|
CARVEDILOL 6.25MG TABS 10X10EA
|
Facility
OP
|
$6.44
|
|
| Hospital Charge Code |
4400137
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.19 |
| Max. Negotiated Rate |
$5.18 |
| Rate for Payer: Aetna of NY Commercial |
$4.51
|
| Rate for Payer: Aetna of NY Medicare |
$2.96
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$4.83
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$4.83
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$2.38
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$3.22
|
| Rate for Payer: Cash Price |
$4.83
|
| Rate for Payer: CDPHP Commercial |
$5.18
|
| Rate for Payer: CDPHP Medicare |
$2.38
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$5.15
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$5.15
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$5.15
|
| Rate for Payer: EmblemHealth Medicaid |
$5.15
|
| Rate for Payer: EmblemHealth Medicare |
$2.19
|
| Rate for Payer: EmblemHealth Select Care |
$4.64
|
| Rate for Payer: Fidelis Medicare |
$2.45
|
| Rate for Payer: Galaxy Health Commercial |
$4.19
|
| Rate for Payer: Hamaspik Choice Medicare |
$2.38
|
| Rate for Payer: Humana Medicare |
$2.38
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$4.51
|
| Rate for Payer: Local 1199SEIU Medicare |
$2.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$4.83
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$3.63
|
| Rate for Payer: MVP Health Care of NY Medicare |
$2.50
|
| Rate for Payer: United Healthcare Medicare |
$2.38
|
| Rate for Payer: WellCare Medicare |
$3.54
|
|
|
CASPOFUNGIN ACETATE 50 MG VIAL 50 mg, 1 each
|
Facility
OP
|
$257.00
|
|
|
Service Code
|
HCPCS J0637
|
| Hospital Charge Code |
4401553
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$206.88 |
| Rate for Payer: Aetna of NY Commercial |
$141.35
|
| Rate for Payer: Aetna of NY Medicare |
$118.22
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$6.63
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$95.09
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$128.50
|
| Rate for Payer: Cash Price |
$192.75
|
| Rate for Payer: Cash Price |
$192.75
|
| Rate for Payer: CDPHP Commercial |
$206.88
|
| Rate for Payer: CDPHP Medicare |
$95.09
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$6.63
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$205.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$205.60
|
| Rate for Payer: EmblemHealth Medicaid |
$205.60
|
| Rate for Payer: EmblemHealth Medicare |
$87.38
|
| Rate for Payer: EmblemHealth Select Care |
$6.63
|
| Rate for Payer: Fidelis Medicare |
$97.94
|
| Rate for Payer: Galaxy Health Commercial |
$167.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$95.09
|
| Rate for Payer: Humana Medicare |
$95.09
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$141.35
|
| Rate for Payer: Local 1199SEIU Medicare |
$118.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$192.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$144.69
|
| Rate for Payer: MVP Health Care of NY Medicare |
$99.84
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$14.22
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$6.63
|
| Rate for Payer: United Healthcare Commercial |
$14.22
|
| Rate for Payer: United Healthcare Medicare |
$95.09
|
| Rate for Payer: WellCare Medicare |
$141.35
|
|
|
CATECHOL FRACT PLASMA
|
Facility
OP
|
$245.00
|
|
|
Service Code
|
HCPCS 82384
|
| Hospital Charge Code |
4300156
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.58 |
| Max. Negotiated Rate |
$197.22 |
| Rate for Payer: Aetna of NY Commercial |
$159.25
|
| Rate for Payer: Aetna of NY Medicare |
$112.70
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$183.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$183.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$90.65
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$122.50
|
| Rate for Payer: Cash Price |
$183.75
|
| Rate for Payer: Cash Price |
$183.75
|
| Rate for Payer: CDPHP Commercial |
$197.22
|
| Rate for Payer: CDPHP Medicare |
$90.65
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$196.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$196.00
|
| Rate for Payer: EmblemHealth Medicaid |
$196.00
|
| Rate for Payer: EmblemHealth Medicare |
$83.30
|
| Rate for Payer: Fidelis Medicare |
$93.37
|
| Rate for Payer: Galaxy Health Commercial |
$159.25
|
| Rate for Payer: Hamaspik Choice Medicare |
$90.65
|
