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Service Code HCPCS 95992 GP,59
Hospital Charge Code 4650391
Hospital Revenue Code 420
Min. Negotiated Rate $84.50
Max. Negotiated Rate $84.50
Rate for Payer: Cash Price $97.50
Rate for Payer: Galaxy Health Commercial $84.50
Service Code HCPCS 95992 GP,59,KX
Hospital Charge Code 4650443
Hospital Revenue Code 420
Min. Negotiated Rate $44.20
Max. Negotiated Rate $179.00
Rate for Payer: Aetna of NY Commercial $112.00
Rate for Payer: Aetna of NY Medicare $59.80
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $97.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $97.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $48.10
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $108.00
Rate for Payer: Cash Price $97.50
Rate for Payer: Cash Price $97.50
Rate for Payer: Cash Price $97.50
Rate for Payer: CDPHP Commercial $104.65
Rate for Payer: CDPHP Medicare $48.10
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $104.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $104.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $104.00
Rate for Payer: EmblemHealth Medicaid $104.00
Rate for Payer: EmblemHealth Medicare $44.20
Rate for Payer: EmblemHealth Select Care $93.60
Rate for Payer: Fidelis Medicare $49.54
Rate for Payer: Galaxy Health Commercial $84.50
Rate for Payer: Hamaspik Choice Medicare $48.10
Rate for Payer: Humana Medicare $48.10
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $112.00
Rate for Payer: Local 1199SEIU Medicare $59.80
Rate for Payer: MVP Health Care of NY Commercial $179.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $134.00
Rate for Payer: MVP Health Care of NY Medicare $50.50
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $156.00
Rate for Payer: United Healthcare Commercial $156.00
Rate for Payer: United Healthcare Medicare $48.10
Rate for Payer: WellCare Medicare $71.50
Service Code HCPCS 95992 GP,59,KX
Hospital Charge Code 4650443
Hospital Revenue Code 420
Min. Negotiated Rate $84.50
Max. Negotiated Rate $84.50
Rate for Payer: Cash Price $97.50
Rate for Payer: Galaxy Health Commercial $84.50
Service Code HCPCS 95992 GP,KX
Hospital Charge Code 4650339
Hospital Revenue Code 420
Min. Negotiated Rate $44.20
Max. Negotiated Rate $179.00
Rate for Payer: Aetna of NY Commercial $112.00
Rate for Payer: Aetna of NY Medicare $59.80
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $97.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $97.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $48.10
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $108.00
Rate for Payer: Cash Price $97.50
Rate for Payer: Cash Price $97.50
Rate for Payer: Cash Price $97.50
Rate for Payer: CDPHP Commercial $104.65
Rate for Payer: CDPHP Medicare $48.10
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $104.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $104.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $104.00
Rate for Payer: EmblemHealth Medicaid $104.00
Rate for Payer: EmblemHealth Medicare $44.20
Rate for Payer: EmblemHealth Select Care $93.60
Rate for Payer: Fidelis Medicare $49.54
Rate for Payer: Galaxy Health Commercial $84.50
Rate for Payer: Hamaspik Choice Medicare $48.10
Rate for Payer: Humana Medicare $48.10
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $112.00
Rate for Payer: Local 1199SEIU Medicare $59.80
Rate for Payer: MVP Health Care of NY Commercial $179.00
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $134.00
Rate for Payer: MVP Health Care of NY Medicare $50.50
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $156.00
Rate for Payer: United Healthcare Commercial $156.00
Rate for Payer: United Healthcare Medicare $48.10
Rate for Payer: WellCare Medicare $71.50
Service Code HCPCS 95992 GP,KX
Hospital Charge Code 4650339
Hospital Revenue Code 420
Min. Negotiated Rate $84.50
Max. Negotiated Rate $84.50
Rate for Payer: Cash Price $97.50
Rate for Payer: Galaxy Health Commercial $84.50
Hospital Charge Code 4602606
Hospital Revenue Code 270
Min. Negotiated Rate $12.92
Max. Negotiated Rate $30.59
Rate for Payer: Aetna of NY Commercial $26.60
