hospital Charge Code |
4409224
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$5.42 |
| Max. Negotiated Rate |
$12.84 |
| Rate for Payer: Aetna of NY Commercial |
$11.16
|
| Rate for Payer: Aetna of NY Medicare |
$7.34
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$11.96
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$11.96
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$5.90
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$7.98
|
| Rate for Payer: Cash Price |
$11.96
|
| Rate for Payer: CDPHP Commercial |
$12.84
|
| Rate for Payer: CDPHP Medicare |
$5.90
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$12.76
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$12.76
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$12.76
|
| Rate for Payer: EmblemHealth Medicaid |
$12.76
|
| Rate for Payer: EmblemHealth Medicare |
$5.42
|
| Rate for Payer: EmblemHealth Select Care |
$11.48
|
| Rate for Payer: Fidelis Medicare |
$6.08
|
| Rate for Payer: Galaxy Health Commercial |
$10.37
|
| Rate for Payer: Hamaspik Choice Medicare |
$5.90
|
| Rate for Payer: Humana Medicare |
$5.90
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$11.16
|
| Rate for Payer: Local 1199SEIU Medicare |
$7.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$11.96
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$8.98
|
| Rate for Payer: MVP Health Care of NY Medicare |
$6.20
|
| Rate for Payer: United Healthcare Medicare |
$5.90
|
| Rate for Payer: WellCare Medicare |
$8.77
|
|
|
BITE BLOCKS
|
Facility
OP
|
$49.00
|
|
| Hospital Charge Code |
4479157
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.66 |
| Max. Negotiated Rate |
$39.44 |
| Rate for Payer: Aetna of NY Commercial |
$34.30
|
| Rate for Payer: Aetna of NY Medicare |
$22.54
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$36.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$18.13
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$24.50
|
| Rate for Payer: Cash Price |
$36.75
|
| Rate for Payer: CDPHP Commercial |
$39.44
|
| Rate for Payer: CDPHP Medicare |
$18.13
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$39.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$39.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$39.20
|
| Rate for Payer: EmblemHealth Medicaid |
$39.20
|
| Rate for Payer: EmblemHealth Medicare |
$16.66
|
| Rate for Payer: EmblemHealth Select Care |
$35.28
|
| Rate for Payer: Fidelis Medicare |
$18.67
|
| Rate for Payer: Galaxy Health Commercial |
$31.85
|
| Rate for Payer: Hamaspik Choice Medicare |
$18.13
|
| Rate for Payer: Humana Medicare |
$18.13
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$34.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$22.54
|
| Rate for Payer: MVP Health Care of NY Commercial |
$36.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$27.59
|
| Rate for Payer: MVP Health Care of NY Medicare |
$19.04
|
| Rate for Payer: United Healthcare Medicare |
$18.13
|
| Rate for Payer: WellCare Medicare |
$26.95
|
|
|
BLADE SURGICAL SZ 10
|
Facility
OP
|
$34.00
|
|
| Hospital Charge Code |
4471117
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.56 |
| Max. Negotiated Rate |
$27.37 |
| Rate for Payer: Aetna of NY Commercial |
$23.80
|
| Rate for Payer: Aetna of NY Medicare |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$12.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$17.00
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: CDPHP Commercial |
$27.37
|
| Rate for Payer: CDPHP Medicare |
$12.58
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.20
|
| Rate for Payer: EmblemHealth Medicaid |
$27.20
|
| Rate for Payer: EmblemHealth Medicare |
$11.56
|
| Rate for Payer: EmblemHealth Select Care |
$24.48
|
| Rate for Payer: Fidelis Medicare |
$12.96
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$23.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$19.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.21
|
| Rate for Payer: United Healthcare Medicare |
$12.58
|
| Rate for Payer: WellCare Medicare |
$18.70
|
|
|
BLANKET
|
Facility
OP
|
$28.00
|
|
| Hospital Charge Code |
4478239
|
|
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
|
|
|
BLDR IRRIGATION SMPL LAVAGE &/INSTLJ
|
Facility
OP
|
$707.00
|
|
|
Service Code
|
HCPCS 51700
|
| Hospital Charge Code |
4002005
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$235.48 |
| Max. Negotiated Rate |
$2,521.93 |
| Rate for Payer: Aetna of NY Commercial |
$1,857.00
|
| Rate for Payer: Aetna of NY Medicare |
$325.22
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$2,017.33
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$2,521.93
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$261.59
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$636.00