| Rate for Payer: Humana Medicare |
$90.65
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$159.25
|
| Rate for Payer: Local 1199SEIU Medicare |
$112.70
|
| Rate for Payer: MVP Health Care of NY Commercial |
$183.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$137.94
|
| Rate for Payer: MVP Health Care of NY Medicare |
$95.18
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$183.75
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$18.58
|
| Rate for Payer: United Healthcare Commercial |
$183.75
|
| Rate for Payer: United Healthcare Medicare |
$90.65
|
| Rate for Payer: WellCare Medicare |
$134.75
|
|
|
CATH 16FR 2WAY COUDE
|
Facility
OP
|
$67.00
|
|
| Hospital Charge Code |
4471033
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.78 |
| Max. Negotiated Rate |
$53.94 |
| Rate for Payer: Aetna of NY Commercial |
$46.90
|
| Rate for Payer: Aetna of NY Medicare |
$30.82
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$50.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$50.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$24.79
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$33.50
|
| Rate for Payer: Cash Price |
$50.25
|
| Rate for Payer: CDPHP Commercial |
$53.94
|
| Rate for Payer: CDPHP Medicare |
$24.79
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$53.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$53.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$53.60
|
| Rate for Payer: EmblemHealth Medicaid |
$53.60
|
| Rate for Payer: EmblemHealth Medicare |
$22.78
|
| Rate for Payer: EmblemHealth Select Care |
$48.24
|
| Rate for Payer: Fidelis Medicare |
$25.53
|
| Rate for Payer: Galaxy Health Commercial |
$43.55
|
| Rate for Payer: Hamaspik Choice Medicare |
$24.79
|
| Rate for Payer: Humana Medicare |
$24.79
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$46.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$30.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$50.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$37.72
|
| Rate for Payer: MVP Health Care of NY Medicare |
$26.03
|
| Rate for Payer: United Healthcare Medicare |
$24.79
|
| Rate for Payer: WellCare Medicare |
$36.85
|
|
|
CATH 8709SC 1PC SUTHERLESS US TRAY MED
|
Facility
OP
|
$2,513.00
|
|
| Hospital Charge Code |
4479124
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$854.42 |
| Max. Negotiated Rate |
$2,022.96 |
| Rate for Payer: Aetna of NY Commercial |
$1,759.10
|
| Rate for Payer: Aetna of NY Medicare |
$1,155.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1,884.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,884.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$929.81
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$1,256.50
|
| Rate for Payer: Cash Price |
$1,884.75
|
| Rate for Payer: CDPHP Commercial |
$2,022.96
|
| Rate for Payer: CDPHP Medicare |
$929.81
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$2,010.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$2,010.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$2,010.40
|
| Rate for Payer: EmblemHealth Medicaid |
$2,010.40
|
| Rate for Payer: EmblemHealth Medicare |
$854.42
|
| Rate for Payer: EmblemHealth Select Care |
$1,809.36
|
| Rate for Payer: Fidelis Medicare |
$957.70
|
| Rate for Payer: Galaxy Health Commercial |
$1,633.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$929.81
|
| Rate for Payer: Humana Medicare |
$929.81
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,759.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$1,155.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,884.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$1,414.82
|
| Rate for Payer: MVP Health Care of NY Medicare |
$976.30
|
| Rate for Payer: United Healthcare Medicare |
$929.81
|
| Rate for Payer: WellCare Medicare |
$1,382.15
|
|
|
CATHETHER SECUREMENT KIT
|
Facility
OP
|
$17.00
|
|
| Hospital Charge Code |
4472216
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.78 |
| Max. Negotiated Rate |
$13.68 |
| Rate for Payer: Aetna of NY Commercial |
$11.90
|
| Rate for Payer: Aetna of NY Medicare |
$7.82
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$12.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$12.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$6.29
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$8.50
|
| Rate for Payer: Cash Price |
$12.75
|
| Rate for Payer: CDPHP Commercial |
$13.68
|
