|
CULTURE CSF
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4300237
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$27.37 |
| Rate for Payer: Aetna of NY Commercial |
$22.10
|
| Rate for Payer: Aetna of NY Medicare |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$12.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$17.00
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: CDPHP Commercial |
$27.37
|
| Rate for Payer: CDPHP Medicare |
$12.58
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$20.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.20
|
| Rate for Payer: EmblemHealth Medicaid |
$27.20
|
| Rate for Payer: EmblemHealth Medicare |
$11.56
|
| Rate for Payer: EmblemHealth Select Care |
$20.40
|
| Rate for Payer: Fidelis Medicare |
$12.96
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$19.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.21
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$25.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.23
|
| Rate for Payer: United Healthcare Commercial |
$25.50
|
| Rate for Payer: United Healthcare Medicare |
$12.58
|
| Rate for Payer: WellCare Medicare |
$18.70
|
|
|
CULTURE FLUID
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4300238
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.10 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
|
|
CULTURE FLUID
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4300238
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$27.37 |
| Rate for Payer: Aetna of NY Commercial |
$22.10
|
| Rate for Payer: Aetna of NY Medicare |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$12.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$17.00
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: CDPHP Commercial |
$27.37
|
| Rate for Payer: CDPHP Medicare |
$12.58
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$20.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.20
|
| Rate for Payer: EmblemHealth Medicaid |
$27.20
|
| Rate for Payer: EmblemHealth Medicare |
$11.56
|
| Rate for Payer: EmblemHealth Select Care |
$20.40
|
| Rate for Payer: Fidelis Medicare |
$12.96
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$19.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.21
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$25.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.23
|
| Rate for Payer: United Healthcare Commercial |
$25.50
|
| Rate for Payer: United Healthcare Medicare |
$12.58
|
| Rate for Payer: WellCare Medicare |
$18.70
|
|
|
CULTURE G C
|
Facility
|
OP
|
$27.00
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
4300240
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$21.74 |
| Rate for Payer: Aetna of NY Commercial |
$17.55
|
| Rate for Payer: Aetna of NY Medicare |
$12.42
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$20.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$20.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$9.99
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$13.50
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: CDPHP Commercial |
$21.74
|
| Rate for Payer: CDPHP Medicare |
$9.99
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$16.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$21.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$21.60
|
| Rate for Payer: EmblemHealth Medicaid |
$21.60
|
| Rate for Payer: EmblemHealth Medicare |
$9.18
|
| Rate for Payer: EmblemHealth Select Care |
$16.20
|
| Rate for Payer: Fidelis Medicare |
$10.29
|
| Rate for Payer: Galaxy Health Commercial |
$17.55
|
| Rate for Payer: Hamaspik Choice Medicare |
$9.99
|
| Rate for Payer: Humana Medicare |
$9.99
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$17.55
|
| Rate for Payer: Local 1199SEIU Medicare |
$12.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$20.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$15.20
|
| Rate for Payer: MVP Health Care of NY Medicare |
$10.49
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$20.25
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$5.25
|
| Rate for Payer: United Healthcare Commercial |
$20.25
|
| Rate for Payer: United Healthcare Medicare |
$9.99
|
| Rate for Payer: WellCare Medicare |
$14.85
|
|
|
CULTURE G C
|
Facility
|
IP
|
$27.00
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
4300240
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.55 |
| Max. Negotiated Rate |
$17.55 |
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Galaxy Health Commercial |
$17.55
|
|
|
CULTURELLE HEALTH-WELLNESS CAP 1 ea, 30 eaches
|
Facility
|
IP
|
$1.50
|
|
|
Service Code
|
NDC 49100036404
|
| Hospital Charge Code |
4401300
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.83 |
| Max. Negotiated Rate |
$0.98 |
| Rate for Payer: Cash Price |
$1.13
|
| Rate for Payer: Galaxy Health Commercial |
$0.98
|
| Rate for Payer: WellCare Medicare |
$0.83
|
|
|
CULTURELLE HEALTH-WELLNESS CAP 1 ea, 30 eaches
|
Facility
|
OP
|
$1.50
|
|
|
Service Code
|
NDC 49100036404
|
| Hospital Charge Code |
4401300
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.51 |
| Max. Negotiated Rate |
$1.21 |
| Rate for Payer: Aetna of NY Commercial |
$1.05
|
| Rate for Payer: Aetna of NY Medicare |
$0.69
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$0.56