|
| Rate for Payer: Cash Price |
$530.25
|
| Rate for Payer: Cash Price |
$530.25
|
| Rate for Payer: Cash Price |
$530.25
|
| Rate for Payer: CDPHP Commercial |
$569.14
|
| Rate for Payer: CDPHP Medicare |
$261.59
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$565.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$565.60
|
| Rate for Payer: EmblemHealth Medicaid |
$565.60
|
| Rate for Payer: EmblemHealth Medicare |
$240.38
|
| Rate for Payer: Fidelis Medicare |
$269.44
|
| Rate for Payer: Galaxy Health Commercial |
$459.55
|
| Rate for Payer: Hamaspik Choice Medicare |
$261.59
|
| Rate for Payer: Humana Medicare |
$261.59
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,857.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$325.22
|
| Rate for Payer: Multiplan Commercial |
$565.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$530.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$398.04
|
| Rate for Payer: MVP Health Care of NY Medicare |
$274.67
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$1,775.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$235.48
|
| Rate for Payer: United Healthcare Commercial |
$1,775.00
|
| Rate for Payer: United Healthcare Medicare |
$261.59
|
| Rate for Payer: WellCare Medicare |
$388.85
|
|
|
BLEPHAROTOMY DRAIN ABSC EYELID
|
Facility
OP
|
$834.00
|
|
|
Service Code
|
HCPCS 67700
|
| Hospital Charge Code |
4602225
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$250.00 |
| Max. Negotiated Rate |
$1,189.18 |
| Rate for Payer: Aetna of NY Commercial |
$955.00
|
| Rate for Payer: Aetna of NY Medicare |
$383.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$950.93
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,189.18
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$308.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$417.00
|
| Rate for Payer: Cash Price |
$625.50
|
| Rate for Payer: Cash Price |
$625.50
|
| Rate for Payer: Cash Price |
$625.50
|
| Rate for Payer: Cash Price |
$625.50
|
| Rate for Payer: CDPHP Commercial |
$671.37
|
| Rate for Payer: CDPHP Medicare |
$308.58
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,182.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$667.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$667.20
|
| Rate for Payer: EmblemHealth Medicaid |
$667.20
|
| Rate for Payer: EmblemHealth Medicare |
$283.56
|
| Rate for Payer: EmblemHealth Select Care |
$1,064.00
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$250.00
|
| Rate for Payer: Fidelis Medicare |
$317.84
|
| Rate for Payer: Galaxy Health Commercial |
$542.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$308.58
|
| Rate for Payer: Humana Medicare |
$308.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$955.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$383.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,174.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$881.00
|
| Rate for Payer: MVP Health Care of NY Medicare |
$324.01
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$980.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$277.56
|
| Rate for Payer: United Healthcare Commercial |
$980.00
|
| Rate for Payer: United Healthcare Medicare |
$308.58
|
| Rate for Payer: WellCare Medicare |
$458.70
|
|
|
BLOOD DRAW FROM PORT
|
Facility
OP
|
$366.00
|
|
|
Service Code
|
HCPCS 36591
|
| Hospital Charge Code |
4304863
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$121.71 |
| Max. Negotiated Rate |
$294.63 |
| Rate for Payer: Aetna of NY Commercial |
$256.20
|
| Rate for Payer: Aetna of NY Medicare |
$168.36
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$274.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$274.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$135.42
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$183.00
|
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: CDPHP Commercial |
$294.63
|
| Rate for Payer: CDPHP Medicare |
$135.42
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$292.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$292.80
|
| Rate for Payer: EmblemHealth Medicaid |
$292.80
|
| Rate for Payer: EmblemHealth Medicare |
$124.44
|
| Rate for Payer: Fidelis Medicare |
$139.48
|
| Rate for Payer: Galaxy Health Commercial |
$237.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$135.42
|
| Rate for Payer: Humana Medicare |
$135.42
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$256.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$168.36
|
| Rate for Payer: MVP Health Care of NY Commercial |
$274.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$206.06
|
| Rate for Payer: MVP Health Care of NY Medicare |
$142.19
