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Hospital Charge Code 4007610
Hospital Revenue Code 710
Min. Negotiated Rate $104.04
Max. Negotiated Rate $246.33
Rate for Payer: Aetna of NY Commercial $214.20
Rate for Payer: Aetna of NY Medicare $140.76
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $229.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $229.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $113.22
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $153.00
Rate for Payer: Cash Price $229.50
Rate for Payer: CDPHP Commercial $246.33
Rate for Payer: CDPHP Medicare $113.22
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $244.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $244.80
Rate for Payer: EmblemHealth Medicaid $244.80
Rate for Payer: EmblemHealth Medicare $104.04
Rate for Payer: Fidelis Medicare $116.62
Rate for Payer: Galaxy Health Commercial $198.90
Rate for Payer: Hamaspik Choice Medicare $113.22
Rate for Payer: Humana Medicare $113.22
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $214.20
Rate for Payer: Local 1199SEIU Medicare $140.76
Rate for Payer: MVP Health Care of NY Commercial $229.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $172.28
Rate for Payer: MVP Health Care of NY Medicare $118.88
Rate for Payer: United Healthcare Medicare $113.22
Rate for Payer: WellCare Medicare $168.30
Hospital Charge Code 4007610
Hospital Revenue Code 710
Min. Negotiated Rate $198.90
Max. Negotiated Rate $198.90
Rate for Payer: Cash Price $229.50
Rate for Payer: Galaxy Health Commercial $198.90
Hospital Charge Code 4000213
Hospital Revenue Code 710
Min. Negotiated Rate $289.34
Max. Negotiated Rate $685.06
Rate for Payer: Aetna of NY Commercial $595.70
Rate for Payer: Aetna of NY Medicare $391.46
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $638.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $638.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $314.87
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $425.50
Rate for Payer: Cash Price $638.25
Rate for Payer: CDPHP Commercial $685.06
Rate for Payer: CDPHP Medicare $314.87
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $680.80
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $680.80
Rate for Payer: EmblemHealth Medicaid $680.80
Rate for Payer: EmblemHealth Medicare $289.34
Rate for Payer: Fidelis Medicare $324.32
Rate for Payer: Galaxy Health Commercial $553.15
Rate for Payer: Hamaspik Choice Medicare $314.87
Rate for Payer: Humana Medicare $314.87
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $595.70
Rate for Payer: Local 1199SEIU Medicare $391.46
Rate for Payer: MVP Health Care of NY Commercial $638.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $479.11
Rate for Payer: MVP Health Care of NY Medicare $330.61
Rate for Payer: United Healthcare Medicare $314.87
Rate for Payer: WellCare Medicare $468.05
Hospital Charge Code 4000213
Hospital Revenue Code 710
Min. Negotiated Rate $553.15
Max. Negotiated Rate $553.15
Rate for Payer: Cash Price $638.25
Rate for Payer: Galaxy Health Commercial $553.15
Hospital Charge Code 4007616
Hospital Revenue Code 710
Min. Negotiated Rate $469.20
Max. Negotiated Rate $1,110.90
Rate for Payer: Aetna of NY Commercial $966.00
Rate for Payer: Aetna of NY Medicare $634.80
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $1,035.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $1,035.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $510.60
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $690.00
Rate for Payer: Cash Price $1,035.00
Rate for Payer: CDPHP Commercial $1,110.90
Rate for Payer: CDPHP Medicare $510.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $1,104.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $1,104.00
Rate for Payer: EmblemHealth Medicaid $1,104.00
Rate for Payer: EmblemHealth Medicare $469.20
Rate for Payer: Fidelis Medicare $525.92
Rate for Payer: Galaxy Health Commercial $897.00
Rate for Payer: Hamaspik Choice Medicare $510.60
Rate for Payer: Humana Medicare $510.60
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $966.00