| Rate for Payer: CDPHP Medicare |
$6.29
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$13.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$13.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$13.60
|
| Rate for Payer: EmblemHealth Medicaid |
$13.60
|
| Rate for Payer: EmblemHealth Medicare |
$5.78
|
| Rate for Payer: EmblemHealth Select Care |
$12.24
|
| Rate for Payer: Fidelis Medicare |
$6.48
|
| Rate for Payer: Galaxy Health Commercial |
$11.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$6.29
|
| Rate for Payer: Humana Medicare |
$6.29
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$11.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$7.82
|
| Rate for Payer: MVP Health Care of NY Commercial |
$12.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$9.57
|
| Rate for Payer: MVP Health Care of NY Medicare |
$6.60
|
| Rate for Payer: United Healthcare Medicare |
$6.29
|
| Rate for Payer: WellCare Medicare |
$9.35
|
|
|
CATH FOLEY 14FR DOVER
|
Facility
OP
|
$54.00
|
|
| Hospital Charge Code |
4471530
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.36 |
| Max. Negotiated Rate |
$43.47 |
| Rate for Payer: Aetna of NY Commercial |
$37.80
|
| Rate for Payer: Aetna of NY Medicare |
$24.84
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$19.98
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$27.00
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: CDPHP Commercial |
$43.47
|
| Rate for Payer: CDPHP Medicare |
$19.98
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$43.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$43.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$43.20
|
| Rate for Payer: EmblemHealth Medicaid |
$43.20
|
| Rate for Payer: EmblemHealth Medicare |
$18.36
|
| Rate for Payer: EmblemHealth Select Care |
$38.88
|
| Rate for Payer: Fidelis Medicare |
$20.58
|
| Rate for Payer: Galaxy Health Commercial |
$35.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$19.98
|
| Rate for Payer: Humana Medicare |
$19.98
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$37.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$24.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$40.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$30.40
|
| Rate for Payer: MVP Health Care of NY Medicare |
$20.98
|
| Rate for Payer: United Healthcare Medicare |
$19.98
|
| Rate for Payer: WellCare Medicare |
$29.70
|
|
|
CATH FOLEY 16FR BARDEX SI
|
Facility
OP
|
$54.00
|
|
| Hospital Charge Code |
4471354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.36 |
| Max. Negotiated Rate |
$43.47 |
| Rate for Payer: Aetna of NY Commercial |
$37.80
|
| Rate for Payer: Aetna of NY Medicare |
$24.84
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$19.98
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$27.00
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: CDPHP Commercial |
$43.47
|
| Rate for Payer: CDPHP Medicare |
$19.98
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$43.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$43.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$43.20
|
| Rate for Payer: EmblemHealth Medicaid |
$43.20
|
| Rate for Payer: EmblemHealth Medicare |
$18.36
|
| Rate for Payer: EmblemHealth Select Care |
$38.88
|
| Rate for Payer: Fidelis Medicare |
$20.58
|
| Rate for Payer: Galaxy Health Commercial |
$35.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$19.98
|
| Rate for Payer: Humana Medicare |
$19.98
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$37.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$24.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$40.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$30.40
|
| Rate for Payer: MVP Health Care of NY Medicare |
$20.98
|
| Rate for Payer: United Healthcare Medicare |
$19.98
|
| Rate for Payer: WellCare Medicare |
$29.70
|
|
|
CATH FOLEY 16FR DOVER
|
Facility
OP
|
$54.00
|
|
| Hospital Charge Code |
4471546
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.36 |
| Max. Negotiated Rate |
$43.47 |
| Rate for Payer: Aetna of NY Commercial |
$37.80
|
| Rate for Payer: Aetna of NY Medicare |
$24.84
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$40.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$19.98
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$27.00
|
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: CDPHP Commercial |
$43.47
|
| Rate for Payer: CDPHP Medicare |
$19.98