Rate for Payer: Aetna of NY Medicare $17.48
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $28.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $28.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $14.06
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $19.00
Rate for Payer: Cash Price $28.50
Rate for Payer: CDPHP Commercial $30.59
Rate for Payer: CDPHP Medicare $14.06
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $30.40
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $30.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $30.40
Rate for Payer: EmblemHealth Medicaid $30.40
Rate for Payer: EmblemHealth Medicare $12.92
Rate for Payer: EmblemHealth Select Care $27.36
Rate for Payer: Fidelis Medicare $14.48
Rate for Payer: Galaxy Health Commercial $24.70
Rate for Payer: Hamaspik Choice Medicare $14.06
Rate for Payer: Humana Medicare $14.06
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $26.60
Rate for Payer: Local 1199SEIU Medicare $17.48
Rate for Payer: MVP Health Care of NY Commercial $28.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $21.39
Rate for Payer: MVP Health Care of NY Medicare $14.76
Rate for Payer: United Healthcare Medicare $14.06
Rate for Payer: WellCare Medicare $20.90
Hospital Charge Code 4479076
Hospital Revenue Code 270
Min. Negotiated Rate $24.70
Max. Negotiated Rate $24.70
Rate for Payer: Cash Price $28.50
Rate for Payer: Galaxy Health Commercial $24.70
Hospital Charge Code 4479076
Hospital Revenue Code 270
Min. Negotiated Rate $12.92
Max. Negotiated Rate $30.59
Rate for Payer: Aetna of NY Commercial $26.60
Rate for Payer: Aetna of NY Medicare $17.48
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $28.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $28.50
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $14.06
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $19.00
Rate for Payer: Cash Price $28.50
Rate for Payer: CDPHP Commercial $30.59
Rate for Payer: CDPHP Medicare $14.06
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $30.40
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $30.40
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $30.40
Rate for Payer: EmblemHealth Medicaid $30.40
Rate for Payer: EmblemHealth Medicare $12.92
Rate for Payer: EmblemHealth Select Care $27.36
Rate for Payer: Fidelis Medicare $14.48
Rate for Payer: Galaxy Health Commercial $24.70
Rate for Payer: Hamaspik Choice Medicare $14.06
Rate for Payer: Humana Medicare $14.06
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $26.60
Rate for Payer: Local 1199SEIU Medicare $17.48
Rate for Payer: MVP Health Care of NY Commercial $28.50
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $21.39
Rate for Payer: MVP Health Care of NY Medicare $14.76
Rate for Payer: United Healthcare Medicare $14.06
Rate for Payer: WellCare Medicare $20.90
Hospital Charge Code 4602606
Hospital Revenue Code 270
Min. Negotiated Rate $24.70
Max. Negotiated Rate $24.70
Rate for Payer: Cash Price $28.50
Rate for Payer: Galaxy Health Commercial $24.70
Hospital Charge Code 4479216
Hospital Revenue Code 270
Min. Negotiated Rate $270.30
Max. Negotiated Rate $639.98
Rate for Payer: Aetna of NY Commercial $556.50
Rate for Payer: Aetna of NY Medicare $365.70
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $596.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $596.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $294.15
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $397.50
Rate for Payer: Cash Price $596.25
Rate for Payer: CDPHP Commercial $639.98
Rate for Payer: CDPHP Medicare $294.15
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $636.00
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $636.00
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $636.00
Rate for Payer: EmblemHealth Medicaid $636.00
Rate for Payer: EmblemHealth Medicare $270.30
Rate for Payer: EmblemHealth Select Care $572.40
Rate for Payer: Fidelis Medicare $302.97
Rate for Payer: Galaxy Health Commercial $516.75
Rate for Payer: Hamaspik Choice Medicare $294.15
Rate for Payer: Humana Medicare $294.15
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $556.50