Rate for Payer: Local 1199SEIU Medicare $634.80
Rate for Payer: MVP Health Care of NY Commercial $1,035.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $776.94
Rate for Payer: MVP Health Care of NY Medicare $536.13
Rate for Payer: United Healthcare Medicare $510.60
Rate for Payer: WellCare Medicare $759.00
Hospital Charge Code 4007616
Hospital Revenue Code 710
Min. Negotiated Rate $897.00
Max. Negotiated Rate $897.00
Rate for Payer: Cash Price $1,035.00
Rate for Payer: Galaxy Health Commercial $897.00
Hospital Charge Code 4000214
Hospital Revenue Code 710
Min. Negotiated Rate $1,107.60
Max. Negotiated Rate $1,107.60
Rate for Payer: Cash Price $1,278.00
Rate for Payer: Galaxy Health Commercial $1,107.60
Hospital Charge Code 4000214
Hospital Revenue Code 710
Min. Negotiated Rate $579.36
Max. Negotiated Rate $1,371.72
Rate for Payer: Aetna of NY Commercial $1,192.80
Rate for Payer: Aetna of NY Medicare $783.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $1,278.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $1,278.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $630.48
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $852.00
Rate for Payer: Cash Price $1,278.00
Rate for Payer: CDPHP Commercial $1,371.72
Rate for Payer: CDPHP Medicare $630.48
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $1,363.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $1,363.20
Rate for Payer: EmblemHealth Medicaid $1,363.20
Rate for Payer: EmblemHealth Medicare $579.36
Rate for Payer: Fidelis Medicare $649.39
Rate for Payer: Galaxy Health Commercial $1,107.60
Rate for Payer: Hamaspik Choice Medicare $630.48
Rate for Payer: Humana Medicare $630.48
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $1,192.80
Rate for Payer: Local 1199SEIU Medicare $783.84
Rate for Payer: MVP Health Care of NY Commercial $1,278.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $959.35
Rate for Payer: MVP Health Care of NY Medicare $662.00
Rate for Payer: United Healthcare Medicare $630.48
Rate for Payer: WellCare Medicare $937.20
Service Code HCPCS J2785
Hospital Charge Code 4400436
Hospital Revenue Code 636
Min. Negotiated Rate $7.05
Max. Negotiated Rate $142.13
Rate for Payer: Aetna of NY Commercial $120.26
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $7.05
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $7.05
Rate for Payer: Cash Price $164.00
Rate for Payer: Cash Price $164.00
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $7.05
Rate for Payer: EmblemHealth Select Care $7.05
Rate for Payer: Galaxy Health Commercial $142.13
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $120.26
Rate for Payer: WellCare Medicare $120.26
Service Code HCPCS J2785
Hospital Charge Code 4400436
Hospital Revenue Code 636
Min. Negotiated Rate $7.05
Max. Negotiated Rate $176.02
Rate for Payer: Aetna of NY Commercial $120.26
Rate for Payer: Aetna of NY Medicare $100.58
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $7.05
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $7.05
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $80.90
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $109.33
Rate for Payer: Cash Price $164.00
Rate for Payer: Cash Price $164.00
Rate for Payer: CDPHP Commercial $176.02
Rate for Payer: CDPHP Medicare $80.90
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $7.05
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $174.93
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $174.93
Rate for Payer: EmblemHealth Medicaid $174.93
Rate for Payer: EmblemHealth Medicare $74.34
Rate for Payer: EmblemHealth Select Care $7.05
Rate for Payer: Fidelis Medicare $83.33
Rate for Payer: Galaxy Health Commercial $142.13
Rate for Payer: Hamaspik Choice Medicare $80.90
Rate for Payer: Humana Medicare $80.90
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $120.26
Rate for Payer: Local 1199SEIU Medicare $100.58
Rate for Payer: MVP Health Care of NY Commercial $164.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $123.11
Rate for Payer: MVP Health Care of NY Medicare $84.95