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$43.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$43.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$43.20
|
| Rate for Payer: EmblemHealth Medicaid |
$43.20
|
| Rate for Payer: EmblemHealth Medicare |
$18.36
|
| Rate for Payer: EmblemHealth Select Care |
$38.88
|
| Rate for Payer: Fidelis Medicare |
$20.58
|
| Rate for Payer: Galaxy Health Commercial |
$35.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$19.98
|
| Rate for Payer: Humana Medicare |
$19.98
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$37.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$24.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$40.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$30.40
|
| Rate for Payer: MVP Health Care of NY Medicare |
$20.98
|
| Rate for Payer: United Healthcare Medicare |
$19.98
|
| Rate for Payer: WellCare Medicare |
$29.70
|
|
|
CATH FOLEY LATEX 5CC 14FR
|
Facility
OP
|
$53.00
|
|
| Hospital Charge Code |
4471448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.02 |
| Max. Negotiated Rate |
$42.66 |
| Rate for Payer: Aetna of NY Commercial |
$37.10
|
| Rate for Payer: Aetna of NY Medicare |
$24.38
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$39.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$39.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$19.61
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$26.50
|
| Rate for Payer: Cash Price |
$39.75
|
| Rate for Payer: CDPHP Commercial |
$42.66
|
| Rate for Payer: CDPHP Medicare |
$19.61
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$42.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$42.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$42.40
|
| Rate for Payer: EmblemHealth Medicaid |
$42.40
|
| Rate for Payer: EmblemHealth Medicare |
$18.02
|
| Rate for Payer: EmblemHealth Select Care |
$38.16
|
| Rate for Payer: Fidelis Medicare |
$20.20
|
| Rate for Payer: Galaxy Health Commercial |
$34.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$19.61
|
| Rate for Payer: Humana Medicare |
$19.61
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$37.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$24.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$39.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$29.84
|
| Rate for Payer: MVP Health Care of NY Medicare |
$20.59
|
| Rate for Payer: United Healthcare Medicare |
$19.61
|
| Rate for Payer: WellCare Medicare |
$29.15
|
|
|
CATH FOLEY LATEX 5CC 22FR
|
Facility
OP
|
$20.00
|
|
| Hospital Charge Code |
4471661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$16.10 |
| Rate for Payer: Aetna of NY Commercial |
$14.00
|
| Rate for Payer: Aetna of NY Medicare |
$9.20
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$15.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$15.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$7.40
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$10.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: CDPHP Commercial |
$16.10
|
| Rate for Payer: CDPHP Medicare |
$7.40
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$16.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$16.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$16.00
|
| Rate for Payer: EmblemHealth Medicaid |
$16.00
|
| Rate for Payer: EmblemHealth Medicare |
$6.80
|
| Rate for Payer: EmblemHealth Select Care |
$14.40
|
| Rate for Payer: Fidelis Medicare |
$7.62
|
| Rate for Payer: Galaxy Health Commercial |
$13.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$7.40
|
| Rate for Payer: Humana Medicare |
$7.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$14.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$9.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$15.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$11.26
|
| Rate for Payer: MVP Health Care of NY Medicare |
$7.77
|
| Rate for Payer: United Healthcare Medicare |
$7.40
|
| Rate for Payer: WellCare Medicare |
$11.00
|
|
|
CATH INDW FOLEY 3 WAY
|
Facility
OP
|
$57.00
|
|
|
Service Code
|
HCPCS A4346
|
| Hospital Charge Code |
4600271
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna of NY Commercial |
$39.90
|
| Rate for Payer: Aetna of NY Medicare |
$26.22
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$42.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$42.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$21.09
