|
GLUCOSE RANDOM
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
HCPCS 82947
|
| Hospital Charge Code |
4300379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$17.71 |
| Rate for Payer: Aetna of NY Commercial |
$14.30
|
| Rate for Payer: Aetna of NY Medicare |
$10.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$16.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$16.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$8.14
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$11.00
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: Cash Price |
$16.50
|
| Rate for Payer: CDPHP Commercial |
$17.71
|
| Rate for Payer: CDPHP Medicare |
$8.14
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$17.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$17.60
|
| Rate for Payer: EmblemHealth Medicaid |
$17.60
|
| Rate for Payer: EmblemHealth Medicare |
$7.48
|
| Rate for Payer: Fidelis Medicare |
$8.38
|
| Rate for Payer: Galaxy Health Commercial |
$14.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$8.14
|
| Rate for Payer: Humana Medicare |
$8.14
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$14.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$10.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$16.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$12.39
|
| Rate for Payer: MVP Health Care of NY Medicare |
$8.55
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$16.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$3.93
|
| Rate for Payer: United Healthcare Commercial |
$16.50
|
| Rate for Payer: United Healthcare Medicare |
$8.14
|
| Rate for Payer: WellCare Medicare |
$12.10
|
|
|
GLYBURIDE 5MG TABS 100 EA
|
Facility
OP
|
$6.18
|
|
| Hospital Charge Code |
4400335
|
|
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
|
|
|
GLYCOPYROLLATE INJ
|
Facility
OP
|
$85.23
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
4408986
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.98 |
| Max. Negotiated Rate |
$68.61 |
| Rate for Payer: Aetna of NY Commercial |
$46.88
|
| Rate for Payer: Aetna of NY Medicare |
$39.21
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$38.35
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$38.35
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$31.54
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$42.62
|
| Rate for Payer: Cash Price |
$63.92
|
| Rate for Payer: CDPHP Commercial |
$68.61
|
| Rate for Payer: CDPHP Medicare |
$31.54
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$68.18
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$68.18
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$68.18
|
| Rate for Payer: EmblemHealth Medicaid |
$68.18
|
| Rate for Payer: EmblemHealth Medicare |
$28.98
|
| Rate for Payer: EmblemHealth Select Care |
$61.37
|
| Rate for Payer: Fidelis Medicare |
$32.48
|
| Rate for Payer: Galaxy Health Commercial |
$55.40
|
| Rate for Payer: Hamaspik Choice Medicare |
$31.54
|
| Rate for Payer: Humana Medicare |
$31.54
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$46.88
|
| Rate for Payer: Local 1199SEIU Medicare |
$39.21
|
| Rate for Payer: MVP Health Care of NY Commercial |
$63.92
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$47.98
|
| Rate for Payer: MVP Health Care of NY Medicare |
$33.11
|
| Rate for Payer: United Healthcare Medicare |
$31.54
|
| Rate for Payer: WellCare Medicare |
$46.88
|
|
|
GLYCOSYLATED HEMOGLOBIN
|
Facility
OP
|
$56.00
|
|
|
Service Code
|
HCPCS 83036
|
| Hospital Charge Code |
4300385
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$45.08 |
| Rate for Payer: Aetna of NY Commercial |
$36.40
|
| Rate for Payer: Aetna of NY Medicare |
$25.76
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$42.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$42.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$20.72
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$28.00
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: CDPHP Commercial |
$45.08
|
| Rate for Payer: CDPHP Medicare |
$20.72
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$44.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$44.80
|
| Rate for Payer: EmblemHealth Medicaid |
$44.80
|
| Rate for Payer: EmblemHealth Medicare |
$19.04
|
| Rate for Payer: Fidelis Medicare |
$21.34
|
| Rate for Payer: Galaxy Health Commercial |
$36.40
|
| Rate for Payer: Hamaspik Choice Medicare |
$20.72
|
| Rate for Payer: Humana Medicare |
$20.72
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$36.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$25.76
|
| Rate for Payer: MVP Health Care of NY Commercial |
$42.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$31.53
|