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$274.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$121.71
|
| Rate for Payer: United Healthcare Commercial |
$274.50
|
| Rate for Payer: United Healthcare Medicare |
$135.42
|
| Rate for Payer: WellCare Medicare |
$201.30
|
|
|
BLOOD GAS ANALYSIS
|
Facility
OP
|
$100.00
|
|
|
Service Code
|
HCPCS 82803
|
| Hospital Charge Code |
4300131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$80.50 |
| Rate for Payer: Aetna of NY Commercial |
$65.00
|
| Rate for Payer: Aetna of NY Medicare |
$46.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$37.00
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$50.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: CDPHP Commercial |
$80.50
|
| Rate for Payer: CDPHP Medicare |
$37.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$80.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$80.00
|
| Rate for Payer: EmblemHealth Medicaid |
$80.00
|
| Rate for Payer: EmblemHealth Medicare |
$34.00
|
| Rate for Payer: Fidelis Medicare |
$38.11
|
| Rate for Payer: Galaxy Health Commercial |
$65.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$37.00
|
| Rate for Payer: Humana Medicare |
$37.00
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$65.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$46.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$75.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$56.30
|
| Rate for Payer: MVP Health Care of NY Medicare |
$38.85
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$75.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$16.36
|
| Rate for Payer: United Healthcare Commercial |
$75.00
|
| Rate for Payer: United Healthcare Medicare |
$37.00
|
| Rate for Payer: WellCare Medicare |
$55.00
|
|
|
BLOOD GAS MIXED WO O2 SAT
|
Facility
OP
|
$100.00
|
|
|
Service Code
|
HCPCS 82803
|
| Hospital Charge Code |
4301018
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$80.50 |
| Rate for Payer: Aetna of NY Commercial |
$65.00
|
| Rate for Payer: Aetna of NY Medicare |
$46.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$75.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$37.00
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$50.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: Cash Price |
$75.00
|
| Rate for Payer: CDPHP Commercial |
$80.50
|
| Rate for Payer: CDPHP Medicare |
$37.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$80.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$80.00
|
| Rate for Payer: EmblemHealth Medicaid |
$80.00
|
| Rate for Payer: EmblemHealth Medicare |
$34.00
|
| Rate for Payer: Fidelis Medicare |
$38.11
|
| Rate for Payer: Galaxy Health Commercial |
$65.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$37.00
|
| Rate for Payer: Humana Medicare |
$37.00
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$65.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$46.00
|
| Rate for Payer: MVP Health Care of NY Commercial |
$75.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$56.30
|
| Rate for Payer: MVP Health Care of NY Medicare |
$38.85
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$75.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$16.36
|
| Rate for Payer: United Healthcare Commercial |
$75.00
|
| Rate for Payer: United Healthcare Medicare |
$37.00
|
| Rate for Payer: WellCare Medicare |
$55.00
|
|
|
BLOOD TRANSFUSION
|
Facility
OP
|
$1,242.00
|
|
|
Service Code
|
HCPCS 36430
|
| Hospital Charge Code |
4602028
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$999.81 |
| Rate for Payer: Aetna of NY Commercial |
$869.40
|
| Rate for Payer: Aetna of NY Medicare |
$571.32
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$931.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$931.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$459.54
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$621.00
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: CDPHP Commercial |
$999.81
|
| Rate for Payer: CDPHP Medicare |
$459.54
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$621.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$993.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$993.60
|
| Rate for Payer: EmblemHealth Medicaid |
$993.60
|
| Rate for Payer: EmblemHealth Medicare |
$422.28
|
| Rate for Payer: EmblemHealth Select Care |
$621.00
|
| Rate for Payer: Fidelis Medicare |
$473.33
|
| Rate for Payer: Galaxy Health Commercial |
$807.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$459.54
|
| Rate for Payer: Humana Medicare |
$459.54
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$869.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$571.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$931.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$699.25