Rate for Payer: Local 1199SEIU Medicare $365.70
Rate for Payer: MVP Health Care of NY Commercial $596.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $447.58
Rate for Payer: MVP Health Care of NY Medicare $308.86
Rate for Payer: United Healthcare Medicare $294.15
Rate for Payer: WellCare Medicare $437.25
Hospital Charge Code 4479216
Hospital Revenue Code 270
Min. Negotiated Rate $516.75
Max. Negotiated Rate $516.75
Rate for Payer: Cash Price $596.25
Rate for Payer: Galaxy Health Commercial $516.75
Hospital Charge Code 4479273
Hospital Revenue Code 270
Min. Negotiated Rate $26.86
Max. Negotiated Rate $63.60
Rate for Payer: Aetna of NY Commercial $55.30
Rate for Payer: Aetna of NY Medicare $36.34
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $59.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $59.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $29.23
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $39.50
Rate for Payer: Cash Price $59.25
Rate for Payer: CDPHP Commercial $63.60
Rate for Payer: CDPHP Medicare $29.23
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $63.20
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $63.20
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $63.20
Rate for Payer: EmblemHealth Medicaid $63.20
Rate for Payer: EmblemHealth Medicare $26.86
Rate for Payer: EmblemHealth Select Care $56.88
Rate for Payer: Fidelis Medicare $30.11
Rate for Payer: Galaxy Health Commercial $51.35
Rate for Payer: Hamaspik Choice Medicare $29.23
Rate for Payer: Humana Medicare $29.23
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $55.30
Rate for Payer: Local 1199SEIU Medicare $36.34
Rate for Payer: MVP Health Care of NY Commercial $59.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $44.48
Rate for Payer: MVP Health Care of NY Medicare $30.69
Rate for Payer: United Healthcare Medicare $29.23
Rate for Payer: WellCare Medicare $43.45
Hospital Charge Code 4479273
Hospital Revenue Code 270
Min. Negotiated Rate $51.35
Max. Negotiated Rate $51.35
Rate for Payer: Cash Price $59.25
Rate for Payer: Galaxy Health Commercial $51.35
Hospital Charge Code 4471352
Hospital Revenue Code 270
Min. Negotiated Rate $818.38
Max. Negotiated Rate $1,937.64
Rate for Payer: Aetna of NY Commercial $1,684.90
Rate for Payer: Aetna of NY Medicare $1,107.22
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $1,805.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $1,805.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $890.59
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $1,203.50
Rate for Payer: Cash Price $1,805.25
Rate for Payer: CDPHP Commercial $1,937.64
Rate for Payer: CDPHP Medicare $890.59
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $1,925.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $1,925.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $1,925.60
Rate for Payer: EmblemHealth Medicaid $1,925.60
Rate for Payer: EmblemHealth Medicare $818.38
Rate for Payer: EmblemHealth Select Care $1,733.04
Rate for Payer: Fidelis Medicare $917.31
Rate for Payer: Galaxy Health Commercial $1,564.55
Rate for Payer: Hamaspik Choice Medicare $890.59
Rate for Payer: Humana Medicare $890.59
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $1,684.90
Rate for Payer: Local 1199SEIU Medicare $1,107.22
Rate for Payer: MVP Health Care of NY Commercial $1,805.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $1,355.14
Rate for Payer: MVP Health Care of NY Medicare $935.12
Rate for Payer: United Healthcare Medicare $890.59
Rate for Payer: WellCare Medicare $1,323.85
Hospital Charge Code 4471352
Hospital Revenue Code 270
Min. Negotiated Rate $1,564.55
Max. Negotiated Rate $1,564.55
Rate for Payer: Cash Price $1,805.25
Rate for Payer: Galaxy Health Commercial $1,564.55
Hospital Charge Code 4471351
Hospital Revenue Code 270
Min. Negotiated Rate $818.38
Max. Negotiated Rate $1,937.64
Rate for Payer: Aetna of NY Commercial $1,684.90
Rate for Payer: Aetna of NY Medicare $1,107.22
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $1,805.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $1,805.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $890.59