| Rate for Payer: MVP Health Care of NY Medicare |
$21.76
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$42.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$9.71
|
| Rate for Payer: United Healthcare Commercial |
$42.00
|
| Rate for Payer: United Healthcare Medicare |
$20.72
|
| Rate for Payer: WellCare Medicare |
$30.80
|
|
|
GPS III APPLICATOR KIT
|
Facility
OP
|
$127.00
|
|
| Hospital Charge Code |
4471612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$43.18 |
| Max. Negotiated Rate |
$102.24 |
| Rate for Payer: Aetna of NY Commercial |
$88.90
|
| Rate for Payer: Aetna of NY Medicare |
$58.42
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$95.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$95.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$46.99
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$63.50
|
| Rate for Payer: Cash Price |
$95.25
|
| Rate for Payer: CDPHP Commercial |
$102.24
|
| Rate for Payer: CDPHP Medicare |
$46.99
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$101.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$101.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$101.60
|
| Rate for Payer: EmblemHealth Medicaid |
$101.60
|
| Rate for Payer: EmblemHealth Medicare |
$43.18
|
| Rate for Payer: EmblemHealth Select Care |
$91.44
|
| Rate for Payer: Fidelis Medicare |
$48.40
|
| Rate for Payer: Galaxy Health Commercial |
$82.55
|
| Rate for Payer: Hamaspik Choice Medicare |
$46.99
|
| Rate for Payer: Humana Medicare |
$46.99
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$88.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$58.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$95.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$71.50
|
| Rate for Payer: MVP Health Care of NY Medicare |
$49.34
|
| Rate for Payer: United Healthcare Medicare |
$46.99
|
| Rate for Payer: WellCare Medicare |
$69.85
|
|
|
GPS III SYSTEM
|
Facility
OP
|
$2,088.00
|
|
| Hospital Charge Code |
4471613
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$709.92 |
| Max. Negotiated Rate |
$1,680.84 |
| Rate for Payer: Aetna of NY Commercial |
$1,461.60
|
| Rate for Payer: Aetna of NY Medicare |
$960.48
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1,566.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,566.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$772.56
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$1,044.00
|
| Rate for Payer: Cash Price |
$1,566.00
|
| Rate for Payer: CDPHP Commercial |
$1,680.84
|
| Rate for Payer: CDPHP Medicare |
$772.56
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,670.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,670.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,670.40
|
| Rate for Payer: EmblemHealth Medicaid |
$1,670.40
|
| Rate for Payer: EmblemHealth Medicare |
$709.92
|
| Rate for Payer: EmblemHealth Select Care |
$1,503.36
|
| Rate for Payer: Fidelis Medicare |
$795.74
|
| Rate for Payer: Galaxy Health Commercial |
$1,357.20
|
| Rate for Payer: Hamaspik Choice Medicare |
$772.56
|
| Rate for Payer: Humana Medicare |
$772.56
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,461.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$960.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,566.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$1,175.54
|
| Rate for Payer: MVP Health Care of NY Medicare |
$811.19
|
| Rate for Payer: United Healthcare Medicare |
$772.56
|
| Rate for Payer: WellCare Medicare |
$1,148.40
|
|
|
GROSS & MICRO LAB ONLY(TISSUE PATHOLOGY)
|
Facility
OP
|
$155.00
|
|
|
Service Code
|
HCPCS 88305 TC
|
| Hospital Charge Code |
4301144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$52.70 |
| Max. Negotiated Rate |
$124.78 |
| Rate for Payer: Aetna of NY Commercial |
$100.75
|
| Rate for Payer: Aetna of NY Medicare |
$71.30
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$116.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$116.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$57.35
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$77.50
|
| Rate for Payer: Cash Price |
$116.25
|
| Rate for Payer: CDPHP Commercial |
$124.78
|
| Rate for Payer: CDPHP Medicare |
$57.35
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$124.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$124.00
|
| Rate for Payer: EmblemHealth Medicaid |
$124.00
|
| Rate for Payer: EmblemHealth Medicare |
$52.70
|
| Rate for Payer: Fidelis Medicare |
$59.07
|
| Rate for Payer: Galaxy Health Commercial |
$100.75
|
| Rate for Payer: Hamaspik Choice Medicare |
$57.35
|
| Rate for Payer: Humana Medicare |
$57.35
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$100.75