|
| Rate for Payer: MVP Health Care of NY Medicare |
$482.52
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$931.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.08
|
| Rate for Payer: United Healthcare Commercial |
$931.50
|
| Rate for Payer: United Healthcare Medicare |
$459.54
|
| Rate for Payer: WellCare Medicare |
$683.10
|
|
|
BONE AND/OR JOINT IMAGING LIMITED
|
Facility
OP
|
$1,180.00
|
|
|
Service Code
|
HCPCS 78300
|
| Hospital Charge Code |
4210004
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$60.60 |
| Max. Negotiated Rate |
$1,500.00 |
| Rate for Payer: Aetna of NY Commercial |
$826.00
|
| Rate for Payer: Aetna of NY Medicare |
$542.80
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$885.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$885.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$436.60
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$590.00
|
| Rate for Payer: Cash Price |
$885.00
|
| Rate for Payer: Cash Price |
$885.00
|
| Rate for Payer: CDPHP Commercial |
$949.90
|
| Rate for Payer: CDPHP Medicare |
$436.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$944.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$944.00
|
| Rate for Payer: EmblemHealth Medicaid |
$944.00
|
| Rate for Payer: EmblemHealth Medicare |
$401.20
|
| Rate for Payer: Fidelis Medicare |
$449.70
|
| Rate for Payer: Galaxy Health Commercial |
$767.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$436.60
|
| Rate for Payer: Humana Medicare |
$436.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$826.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$542.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$885.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$664.34
|
| Rate for Payer: MVP Health Care of NY Medicare |
$458.43
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$1,500.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$60.60
|
| Rate for Payer: United Healthcare Commercial |
$1,500.00
|
| Rate for Payer: United Healthcare Medicare |
$436.60
|
| Rate for Payer: WellCare Medicare |
$649.00
|
|
|
BONE CEMENT AND MIXER PACK
|
Facility
OP
|
$1,152.00
|
|
| Hospital Charge Code |
4478251
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$391.68 |
| Max. Negotiated Rate |
$927.36 |
| Rate for Payer: Aetna of NY Commercial |
$806.40
|
| Rate for Payer: Aetna of NY Medicare |
$529.92
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$518.40
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$518.40
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$426.24
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$576.00
|
| Rate for Payer: Cash Price |
$864.00
|
| Rate for Payer: CDPHP Commercial |
$927.36
|
| Rate for Payer: CDPHP Medicare |
$426.24
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$576.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$921.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$921.60
|
| Rate for Payer: EmblemHealth Medicaid |
$921.60
|
| Rate for Payer: EmblemHealth Medicare |
$391.68
|
| Rate for Payer: EmblemHealth Select Care |
$576.00
|
| Rate for Payer: Fidelis Medicare |
$439.03
|
| Rate for Payer: Galaxy Health Commercial |
$748.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$426.24
|
| Rate for Payer: Humana Medicare |
$426.24
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$806.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$529.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$748.80
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$748.80
|
| Rate for Payer: MVP Health Care of NY Medicare |
$447.55
|
| Rate for Payer: United Healthcare Medicare |
$426.24
|
| Rate for Payer: WellCare Medicare |
$633.60
|
|
|
BONE CEMENT PLUS MIXER
|
Facility
OP
|
$1,212.00
|
|
| Hospital Charge Code |
4471760
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$412.08 |
| Max. Negotiated Rate |
$975.66 |
| Rate for Payer: Aetna of NY Commercial |
$848.40
|
| Rate for Payer: Aetna of NY Medicare |
$557.52
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$545.40
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$545.40
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$448.44
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$606.00
|
| Rate for Payer: Cash Price |
$909.00
|
| Rate for Payer: CDPHP Commercial |
$975.66
|
| Rate for Payer: CDPHP Medicare |
$448.44
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$606.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$969.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$969.60
|
| Rate for Payer: EmblemHealth Medicaid |
$969.60
|
| Rate for Payer: EmblemHealth Medicare |
$412.08
|
| Rate for Payer: EmblemHealth Select Care |
$606.00
|
| Rate for Payer: Fidelis Medicare |
$461.89
|