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$0.75
|
| Rate for Payer: Cash Price |
$1.13
|
| Rate for Payer: CDPHP Commercial |
$1.21
|
| Rate for Payer: CDPHP Medicare |
$0.56
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1.20
|
| Rate for Payer: EmblemHealth Medicaid |
$1.20
|
| Rate for Payer: EmblemHealth Medicare |
$0.51
|
| Rate for Payer: EmblemHealth Select Care |
$1.08
|
| Rate for Payer: Fidelis Medicare |
$0.57
|
| Rate for Payer: Galaxy Health Commercial |
$0.98
|
| Rate for Payer: Hamaspik Choice Medicare |
$0.56
|
| Rate for Payer: Humana Medicare |
$0.56
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1.05
|
| Rate for Payer: Local 1199SEIU Medicare |
$0.69
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1.12
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$0.84
|
| Rate for Payer: MVP Health Care of NY Medicare |
$0.58
|
| Rate for Payer: United Healthcare Medicare |
$0.56
|
| Rate for Payer: WellCare Medicare |
$0.83
|
|
|
CULTURE SPUTUM
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4300243
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$27.37 |
| Rate for Payer: Aetna of NY Commercial |
$22.10
|
| Rate for Payer: Aetna of NY Medicare |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$12.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$17.00
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: CDPHP Commercial |
$27.37
|
| Rate for Payer: CDPHP Medicare |
$12.58
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$20.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.20
|
| Rate for Payer: EmblemHealth Medicaid |
$27.20
|
| Rate for Payer: EmblemHealth Medicare |
$11.56
|
| Rate for Payer: EmblemHealth Select Care |
$20.40
|
| Rate for Payer: Fidelis Medicare |
$12.96
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$19.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.21
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$25.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.23
|
| Rate for Payer: United Healthcare Commercial |
$25.50
|
| Rate for Payer: United Healthcare Medicare |
$12.58
|
| Rate for Payer: WellCare Medicare |
$18.70
|
|
|
CULTURE SPUTUM
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4300243
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.10 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
|
|
CULTURE STOOL
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
HCPCS 87045
|
| Hospital Charge Code |
4300244
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$53.30 |
| Max. Negotiated Rate |
$53.30 |
| Rate for Payer: Cash Price |
$61.50
|
| Rate for Payer: Galaxy Health Commercial |
$53.30
|
|
|
CULTURE STOOL
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
HCPCS 87045
|
| Hospital Charge Code |
4300244
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$66.01 |
| Rate for Payer: Aetna of NY Commercial |
$53.30
|
| Rate for Payer: Aetna of NY Medicare |
$37.72
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$61.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$61.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$30.34
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$41.00
|
| Rate for Payer: Cash Price |
$61.50
|
| Rate for Payer: Cash Price |
$61.50
|
| Rate for Payer: CDPHP Commercial |
$66.01
|
| Rate for Payer: CDPHP Medicare |
$30.34
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$49.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$65.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$65.60
|
| Rate for Payer: EmblemHealth Medicaid |
$65.60
|
| Rate for Payer: EmblemHealth Medicare |
$27.88
|
| Rate for Payer: EmblemHealth Select Care |
$49.20
|
| Rate for Payer: Fidelis Medicare |
$31.25
|
| Rate for Payer: Galaxy Health Commercial |
$53.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$30.34
|
| Rate for Payer: Humana Medicare |
$30.34
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$53.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$37.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$61.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$46.17
|
| Rate for Payer: MVP Health Care of NY Medicare |
$31.86
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$61.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.23
|
| Rate for Payer: United Healthcare Commercial |
$61.50
|
| Rate for Payer: United Healthcare Medicare |
$30.34
|
| Rate for Payer: WellCare Medicare |
$45.10
|
|
|
CULTURE THROAT (CULTURE AND SENSITIVITY)
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4300246
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$27.37 |
| Rate for Payer: Aetna of NY Commercial |
$22.10
|
| Rate for Payer: Aetna of NY Medicare |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$12.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$17.00
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: CDPHP Commercial |
$27.37
|
| Rate for Payer: CDPHP Medicare |
$12.58
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$20.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.20
|
| Rate for Payer: EmblemHealth Medicaid |
$27.20
|
| Rate for Payer: EmblemHealth Medicare |
$11.56
|
| Rate for Payer: EmblemHealth Select Care |
$20.40
|
| Rate for Payer: Fidelis Medicare |
$12.96
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$19.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.21