|
| Rate for Payer: Local 1199SEIU Medicare |
$71.30
|
| Rate for Payer: MVP Health Care of NY Commercial |
$116.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$87.26
|
| Rate for Payer: MVP Health Care of NY Medicare |
$60.22
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$116.25
|
| Rate for Payer: United Healthcare Commercial |
$116.25
|
| Rate for Payer: United Healthcare Medicare |
$57.35
|
| Rate for Payer: WellCare Medicare |
$85.25
|
|
|
GROUNDING PADS
|
Facility
OP
|
$42.00
|
|
| Hospital Charge Code |
4479217
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$33.81 |
| Rate for Payer: Aetna of NY Commercial |
$29.40
|
| Rate for Payer: Aetna of NY Medicare |
$19.32
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$31.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$31.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$15.54
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$21.00
|
| Rate for Payer: Cash Price |
$31.50
|
| Rate for Payer: CDPHP Commercial |
$33.81
|
| Rate for Payer: CDPHP Medicare |
$15.54
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$33.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$33.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$33.60
|
| Rate for Payer: EmblemHealth Medicaid |
$33.60
|
| Rate for Payer: EmblemHealth Medicare |
$14.28
|
| Rate for Payer: EmblemHealth Select Care |
$30.24
|
| Rate for Payer: Fidelis Medicare |
$16.01
|
| Rate for Payer: Galaxy Health Commercial |
$27.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$15.54
|
| Rate for Payer: Humana Medicare |
$15.54
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$29.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$19.32
|
| Rate for Payer: MVP Health Care of NY Commercial |
$31.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$23.65
|
| Rate for Payer: MVP Health Care of NY Medicare |
$16.32
|
| Rate for Payer: United Healthcare Medicare |
$15.54
|
| Rate for Payer: WellCare Medicare |
$23.10
|
|
|
GROUP TREATMENT THERA PROCED
|
Facility
OP
|
$63.00
|
|
|
Service Code
|
HCPCS 97150 GP
|
| Hospital Charge Code |
4650012
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$179.00 |
| Rate for Payer: Aetna of NY Commercial |
$112.00
|
| Rate for Payer: Aetna of NY Medicare |
$28.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$47.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$47.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$23.31
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$108.00
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: CDPHP Commercial |
$50.72
|
| Rate for Payer: CDPHP Medicare |
$23.31
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$50.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$50.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$50.40
|
| Rate for Payer: EmblemHealth Medicaid |
$50.40
|
| Rate for Payer: EmblemHealth Medicare |
$21.42
|
| Rate for Payer: EmblemHealth Select Care |
$45.36
|
| Rate for Payer: Fidelis Medicare |
$24.01
|
| Rate for Payer: Galaxy Health Commercial |
$40.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$23.31
|
| Rate for Payer: Humana Medicare |
$23.31
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$112.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$28.98
|
| 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 |
$24.48
|
| 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 |
$23.31
|
| Rate for Payer: WellCare Medicare |
$34.65
|
|
|
GROUP TREATMENT THERA PROCED (MOD 59)
|
Facility
OP
|
$63.00
|
|
|
Service Code
|
HCPCS 97150 GP,59
|
| Hospital Charge Code |
4650364
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$179.00 |
| Rate for Payer: Aetna of NY Commercial |
$112.00
|
| Rate for Payer: Aetna of NY Medicare |
$28.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$47.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$47.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$23.31
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$108.00
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: CDPHP Commercial |
$50.72
|
| Rate for Payer: CDPHP Medicare |
$23.31
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$50.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$50.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$50.40
|
| Rate for Payer: EmblemHealth Medicaid |
$50.40
|
| Rate for Payer: EmblemHealth Medicare |
$21.42
|
| Rate for Payer: EmblemHealth Select Care |
$45.36
|
| Rate for Payer: Fidelis Medicare |
$24.01
|
| Rate for Payer: Galaxy Health Commercial |
$40.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$23.31
|
| Rate for Payer: Humana Medicare |
$23.31