| Rate for Payer: Galaxy Health Commercial |
$787.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$448.44
|
| Rate for Payer: Humana Medicare |
$448.44
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$848.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$557.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$787.80
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$787.80
|
| Rate for Payer: MVP Health Care of NY Medicare |
$470.86
|
| Rate for Payer: United Healthcare Medicare |
$448.44
|
| Rate for Payer: WellCare Medicare |
$666.60
|
|
|
BONE CEMENT W/MIXER KYPHX HV-R
|
Facility
OP
|
$767.00
|
|
| Hospital Charge Code |
4471777
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$260.78 |
| Max. Negotiated Rate |
$617.44 |
| Rate for Payer: Aetna of NY Commercial |
$536.90
|
| Rate for Payer: Aetna of NY Medicare |
$352.82
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$345.15
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$345.15
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$283.79
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$383.50
|
| Rate for Payer: Cash Price |
$575.25
|
| Rate for Payer: CDPHP Commercial |
$617.44
|
| Rate for Payer: CDPHP Medicare |
$283.79
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$383.50
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$613.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$613.60
|
| Rate for Payer: EmblemHealth Medicaid |
$613.60
|
| Rate for Payer: EmblemHealth Medicare |
$260.78
|
| Rate for Payer: EmblemHealth Select Care |
$383.50
|
| Rate for Payer: Fidelis Medicare |
$292.30
|
| Rate for Payer: Galaxy Health Commercial |
$498.55
|
| Rate for Payer: Hamaspik Choice Medicare |
$283.79
|
| Rate for Payer: Humana Medicare |
$283.79
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$536.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$352.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$498.55
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$498.55
|
| Rate for Payer: MVP Health Care of NY Medicare |
$297.98
|
| Rate for Payer: United Healthcare Medicare |
$283.79
|
| Rate for Payer: WellCare Medicare |
$421.85
|
|
|
BONE FILLER DEVICE - SIZE 2
|
Facility
OP
|
$452.00
|
|
| Hospital Charge Code |
4478253
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$153.68 |
| Max. Negotiated Rate |
$363.86 |
| Rate for Payer: Aetna of NY Commercial |
$316.40
|
| Rate for Payer: Aetna of NY Medicare |
$207.92
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$339.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$339.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$167.24
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$226.00
|
| Rate for Payer: Cash Price |
$339.00
|
| Rate for Payer: CDPHP Commercial |
$363.86
|
| Rate for Payer: CDPHP Medicare |
$167.24
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$361.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$361.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$361.60
|
| Rate for Payer: EmblemHealth Medicaid |
$361.60
|
| Rate for Payer: EmblemHealth Medicare |
$153.68
|
| Rate for Payer: EmblemHealth Select Care |
$325.44
|
| Rate for Payer: Fidelis Medicare |
$172.26
|
| Rate for Payer: Galaxy Health Commercial |
$293.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$167.24
|
| Rate for Payer: Humana Medicare |
$167.24
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$316.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$207.92
|
| Rate for Payer: MVP Health Care of NY Commercial |
$339.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$254.48
|
| Rate for Payer: MVP Health Care of NY Medicare |
$175.60
|
| Rate for Payer: United Healthcare Medicare |
$167.24
|
| Rate for Payer: WellCare Medicare |
$248.60
|
|
|
BONE SCAN-WHOLE BODY
|
Facility
OP
|
$1,180.00
|
|
|
Service Code
|
HCPCS 78306
|
| Hospital Charge Code |
4210005
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$60.60 |
| Max. Negotiated Rate |
$1,500.00 |
| Rate for Payer: Aetna of NY Commercial |
$826.00
|
| Rate for Payer: Aetna of NY Medicare |
$542.80
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$885.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$885.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$436.60
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$590.00
|
| Rate for Payer: Cash Price |
$885.00
|
| Rate for Payer: Cash Price |
$885.00
|
| Rate for Payer: CDPHP Commercial |
$949.90
|
| Rate for Payer: CDPHP Medicare |
$436.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$944.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$944.00
|
| Rate for Payer: EmblemHealth Medicaid |
$944.00
|
| Rate for Payer: EmblemHealth Medicare |
$401.20
|
| Rate for Payer: Fidelis Medicare |