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$25.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.23
|
| Rate for Payer: United Healthcare Commercial |
$25.50
|
| Rate for Payer: United Healthcare Medicare |
$12.58
|
| Rate for Payer: WellCare Medicare |
$18.70
|
|
|
CULTURE THROAT (CULTURE AND SENSITIVITY)
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4300246
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.10 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
|
|
CULTURE TYPING NUCLEIC ACID PROBE DIR EA ORGANSM
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
HCPCS 87149
|
| Hospital Charge Code |
4302011
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.05 |
| Max. Negotiated Rate |
$58.76 |
| Rate for Payer: Aetna of NY Commercial |
$47.45
|
| Rate for Payer: Aetna of NY Medicare |
$33.58
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$54.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$54.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$27.01
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$36.50
|
| Rate for Payer: Cash Price |
$54.75
|
| Rate for Payer: Cash Price |
$54.75
|
| Rate for Payer: CDPHP Commercial |
$58.76
|
| Rate for Payer: CDPHP Medicare |
$27.01
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$43.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$58.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$58.40
|
| Rate for Payer: EmblemHealth Medicaid |
$58.40
|
| Rate for Payer: EmblemHealth Medicare |
$24.82
|
| Rate for Payer: EmblemHealth Select Care |
$43.80
|
| Rate for Payer: Fidelis Medicare |
$27.82
|
| Rate for Payer: Galaxy Health Commercial |
$47.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$27.01
|
| Rate for Payer: Humana Medicare |
$27.01
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$47.45
|
| Rate for Payer: Local 1199SEIU Medicare |
$33.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$54.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$41.10
|
| Rate for Payer: MVP Health Care of NY Medicare |
$28.36
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$54.75
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$20.05
|
| Rate for Payer: United Healthcare Commercial |
$54.75
|
| Rate for Payer: United Healthcare Medicare |
$27.01
|
| Rate for Payer: WellCare Medicare |
$40.15
|
|
|
CULTURE TYPING NUCLEIC ACID PROBE DIR EA ORGANSM
|
Facility
|
IP
|
$73.00
|
|
|
Service Code
|
HCPCS 87149
|
| Hospital Charge Code |
4302011
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$47.45 |
| Max. Negotiated Rate |
$47.45 |
| Rate for Payer: Cash Price |
$54.75
|
| Rate for Payer: Galaxy Health Commercial |
$47.45
|
|
|
CULTURE URINE ROUTINE
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
HCPCS 87086
|
| Hospital Charge Code |
4300247
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$43.47 |
| Rate for Payer: Aetna of NY Commercial |
$35.10
|
| 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: 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 |
$32.40
|
| 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 |
$32.40
|
| 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 |
$35.10
|
| 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: Oxford Health Plans Freedom/Liberty/Metro |
$40.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.07
|
| Rate for Payer: United Healthcare Commercial |
$40.50
|
| Rate for Payer: United Healthcare Medicare |
$19.98
|
| Rate for Payer: WellCare Medicare |
$29.70
|
|
|
CULTURE URINE ROUTINE
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
HCPCS 87086
|
| Hospital Charge Code |
4300247
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.10 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Galaxy Health Commercial |
$35.10
|
|
|
CULTURE UROGENITAL
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4300248
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$27.37 |
| Rate for Payer: Aetna of NY Commercial |
$22.10
|
| Rate for Payer: Aetna of NY Medicare |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$12.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$17.00
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: CDPHP Commercial |
$27.37
|
| Rate for Payer: CDPHP Medicare |
$12.58
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$20.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.20
|
| Rate for Payer: EmblemHealth Medicaid |
$27.20
|
| Rate for Payer: EmblemHealth Medicare |
$11.56
|
| Rate for Payer: EmblemHealth Select Care |
$20.40
|
| Rate for Payer: Fidelis Medicare |
$12.96
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$19.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.21
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$25.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.23
|
| Rate for Payer: United Healthcare Commercial |
$25.50
|
| Rate for Payer: United Healthcare Medicare |
$12.58
|
| Rate for Payer: WellCare Medicare |
$18.70
|
|
|
CULTURE UROGENITAL
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4300248
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.10 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
|
|
CULTURE VIRAL
|
Facility
|
IP
|
$272.00
|
|
|
Service Code
|
HCPCS 87252
|
| Hospital Charge Code |
4300250
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$176.80 |