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $1,203.50
Rate for Payer: Cash Price $1,805.25
Rate for Payer: CDPHP Commercial $1,937.64
Rate for Payer: CDPHP Medicare $890.59
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $1,925.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $1,925.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $1,925.60
Rate for Payer: EmblemHealth Medicaid $1,925.60
Rate for Payer: EmblemHealth Medicare $818.38
Rate for Payer: EmblemHealth Select Care $1,733.04
Rate for Payer: Fidelis Medicare $917.31
Rate for Payer: Galaxy Health Commercial $1,564.55
Rate for Payer: Hamaspik Choice Medicare $890.59
Rate for Payer: Humana Medicare $890.59
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $1,684.90
Rate for Payer: Local 1199SEIU Medicare $1,107.22
Rate for Payer: MVP Health Care of NY Commercial $1,805.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $1,355.14
Rate for Payer: MVP Health Care of NY Medicare $935.12
Rate for Payer: United Healthcare Medicare $890.59
Rate for Payer: WellCare Medicare $1,323.85
Hospital Charge Code 4471351
Hospital Revenue Code 270
Min. Negotiated Rate $1,564.55
Max. Negotiated Rate $1,564.55
Rate for Payer: Cash Price $1,805.25
Rate for Payer: Galaxy Health Commercial $1,564.55
Hospital Charge Code 4471350
Hospital Revenue Code 270
Min. Negotiated Rate $818.38
Max. Negotiated Rate $1,937.64
Rate for Payer: Aetna of NY Commercial $1,684.90
Rate for Payer: Aetna of NY Medicare $1,107.22
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $1,805.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $1,805.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $890.59
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $1,203.50
Rate for Payer: Cash Price $1,805.25
Rate for Payer: CDPHP Commercial $1,937.64
Rate for Payer: CDPHP Medicare $890.59
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $1,925.60
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $1,925.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $1,925.60
Rate for Payer: EmblemHealth Medicaid $1,925.60
Rate for Payer: EmblemHealth Medicare $818.38
Rate for Payer: EmblemHealth Select Care $1,733.04
Rate for Payer: Fidelis Medicare $917.31
Rate for Payer: Galaxy Health Commercial $1,564.55
Rate for Payer: Hamaspik Choice Medicare $890.59
Rate for Payer: Humana Medicare $890.59
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $1,684.90
Rate for Payer: Local 1199SEIU Medicare $1,107.22
Rate for Payer: MVP Health Care of NY Commercial $1,805.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $1,355.14
Rate for Payer: MVP Health Care of NY Medicare $935.12
Rate for Payer: United Healthcare Medicare $890.59
Rate for Payer: WellCare Medicare $1,323.85
Hospital Charge Code 4471350
Hospital Revenue Code 270
Min. Negotiated Rate $1,564.55
Max. Negotiated Rate $1,564.55
Rate for Payer: Cash Price $1,805.25
Rate for Payer: Galaxy Health Commercial $1,564.55
Service Code NDC 51079086301
Hospital Charge Code 4400128
Hospital Revenue Code 250
Min. Negotiated Rate $2.10
Max. Negotiated Rate $4.97
Rate for Payer: Aetna of NY Commercial $4.33
Rate for Payer: Aetna of NY Medicare $2.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.64
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.64
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $2.29
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $3.09
Rate for Payer: Cash Price $4.64
Rate for Payer: CDPHP Commercial $4.97
Rate for Payer: CDPHP Medicare $2.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.94
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $4.94
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $4.94
Rate for Payer: EmblemHealth Medicaid $4.94
Rate for Payer: EmblemHealth Medicare $2.10
Rate for Payer: EmblemHealth Select Care $4.45
Rate for Payer: Fidelis Medicare $2.36
Rate for Payer: Galaxy Health Commercial $4.02
Rate for Payer: Hamaspik Choice Medicare $2.29
Rate for Payer: Humana Medicare $2.29
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $4.33
Rate for Payer: Local 1199SEIU Medicare $2.84