$449.70
|
| Rate for Payer: Galaxy Health Commercial |
$767.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$436.60
|
| Rate for Payer: Humana Medicare |
$436.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$826.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$542.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$885.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$664.34
|
| Rate for Payer: MVP Health Care of NY Medicare |
$458.43
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$1,500.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$60.60
|
| Rate for Payer: United Healthcare Commercial |
$1,500.00
|
| Rate for Payer: United Healthcare Medicare |
$436.60
|
| Rate for Payer: WellCare Medicare |
$649.00
|
|
|
BORDER STATUS ROOM AND BED SEMI PRIVATE
|
Facility
IP
|
$487.00
|
|
| Hospital Charge Code |
1000110
|
|
Hospital Revenue Code
|
120
|
| Min. Negotiated Rate |
$316.55 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna of NY Commercial |
$4,918.00
|
| Rate for Payer: Aetna of NY Medicare |
$2,328.56
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$3,943.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$4,928.37
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$4,484.66
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$1,993.18
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$1,990.70
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$4,577.00
|
| Rate for Payer: Cash Price |
$365.25
|
| Rate for Payer: Cash Price |
$365.25
|
| Rate for Payer: Cash Price |
$365.25
|
| Rate for Payer: Cash Price |
$365.25
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$1,993.18
|
| Rate for Payer: CDPHP Commercial |
$3,562.00
|
| Rate for Payer: CDPHP Essential Plan |
$4,484.66
|
| Rate for Payer: CDPHP Medicare |
$1,990.70
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$4,729.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$2,391.82
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,993.18
|
| Rate for Payer: EmblemHealth Medicaid |
$1,993.18
|
| Rate for Payer: EmblemHealth Medicare |
$1,951.00
|
| Rate for Payer: EmblemHealth Select Care |
$4,255.00
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$1,825.00
|
| Rate for Payer: Fidelis Medicare |
$1,825.00
|
| Rate for Payer: Galaxy Health Commercial |
$316.55
|
| Rate for Payer: Galaxy Health Workers Comp |
$2,587.13
|
| Rate for Payer: Hamaspik Choice Medicaid |
$1,993.18
|
| Rate for Payer: Hamaspik Choice Medicare |
$1,990.70
|
| Rate for Payer: Humana Medicare |
$1,990.70
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$4,918.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$2,328.56
|
| Rate for Payer: Multiplan Commercial |
$3,750.00
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$1,993.18
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4,284.00
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$4,285.34
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$4,285.34
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$3,213.00
|
| Rate for Payer: MVP Health Care of NY Medicare |
$2,090.24
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$4,124.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1,770.58
|
| Rate for Payer: United Healthcare Commercial |
$4,124.00
|
| Rate for Payer: United Healthcare Medicare |
$1,990.70
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$1,993.18
|
| Rate for Payer: WellCare Medicare |
$2,189.77
|
|
|
BORDETELLA PERTUSSIS NASOPHARYNGEAL CULT
|
Facility
OP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4304871
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$27.37 |
| Rate for Payer: Aetna of NY Commercial |
$22.10
|
| Rate for Payer: Aetna of NY Medicare |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$12.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$17.00
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: CDPHP Commercial |
$27.37
|
| Rate for Payer: CDPHP Medicare |
$12.58
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.20
|
| Rate for Payer: EmblemHealth Medicaid |
$27.20
|
| Rate for Payer: EmblemHealth Medicare |
$11.56
|
| Rate for Payer: Fidelis Medicare |
$12.96
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$19.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.21
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$25.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.23
|
| Rate for Payer: United Healthcare Commercial |
$25.50
|
| Rate for Payer: United Healthcare Medicare |
$12.58
|
| Rate for Payer: WellCare Medicare |
$18.70
|
|
|
BOSTON SCIENTIFIC CHARGING KIT SC64123
|
Facility
OP
|
$8,645.00
|
|
| Hospital Charge Code |
4479091
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,939.30 |
| Max. Negotiated Rate |