| Max. Negotiated Rate |
$176.80 |
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Galaxy Health Commercial |
$176.80
|
|
|
CULTURE VIRAL
|
Facility
|
OP
|
$272.00
|
|
|
Service Code
|
HCPCS 87252
|
| Hospital Charge Code |
4300250
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.07 |
| Max. Negotiated Rate |
$218.96 |
| Rate for Payer: Aetna of NY Commercial |
$176.80
|
| Rate for Payer: Aetna of NY Medicare |
$125.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$204.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$100.64
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$136.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: CDPHP Commercial |
$218.96
|
| Rate for Payer: CDPHP Medicare |
$100.64
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$163.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$217.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$217.60
|
| Rate for Payer: EmblemHealth Medicaid |
$217.60
|
| Rate for Payer: EmblemHealth Medicare |
$92.48
|
| Rate for Payer: EmblemHealth Select Care |
$163.20
|
| Rate for Payer: Fidelis Medicare |
$103.66
|
| Rate for Payer: Galaxy Health Commercial |
$176.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$100.64
|
| Rate for Payer: Humana Medicare |
$100.64
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$176.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$125.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$204.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$153.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$105.67
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$204.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$26.07
|
| Rate for Payer: United Healthcare Commercial |
$204.00
|
| Rate for Payer: United Healthcare Medicare |
$100.64
|
| Rate for Payer: WellCare Medicare |
$149.60
|
|
|
CULTURE WOUND
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4300249
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$27.37 |
| Rate for Payer: Aetna of NY Commercial |
$22.10
|
| Rate for Payer: Aetna of NY Medicare |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$25.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$12.58
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$17.00
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: CDPHP Commercial |
$27.37
|
| Rate for Payer: CDPHP Medicare |
$12.58
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$20.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$27.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.20
|
| Rate for Payer: EmblemHealth Medicaid |
$27.20
|
| Rate for Payer: EmblemHealth Medicare |
$11.56
|
| Rate for Payer: EmblemHealth Select Care |
$20.40
|
| Rate for Payer: Fidelis Medicare |
$12.96
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.58
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$25.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$19.14
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.21
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$25.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.23
|
| Rate for Payer: United Healthcare Commercial |
$25.50
|
| Rate for Payer: United Healthcare Medicare |
$12.58
|
| Rate for Payer: WellCare Medicare |
$18.70
|
|
|
CULTURE WOUND
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
4300249
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.10 |
| Max. Negotiated Rate |
$22.10 |
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Galaxy Health Commercial |
$22.10
|
|
|
CUTTERS/BURRS ULTIMATE SERIES
|
Facility
|
IP
|
$170.00
|
|
| Hospital Charge Code |
4471240
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$110.50 |
| Max. Negotiated Rate |
$110.50 |
| Rate for Payer: Cash Price |
$127.50
|
| Rate for Payer: Galaxy Health Commercial |
$110.50
|
|
|
CUTTERS/BURRS ULTIMATE SERIES
|
Facility
|
OP
|
$170.00
|
|
| Hospital Charge Code |
4471240
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$57.80 |
| Max. Negotiated Rate |
$136.85 |
| Rate for Payer: Aetna of NY Commercial |
$119.00
|
| Rate for Payer: Aetna of NY Medicare |
$78.20
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$127.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$62.90
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$85.00
|
| Rate for Payer: Cash Price |
$127.50
|
| Rate for Payer: CDPHP Commercial |
$136.85
|
| Rate for Payer: CDPHP Medicare |
$62.90
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$136.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$136.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$136.00
|
| Rate for Payer: EmblemHealth Medicaid |
$136.00
|
| Rate for Payer: EmblemHealth Medicare |
$57.80
|
| Rate for Payer: EmblemHealth Select Care |
$122.40
|
| Rate for Payer: Fidelis Medicare |
$64.79
|
| Rate for Payer: Galaxy Health Commercial |
$110.50
|
| Rate for Payer: Hamaspik Choice Medicare |
$62.90
|
| Rate for Payer: Humana Medicare |
$62.90
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$119.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$78.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$127.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$95.71
|
| Rate for Payer: MVP Health Care of NY Medicare |
$66.04
|
| Rate for Payer: United Healthcare Medicare |
$62.90
|
| Rate for Payer: WellCare Medicare |
$93.50
|
|