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $102.76
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $7.05
Rate for Payer: United Healthcare Commercial $102.76
Rate for Payer: United Healthcare Medicare $80.90
Rate for Payer: WellCare Medicare $120.26
Hospital Charge Code 4471641
Hospital Revenue Code 270
Min. Negotiated Rate $3,385.85
Max. Negotiated Rate $3,385.85
Rate for Payer: Cash Price $3,906.75
Rate for Payer: Galaxy Health Commercial $3,385.85
Hospital Charge Code 4471641
Hospital Revenue Code 270
Min. Negotiated Rate $1,771.06
Max. Negotiated Rate $4,193.24
Rate for Payer: Aetna of NY Commercial $3,646.30
Rate for Payer: Aetna of NY Medicare $2,396.14
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $3,906.75
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $3,906.75
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $1,927.33
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $2,604.50
Rate for Payer: Cash Price $3,906.75
Rate for Payer: CDPHP Commercial $4,193.24
Rate for Payer: CDPHP Medicare $1,927.33
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4,167.20
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $4,167.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $4,167.20
Rate for Payer: EmblemHealth Medicaid $4,167.20
Rate for Payer: EmblemHealth Medicare $1,771.06
Rate for Payer: EmblemHealth Select Care $3,750.48
Rate for Payer: Fidelis Medicare $1,985.15
Rate for Payer: Galaxy Health Commercial $3,385.85
Rate for Payer: Hamaspik Choice Medicare $1,927.33
Rate for Payer: Humana Medicare $1,927.33
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $3,646.30
Rate for Payer: Local 1199SEIU Medicare $2,396.14
Rate for Payer: MVP Health Care of NY Commercial $3,906.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $2,932.67
Rate for Payer: MVP Health Care of NY Medicare $2,023.70
Rate for Payer: United Healthcare Medicare $1,927.33
Rate for Payer: WellCare Medicare $2,864.95
Service Code HCPCS 28192
Hospital Charge Code 4856714
Hospital Revenue Code 761
Min. Negotiated Rate $1,544.75
Max. Negotiated Rate $3,734.40
Rate for Payer: Aetna of NY Commercial $3,247.30
Rate for Payer: Aetna of NY Medicare $2,133.94
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 $1,716.43
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $2,319.50
Rate for Payer: Cash Price $3,479.25
Rate for Payer: Cash Price $3,479.25
Rate for Payer: Cash Price $3,479.25
Rate for Payer: CDPHP Commercial $3,734.40
Rate for Payer: CDPHP Medicare $1,716.43
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $3,711.20
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $3,711.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $3,711.20
Rate for Payer: EmblemHealth Medicaid $3,711.20
Rate for Payer: EmblemHealth Medicare $1,577.26
Rate for Payer: EmblemHealth Select Care $3,340.08
Rate for Payer: Fidelis Medicare $1,767.92
Rate for Payer: Galaxy Health Commercial $3,015.35
Rate for Payer: Hamaspik Choice Medicare $1,716.43
Rate for Payer: Humana Medicare $1,716.43
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $3,247.30
Rate for Payer: Local 1199SEIU Medicare $2,133.94
Rate for Payer: MVP Health Care of NY Commercial $3,479.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $2,611.76
Rate for Payer: MVP Health Care of NY Medicare $1,802.25
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $1,544.75
Rate for Payer: United Healthcare Medicare $1,716.43
Rate for Payer: WellCare Medicare $2,551.45
Service Code HCPCS 28192
Hospital Charge Code 4856714
Hospital Revenue Code 761
Min. Negotiated Rate $3,015.35
Max. Negotiated Rate $3,015.35
Rate for Payer: Cash Price $3,479.25
Rate for Payer: Galaxy Health Commercial $3,015.35
Service Code HCPCS 28190
Hospital Charge Code 4856713
Hospital Revenue Code 761
Min. Negotiated Rate $1,308.45
Max. Negotiated Rate $1,308.45
Rate for Payer: Cash Price $1,509.75
Rate for Payer: Galaxy Health Commercial $1,308.45
Service Code HCPCS 28190
Hospital Charge Code 4856713
Hospital Revenue Code 761
Min. Negotiated Rate $670.36
Max. Negotiated Rate $2,521.93