$6,959.22 |
| Rate for Payer: Aetna of NY Commercial |
$6,051.50
|
| Rate for Payer: Aetna of NY Medicare |
$3,976.70
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$3,890.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$3,890.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$3,198.65
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$4,322.50
|
| Rate for Payer: Cash Price |
$6,483.75
|
| Rate for Payer: CDPHP Commercial |
$6,959.22
|
| Rate for Payer: CDPHP Medicare |
$3,198.65
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$4,322.50
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$6,916.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$6,916.00
|
| Rate for Payer: EmblemHealth Medicaid |
$6,916.00
|
| Rate for Payer: EmblemHealth Medicare |
$2,939.30
|
| Rate for Payer: EmblemHealth Select Care |
$4,322.50
|
| Rate for Payer: Fidelis Medicare |
$3,294.61
|
| Rate for Payer: Galaxy Health Commercial |
$5,619.25
|
| Rate for Payer: Hamaspik Choice Medicare |
$3,198.65
|
| Rate for Payer: Humana Medicare |
$3,198.65
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$6,051.50
|
| Rate for Payer: Local 1199SEIU Medicare |
$3,976.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$5,619.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$5,619.25
|
| Rate for Payer: MVP Health Care of NY Medicare |
$3,358.58
|
| Rate for Payer: United Healthcare Medicare |
$3,198.65
|
| Rate for Payer: WellCare Medicare |
$4,754.75
|
|
|
BOTOX 200 UNIT VIAL 200 unit, 1 each
|
Facility
OP
|
$23.00
|
|
|
Service Code
|
HCPCS J0585
|
| Hospital Charge Code |
4401941
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: Aetna of NY Commercial |
$12.65
|
| Rate for Payer: Aetna of NY Medicare |
$10.58
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$6.32
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$6.32
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$8.51
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$11.50
|
| Rate for Payer: Cash Price |
$17.25
|
| Rate for Payer: Cash Price |
$17.25
|
| Rate for Payer: CDPHP Commercial |
$18.52
|
| Rate for Payer: CDPHP Medicare |
$8.51
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$6.32
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$18.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$18.40
|
| Rate for Payer: EmblemHealth Medicaid |
$18.40
|
| Rate for Payer: EmblemHealth Medicare |
$7.82
|
| Rate for Payer: EmblemHealth Select Care |
$6.32
|
| Rate for Payer: Fidelis Medicare |
$8.77
|
| Rate for Payer: Galaxy Health Commercial |
$14.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$8.51
|
| Rate for Payer: Humana Medicare |
$8.51
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$12.65
|
| Rate for Payer: Local 1199SEIU Medicare |
$10.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$17.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$12.95
|
| Rate for Payer: MVP Health Care of NY Medicare |
$8.94
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$10.54
|
| Rate for Payer: United Healthcare Commercial |
$10.54
|
| Rate for Payer: United Healthcare Medicare |
$8.51
|
| Rate for Payer: WellCare Medicare |
$12.65
|
|
|
BOXER SPLINT LRG LT
|
Facility
OP
|
$51.00
|
|
| Hospital Charge Code |
4479017
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.34 |
| Max. Negotiated Rate |
$41.06 |
| Rate for Payer: Aetna of NY Commercial |
$35.70
|
| Rate for Payer: Aetna of NY Medicare |
$23.46
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$38.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$38.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$18.87
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$25.50
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: CDPHP Commercial |
$41.06
|
| Rate for Payer: CDPHP Medicare |
$18.87
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$40.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$40.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$40.80
|
| Rate for Payer: EmblemHealth Medicaid |
$40.80
|
| Rate for Payer: EmblemHealth Medicare |
$17.34
|
| Rate for Payer: EmblemHealth Select Care |
$36.72
|
| Rate for Payer: Fidelis Medicare |
$19.44
|
| Rate for Payer: Galaxy Health Commercial |
$33.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$18.87
|
| Rate for Payer: Humana Medicare |
$18.87
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$35.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$23.46
|
| Rate for Payer: MVP Health Care of NY Commercial |
$38.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$28.71
|
| Rate for Payer: MVP Health Care of NY Medicare |
$19.81
|
| Rate for Payer: United Healthcare Medicare |
$18.87
|
| Rate for Payer: WellCare Medicare |
$28.05
|
|