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$28.50
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: CDPHP Commercial |
$45.88
|
| Rate for Payer: CDPHP Medicare |
$21.09
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$45.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$45.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$45.60
|
| Rate for Payer: EmblemHealth Medicaid |
$45.60
|
| Rate for Payer: EmblemHealth Medicare |
$19.38
|
| Rate for Payer: EmblemHealth Select Care |
$41.04
|
| Rate for Payer: Fidelis Medicare |
$21.72
|
| Rate for Payer: Galaxy Health Commercial |
$37.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$21.09
|
| Rate for Payer: Humana Medicare |
$21.09
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$39.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$26.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$42.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$32.09
|
| Rate for Payer: MVP Health Care of NY Medicare |
$22.14
|
| Rate for Payer: United Healthcare Medicare |
$21.09
|
| Rate for Payer: WellCare Medicare |
$31.35
|
|
|
CATH TROCAR 20FR 16"L
|
Facility
OP
|
$1,346.00
|
|
| Hospital Charge Code |
4471343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$457.64 |
| Max. Negotiated Rate |
$1,083.53 |
| Rate for Payer: Aetna of NY Commercial |
$942.20
|
| Rate for Payer: Aetna of NY Medicare |
$619.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$498.02
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$673.00
|
| Rate for Payer: Cash Price |
$1,009.50
|
| Rate for Payer: CDPHP Commercial |
$1,083.53
|
| Rate for Payer: CDPHP Medicare |
$498.02
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicaid |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicare |
$457.64
|
| Rate for Payer: EmblemHealth Select Care |
$969.12
|
| Rate for Payer: Fidelis Medicare |
$512.96
|
| Rate for Payer: Galaxy Health Commercial |
$874.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$498.02
|
| Rate for Payer: Humana Medicare |
$498.02
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$942.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$619.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,009.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$757.80
|
| Rate for Payer: MVP Health Care of NY Medicare |
$522.92
|
| Rate for Payer: United Healthcare Medicare |
$498.02
|
| Rate for Payer: WellCare Medicare |
$740.30
|
|
|
CATH TROCAR 24FR 16"L
|
Facility
OP
|
$1,346.00
|
|
| Hospital Charge Code |
4471345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$457.64 |
| Max. Negotiated Rate |
$1,083.53 |
| Rate for Payer: Aetna of NY Commercial |
$942.20
|
| Rate for Payer: Aetna of NY Medicare |
$619.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$498.02
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$673.00
|
| Rate for Payer: Cash Price |
$1,009.50
|
| Rate for Payer: CDPHP Commercial |
$1,083.53
|
| Rate for Payer: CDPHP Medicare |
$498.02
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicaid |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicare |
$457.64
|
| Rate for Payer: EmblemHealth Select Care |
$969.12
|
| Rate for Payer: Fidelis Medicare |
$512.96
|
| Rate for Payer: Galaxy Health Commercial |
$874.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$498.02
|
| Rate for Payer: Humana Medicare |
$498.02
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$942.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$619.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,009.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$757.80
|
| Rate for Payer: MVP Health Care of NY Medicare |
$522.92
|
| Rate for Payer: United Healthcare Medicare |
$498.02
|
| Rate for Payer: WellCare Medicare |
$740.30
|
|
|
CATH TROCAR 28FR 16"L
|
Facility
OP
|
$1,346.00
|
|
| Hospital Charge Code |
4471346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$457.64 |
| Max. Negotiated Rate |
$1,083.53 |
| Rate for Payer: Aetna of NY Commercial |
$942.20
|
| Rate for Payer: Aetna of NY Medicare |
$619.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$498.02
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$673.00
|
| Rate for Payer: Cash Price |
$1,009.50
|
| Rate for Payer: CDPHP Commercial |
$1,083.53
|
| Rate for Payer: CDPHP Medicare |
$498.02
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicaid |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicare |
$457.64
|
| Rate for Payer: EmblemHealth Select Care |
$969.12
|
| Rate for Payer: Fidelis Medicare |
$512.96
|
| Rate for Payer: Galaxy Health Commercial |
$874.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$498.02
|
| Rate for Payer: Humana Medicare |
$498.02
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$942.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$619.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,009.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$757.80
|
| Rate for Payer: MVP Health Care of NY Medicare |
$522.92
|
| Rate for Payer: United Healthcare Medicare |
$498.02
|
| Rate for Payer: WellCare Medicare |
$740.30
|
|
|
CATH URETHRAL TRAY
|
Facility
OP
|
$10.00
|
|
| Hospital Charge Code |
4471746
|
|
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
|
|
|
CAUTERY HIGH TEMP FINE TIP
|
Facility
OP
|
$32.00
|
|
| Hospital Charge Code |
4471284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$25.76 |
| Rate for Payer: Aetna of NY Commercial |
$22.40
|
| Rate for Payer: Aetna of NY Medicare |
$14.72
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$24.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$24.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$11.84
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$16.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: CDPHP Commercial |
$25.76
|
| Rate for Payer: CDPHP Medicare |
$11.84
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$25.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$25.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$25.60
|
| Rate for Payer: EmblemHealth Medicaid |
$25.60
|
| Rate for Payer: EmblemHealth Medicare |
$10.88
|
| Rate for Payer: EmblemHealth Select Care |
$23.04
|
| Rate for Payer: Fidelis Medicare |
$12.20
|
| Rate for Payer: Galaxy Health Commercial |
$20.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$11.84
|
| Rate for Payer: Humana Medicare |
$11.84
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$14.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$24.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$18.02
|
| Rate for Payer: MVP Health Care of NY Medicare |
$12.43
|
| Rate for Payer: United Healthcare Medicare |
$11.84
|
| Rate for Payer: WellCare Medicare |
$17.60
|
|
|
CAUTERY LOW TEMP FINE TIP
|
Facility
OP
|
$24.00
|
|
| Hospital Charge Code |
4471274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.16 |
| Max. Negotiated Rate |
$19.32 |
| Rate for Payer: Aetna of NY Commercial |
$16.80
|
| Rate for Payer: Aetna of NY Medicare |
$11.04
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$8.88
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$12.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: CDPHP Commercial |
$19.32
|
| Rate for Payer: CDPHP Medicare |
$8.88
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$19.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$19.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$19.20
|
| Rate for Payer: EmblemHealth Medicaid |
$19.20
|
| Rate for Payer: EmblemHealth Medicare |
$8.16
|
| Rate for Payer: EmblemHealth Select Care |
$17.28
|
| Rate for Payer: Fidelis Medicare |
$9.15
|
| Rate for Payer: Galaxy Health Commercial |
$15.60
|
| Rate for Payer: Hamaspik Choice Medicare |
$8.88
|
| Rate for Payer: Humana Medicare |
$8.88
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$16.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$11.04
|
| Rate for Payer: MVP Health Care of NY Commercial |
$18.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$13.51
|
| Rate for Payer: MVP Health Care of NY Medicare |
$9.32
|
| Rate for Payer: United Healthcare Medicare |
$8.88
|
| Rate for Payer: WellCare Medicare |
$13.20
|
|
|
CAUTERY PAD
|
Facility
OP
|
$11.00
|
|
| Hospital Charge Code |
4479188
|
|
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
|
|
|
CAUTERY PENCIL
|
Facility
OP
|
$20.00
|
|
| Hospital Charge Code |
4479186
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$16.10 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$7.40
|
| Rate for Payer: Aetna of NY Commercial |
$14.00
|
| Rate for Payer: Aetna of NY Medicare |
$9.20
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$15.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$15.00
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$10.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: CDPHP Commercial |