Rate for Payer: MVP Health Care of NY Commercial $4.64
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $3.48
Rate for Payer: MVP Health Care of NY Medicare $2.40
Rate for Payer: United Healthcare Medicare $2.29
Rate for Payer: WellCare Medicare $3.40
Service Code NDC 51079086301
Hospital Charge Code 4400128
Hospital Revenue Code 250
Min. Negotiated Rate $3.40
Max. Negotiated Rate $4.02
Rate for Payer: Cash Price $4.64
Rate for Payer: Galaxy Health Commercial $4.02
Rate for Payer: WellCare Medicare $3.40
Service Code HCPCS 78708
Hospital Charge Code 4210034
Hospital Revenue Code 341
Min. Negotiated Rate $1,005.55
Max. Negotiated Rate $1,005.55
Rate for Payer: Cash Price $1,160.25
Rate for Payer: Galaxy Health Commercial $1,005.55
Service Code HCPCS 78708
Hospital Charge Code 4210034
Hospital Revenue Code 341
Min. Negotiated Rate $101.00
Max. Negotiated Rate $1,500.00
Rate for Payer: Aetna of NY Commercial $1,082.90
Rate for Payer: Aetna of NY Medicare $711.62
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $1,160.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $1,160.25
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $572.39
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $773.50
Rate for Payer: Cash Price $1,160.25
Rate for Payer: Cash Price $1,160.25
Rate for Payer: CDPHP Commercial $1,245.34
Rate for Payer: CDPHP Medicare $572.39
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $1,082.90
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $1,237.60
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $1,237.60
Rate for Payer: EmblemHealth Medicaid $1,237.60
Rate for Payer: EmblemHealth Medicare $525.98
Rate for Payer: EmblemHealth Select Care $1,005.55
Rate for Payer: Fidelis Medicare $589.56
Rate for Payer: Galaxy Health Commercial $1,005.55
Rate for Payer: Hamaspik Choice Medicare $572.39
Rate for Payer: Humana Medicare $572.39
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $1,082.90
Rate for Payer: Local 1199SEIU Medicare $711.62
Rate for Payer: MVP Health Care of NY Commercial $1,160.25
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $870.96
Rate for Payer: MVP Health Care of NY Medicare $601.01
Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro $1,500.00
Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid $101.00
Rate for Payer: United Healthcare Commercial $1,500.00
Rate for Payer: United Healthcare Medicare $572.39
Rate for Payer: WellCare Medicare $850.85
Service Code NDC 00904617261
Hospital Charge Code 4400131
Hospital Revenue Code 250
Min. Negotiated Rate $2.10
Max. Negotiated Rate $4.97
Rate for Payer: Aetna of NY Commercial $4.33
Rate for Payer: Aetna of NY Medicare $2.84
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group $4.64
Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO $4.64
Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare $2.29
Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp $3.09
Rate for Payer: Cash Price $4.64
Rate for Payer: CDPHP Commercial $4.97
Rate for Payer: CDPHP Medicare $2.29
Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access $4.94
Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 $4.94
Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 $4.94
Rate for Payer: EmblemHealth Medicaid $4.94
Rate for Payer: EmblemHealth Medicare $2.10
Rate for Payer: EmblemHealth Select Care $4.45
Rate for Payer: Fidelis Medicare $2.36
Rate for Payer: Galaxy Health Commercial $4.02
Rate for Payer: Hamaspik Choice Medicare $2.29
Rate for Payer: Humana Medicare $2.29
Rate for Payer: Local 1199SEIU Aetna Signature Administrators $4.33
Rate for Payer: Local 1199SEIU Medicare $2.84
Rate for Payer: MVP Health Care of NY Commercial $4.64
Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan $3.48
Rate for Payer: MVP Health Care of NY Medicare $2.40
Rate for Payer: United Healthcare Medicare $2.29
Rate for Payer: WellCare Medicare $3.40
Service Code NDC 00904617261
Hospital Charge Code 4400131
Hospital Revenue Code 250
Min. Negotiated Rate $3.40
Max. Negotiated Rate $4.02
Rate for Payer: Cash Price $4.64
Rate for Payer: Galaxy Health Commercial $4.02
Rate for Payer: WellCare Medicare $3.40