Rate for Payer: Aetna of NY Commercial $1,409.10
Rate for Payer: Aetna of NY Medicare $925.98
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 $744.81
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $1,006.50
Rate for Payer: Cash Price $1,509.75
Rate for Payer: Cash Price $1,509.75
Rate for Payer: Cash Price $1,509.75
Rate for Payer: CDPHP Commercial $1,620.46
Rate for Payer: CDPHP Medicare $744.81
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $1,610.40
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $1,610.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $1,610.40
Rate for Payer: EmblemHealth Medicaid $1,610.40
Rate for Payer: EmblemHealth Medicare $684.42
Rate for Payer: EmblemHealth Select Care $1,449.36
Rate for Payer: Fidelis Medicare $767.15
Rate for Payer: Galaxy Health Commercial $1,308.45
Rate for Payer: Hamaspik Choice Medicare $744.81
Rate for Payer: Humana Medicare $744.81
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $1,409.10
Rate for Payer: Local 1199SEIU Medicare $925.98
Rate for Payer: MVP Health Care of NY Commercial $1,509.75
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $1,133.32
Rate for Payer: MVP Health Care of NY Medicare $782.05
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $670.36
Rate for Payer: United Healthcare Medicare $744.81
Rate for Payer: WellCare Medicare $1,107.15
Service Code HCPCS 69210
Hospital Charge Code 4602124
Hospital Revenue Code 450
Min. Negotiated Rate $113.75
Max. Negotiated Rate $113.75
Rate for Payer: Cash Price $131.25
Rate for Payer: Galaxy Health Commercial $113.75
Service Code HCPCS 69210
Hospital Charge Code 4602124
Hospital Revenue Code 450
Min. Negotiated Rate $58.28
Max. Negotiated Rate $1,189.18
Rate for Payer: Aetna of NY Commercial $955.00
Rate for Payer: Aetna of NY Medicare $80.50
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 $64.75
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $87.50
Rate for Payer: Cash Price $131.25
Rate for Payer: Cash Price $131.25
Rate for Payer: Cash Price $131.25
Rate for Payer: Cash Price $131.25
Rate for Payer: CDPHP Commercial $140.88
Rate for Payer: CDPHP Medicare $64.75
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $1,182.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $140.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $140.00
Rate for Payer: EmblemHealth Medicaid $140.00
Rate for Payer: EmblemHealth Medicare $59.50
Rate for Payer: EmblemHealth Select Care $1,064.00
Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid $250.00
Rate for Payer: Fidelis Medicare $66.69
Rate for Payer: Galaxy Health Commercial $113.75
Rate for Payer: Hamaspik Choice Medicare $64.75
Rate for Payer: Humana Medicare $64.75
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $955.00
Rate for Payer: Local 1199SEIU Medicare $80.50
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 $67.99
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $980.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $58.28
Rate for Payer: United Healthcare Commercial $980.00
Rate for Payer: United Healthcare Medicare $64.75
Rate for Payer: WellCare Medicare $96.25
Service Code HCPCS 93270
Hospital Charge Code 4480038
Hospital Revenue Code 731
Min. Negotiated Rate $9.09
Max. Negotiated Rate $86.94
Rate for Payer: Aetna of NY Commercial $70.20
Rate for Payer: Aetna of NY Medicare $49.68
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $81.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $81.00
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $39.96
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $54.00
Rate for Payer: Cash Price $81.00
Rate for Payer: Cash Price $81.00
Rate for Payer: CDPHP Commercial $86.94
Rate for Payer: CDPHP Medicare $39.96
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $75.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $86.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $86.40
Rate for Payer: EmblemHealth Medicaid $86.40
Rate for Payer: EmblemHealth Medicare $36.72
Rate for Payer: EmblemHealth Select Care $70.20
Rate for Payer: Fidelis Medicare $41.16