$16.10
|
| Rate for Payer: CDPHP Medicare |
$7.40
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$16.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$16.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$16.00
|
| Rate for Payer: EmblemHealth Medicaid |
$16.00
|
| Rate for Payer: EmblemHealth Medicare |
$6.80
|
| Rate for Payer: EmblemHealth Select Care |
$14.40
|
| Rate for Payer: Fidelis Medicare |
$7.62
|
| Rate for Payer: Galaxy Health Commercial |
$13.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$7.40
|
| Rate for Payer: Humana Medicare |
$7.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$14.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$9.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$15.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$11.26
|
| Rate for Payer: MVP Health Care of NY Medicare |
$7.77
|
| Rate for Payer: United Healthcare Medicare |
$7.40
|
| Rate for Payer: WellCare Medicare |
$11.00
|
|
|
CBC WITH DIFF (AUTO)
|
Facility
OP
|
$43.00
|
|
|
Service Code
|
HCPCS 85025
|
| Hospital Charge Code |
4300161
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$34.62 |
| Rate for Payer: Aetna of NY Commercial |
$27.95
|
| Rate for Payer: Aetna of NY Medicare |
$19.78
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$32.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$32.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$15.91
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$21.50
|
| Rate for Payer: Cash Price |
$32.25
|
| Rate for Payer: Cash Price |
$32.25
|
| Rate for Payer: CDPHP Commercial |
$34.62
|
| Rate for Payer: CDPHP Medicare |
$15.91
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$34.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$34.40
|
| Rate for Payer: EmblemHealth Medicaid |
$34.40
|
| Rate for Payer: EmblemHealth Medicare |
$14.62
|
| Rate for Payer: Fidelis Medicare |
$16.39
|
| Rate for Payer: Galaxy Health Commercial |
$27.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$15.91
|
| Rate for Payer: Humana Medicare |
$15.91
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$27.95
|
| Rate for Payer: Local 1199SEIU Medicare |
$19.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$32.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$24.21
|
| Rate for Payer: MVP Health Care of NY Medicare |
$16.71
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$32.25
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$3.20
|
| Rate for Payer: United Healthcare Commercial |
$32.25
|
| Rate for Payer: United Healthcare Medicare |
$15.91
|
| Rate for Payer: WellCare Medicare |
$23.65
|
|
|
CBI CONT BLADDER IRRIG
|
Facility
OP
|
$707.00
|
|
|
Service Code
|
HCPCS 51700
|
| Hospital Charge Code |
4602143
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$235.48 |
| Max. Negotiated Rate |
$1,189.18 |
| Rate for Payer: Aetna of NY Commercial |
$955.00
|
| Rate for Payer: Aetna of NY Medicare |
$325.22
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$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 |
$261.59
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$353.50
|
| Rate for Payer: Cash Price |
$530.25
|
| 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 CBP/EPO/PPO/HMO/Network Access |
$1,182.00
|
| 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: EmblemHealth Select Care |
$1,064.00
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$250.00
|
| 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 |
$955.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$325.22
|
| 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 |
$274.67
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$980.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$235.48
|
| Rate for Payer: United Healthcare Commercial |
$980.00
|
| Rate for Payer: United Healthcare Medicare |
$261.59
|
| Rate for Payer: WellCare Medicare |
$388.85
|
|
|
CDC 2019 NOVEL CORONAVIRUS (2019-NCOV) REAL-TIME RT-PCR DIAGNOSTIC PANEL
|
Facility
OP
|
$115.00
|
|
|
Service Code
|
HCPCS U0001
|
| Hospital Charge Code |
4302019
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$92.58 |
| Rate for Payer: Aetna of NY Commercial |
$74.75
|
| Rate for Payer: Aetna of NY Medicare |
$52.90
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$86.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$86.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$42.55
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$57.50
|
| Rate for Payer: Cash Price |
$86.25
|
| Rate for Payer: Cash Price |
$86.25
|
| Rate for Payer: CDPHP Commercial |
$92.58
|
| Rate for Payer: CDPHP Medicare |
$42.55
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$92.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$92.00
|
| Rate for Payer: EmblemHealth Medicaid |
$92.00
|
| Rate for Payer: EmblemHealth Medicare |
$39.10
|
| Rate for Payer: Fidelis Medicare |
$43.83
|
| Rate for Payer: Galaxy Health Commercial |
$74.75
|
| Rate for Payer: Hamaspik Choice Medicare |
$42.55
|
| Rate for Payer: Humana Medicare |
$42.55
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$74.75
|
| Rate for Payer: Local 1199SEIU Medicare |
$52.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$86.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$64.74
|
| Rate for Payer: MVP Health Care of NY Medicare |
$44.68
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$86.25
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$35.92
|
| Rate for Payer: United Healthcare Commercial |
$86.25
|
| Rate for Payer: United Healthcare Medicare |
$42.55
|
| Rate for Payer: WellCare Medicare |
$63.25
|
|
|
C-DIFFICILE TOXIN
|
Facility
OP
|
$129.00
|
|
|
Service Code
|
HCPCS 87449
|
| Hospital Charge Code |
4300162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$103.84 |
| Rate for Payer: Aetna of NY Commercial |
$83.85
|
| Rate for Payer: Aetna of NY Medicare |
$59.34
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$96.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$96.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$47.73
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$64.50
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: CDPHP Commercial |
$103.84
|
| Rate for Payer: CDPHP Medicare |
$47.73
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$103.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$103.20
|
| Rate for Payer: EmblemHealth Medicaid |
$103.20
|
| Rate for Payer: EmblemHealth Medicare |
$43.86
|
| Rate for Payer: Fidelis Medicare |
$49.16
|
| Rate for Payer: Galaxy Health Commercial |
$83.85
|
| Rate for Payer: Hamaspik Choice Medicare |
$47.73
|
| Rate for Payer: Humana Medicare |
$47.73
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$83.85
|
| Rate for Payer: Local 1199SEIU Medicare |
$59.34
|
| Rate for Payer: MVP Health Care of NY Commercial |
$96.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$72.63
|
| Rate for Payer: MVP Health Care of NY Medicare |
$50.12
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$96.75
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$5.25
|
| Rate for Payer: United Healthcare Commercial |
$96.75
|
| Rate for Payer: United Healthcare Medicare |
$47.73
|
| Rate for Payer: WellCare Medicare |
$70.95
|
|
|
CEA
|
Facility
OP
|
$99.00
|
|
|
Service Code
|
HCPCS 82378
|
| Hospital Charge Code |
4300163
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$79.70 |
| Rate for Payer: Aetna of NY Commercial |
$64.35
|
| Rate for Payer: Aetna of NY Medicare |
$45.54
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$74.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$74.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$36.63
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$49.50
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: CDPHP Commercial |
$79.70
|
| Rate for Payer: CDPHP Medicare |
$36.63
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$79.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$79.20
|
| Rate for Payer: EmblemHealth Medicaid |
$79.20
|
| Rate for Payer: EmblemHealth Medicare |
$33.66
|
| Rate for Payer: Fidelis Medicare |
$37.73
|
| Rate for Payer: Galaxy Health Commercial |
$64.35
|
| Rate for Payer: Hamaspik Choice Medicare |
$36.63
|
| Rate for Payer: Humana Medicare |
$36.63
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$64.35
|
| Rate for Payer: Local 1199SEIU Medicare |
$45.54
|
| Rate for Payer: MVP Health Care of NY Commercial |
$74.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$55.74
|
| Rate for Payer: MVP Health Care of NY Medicare |
$38.46
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$74.25
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$18.96
|
| Rate for Payer: United Healthcare Commercial |
$74.25
|
| Rate for Payer: United Healthcare Medicare |
$36.63
|
| Rate for Payer: WellCare Medicare |
$54.45
|
|