Rate for Payer: Galaxy Health Commercial $70.20
Rate for Payer: Hamaspik Choice Medicare $39.96
Rate for Payer: Humana Medicare $39.96
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $70.20
Rate for Payer: Local 1199SEIU Medicare $49.68
Rate for Payer: MVP Health Care of NY Commercial $81.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $60.80
Rate for Payer: MVP Health Care of NY Medicare $41.96
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $9.09
Rate for Payer: United Healthcare Medicare $39.96
Rate for Payer: WellCare Medicare $59.40
Service Code HCPCS 93270
Hospital Charge Code 4480038
Hospital Revenue Code 731
Min. Negotiated Rate $70.20
Max. Negotiated Rate $70.20
Rate for Payer: Cash Price $81.00
Rate for Payer: Galaxy Health Commercial $70.20
Service Code HCPCS 58301
Hospital Charge Code 4602238
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 $422.28
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 $339.66
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $459.00
Rate for Payer: Cash Price $688.50
Rate for Payer: Cash Price $688.50
Rate for Payer: Cash Price $688.50
Rate for Payer: CDPHP Commercial $738.99
Rate for Payer: CDPHP Medicare $339.66
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $1,182.00
Rate for Payer: EmblemHealth Medicare $312.12
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 $349.85
Rate for Payer: Galaxy Health Commercial $596.70
Rate for Payer: Hamaspik Choice Medicare $339.66
Rate for Payer: Humana Medicare $339.66
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $955.00
Rate for Payer: Local 1199SEIU Medicare $422.28
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 $356.64
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $980.00
Rate for Payer: United Healthcare Commercial $980.00
Rate for Payer: United Healthcare Medicare $339.66
Rate for Payer: WellCare Medicare $504.90
Service Code HCPCS 58301
Hospital Charge Code 4602238
Hospital Revenue Code 450
Min. Negotiated Rate $596.70
Max. Negotiated Rate $596.70
Rate for Payer: Cash Price $688.50
Rate for Payer: Galaxy Health Commercial $596.70
Service Code HCPCS 20520
Hospital Charge Code 4850166
Hospital Revenue Code 761
Min. Negotiated Rate $3,015.35
Max. Negotiated Rate $3,015.35
Rate for Payer: Cash Price $3,479.25
Rate for Payer: Galaxy Health Commercial $3,015.35
Service Code HCPCS 20520
Hospital Charge Code 4850166
Hospital Revenue Code 761
Min. Negotiated Rate $1,544.75
Max. Negotiated Rate $3,734.40
Rate for Payer: Aetna of NY Commercial $3,247.30
Rate for Payer: Aetna of NY Medicare $2,133.94
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 $1,716.43
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $2,319.50
Rate for Payer: Cash Price $3,479.25
Rate for Payer: Cash Price $3,479.25
Rate for Payer: Cash Price $3,479.25
Rate for Payer: CDPHP Commercial $3,734.40
Rate for Payer: CDPHP Medicare $1,716.43
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $3,711.20
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $3,711.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $3,711.20
Rate for Payer: EmblemHealth Medicaid $3,711.20
Rate for Payer: EmblemHealth Medicare $1,577.26
Rate for Payer: EmblemHealth Select Care $3,340.08
Rate for Payer: Fidelis Medicare $1,767.92
Rate for Payer: Galaxy Health Commercial $3,015.35
Rate for Payer: Hamaspik Choice Medicare $1,716.43
Rate for Payer: Humana Medicare $1,716.43
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $3,247.30
Rate for Payer: Local 1199SEIU Medicare $2,133.94
Rate for Payer: MVP Health Care of NY Commercial $3,479.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $2,611.76
Rate for Payer: MVP Health Care of NY Medicare $1,802.25
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $1,544.75
Rate for Payer: United Healthcare Medicare $1,716.43
Rate for Payer: WellCare Medicare $2,551.45
Service Code HCPCS 11750
Hospital Charge Code 4602190
Hospital Revenue Code 450
Min. Negotiated Rate $741.65
Max. Negotiated Rate $741.65
Rate for Payer: Cash Price $855.75
Rate for Payer: Galaxy Health Commercial $741.65