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$112.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$28.98
|
| 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 |
$24.48
|
| 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 |
$23.31
|
| Rate for Payer: WellCare Medicare |
$34.65
|
|
|
GROUP TREATMENT THERA PROCED (MOD 59 W KX)
|
Facility
OP
|
$63.00
|
|
|
Service Code
|
HCPCS 97150 GP,59,KX
|
| Hospital Charge Code |
4650416
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$179.00 |
| Rate for Payer: Aetna of NY Commercial |
$112.00
|
| Rate for Payer: Aetna of NY Medicare |
$28.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$47.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$47.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$23.31
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$108.00
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: CDPHP Commercial |
$50.72
|
| Rate for Payer: CDPHP Medicare |
$23.31
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$50.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$50.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$50.40
|
| Rate for Payer: EmblemHealth Medicaid |
$50.40
|
| Rate for Payer: EmblemHealth Medicare |
$21.42
|
| Rate for Payer: EmblemHealth Select Care |
$45.36
|
| Rate for Payer: Fidelis Medicare |
$24.01
|
| Rate for Payer: Galaxy Health Commercial |
$40.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$23.31
|
| Rate for Payer: Humana Medicare |
$23.31
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$112.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$28.98
|
| 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 |
$24.48
|
| 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 |
$23.31
|
| Rate for Payer: WellCare Medicare |
$34.65
|
|
|
GROUP TREATMENT THERA PROCED (W/ KX)
|
Facility
OP
|
$63.00
|
|
|
Service Code
|
HCPCS 97150 GP,KX
|
| Hospital Charge Code |
4650309
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$179.00 |
| Rate for Payer: Aetna of NY Commercial |
$112.00
|
| Rate for Payer: Aetna of NY Medicare |
$28.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$47.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$47.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$23.31
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$108.00
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: Cash Price |
$47.25
|
| Rate for Payer: CDPHP Commercial |
$50.72
|
| Rate for Payer: CDPHP Medicare |
$23.31
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$50.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$50.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$50.40
|
| Rate for Payer: EmblemHealth Medicaid |
$50.40
|
| Rate for Payer: EmblemHealth Medicare |
$21.42
|
| Rate for Payer: EmblemHealth Select Care |
$45.36
|
| Rate for Payer: Fidelis Medicare |
$24.01
|
| Rate for Payer: Galaxy Health Commercial |
$40.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$23.31
|
| Rate for Payer: Humana Medicare |
$23.31
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$112.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$28.98
|
| 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 |
$24.48
|
| 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 |
$23.31
|
| Rate for Payer: WellCare Medicare |
$34.65
|
|
|
GUAIFEN/COD 100-10MG/5ML SYRP 100X5ML
|
Facility
OP
|
$6.18
|
|
| Hospital Charge Code |
4400338
|
|
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
|
|
|
GUAIFEN/DM 100-10MG/5ML SYRP 100X10ML
|
Facility
OP
|
$6.18
|
|
| Hospital Charge Code |
4400337
|
|
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
|
|
|
GUAIFENESIN 100MG/5ML SYRP 100X10ML
|
Facility
OP
|
$6.18
|
|
| Hospital Charge Code |
4400336
|
|
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
|
|
|
GUAIFENESIN 600MG TABS 100 EA
|
Facility
OP
|
$6.18
|
|
| Hospital Charge Code |
4400529
|
|
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
|
|
|
GUHL ANKLE DISTRAKTER
|
Facility
OP
|
$962.00
|
|
| Hospital Charge Code |
4479158
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$327.08 |
| Max. Negotiated Rate |
$774.41 |
| Rate for Payer: Aetna of NY Commercial |
$673.40
|
| Rate for Payer: Aetna of NY Medicare |
$442.52
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$721.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$721.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$355.94
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$481.00
|
| Rate for Payer: Cash Price |
$721.50
|
| Rate for Payer: CDPHP Commercial |
$774.41
|
| Rate for Payer: CDPHP Medicare |
$355.94
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$769.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$769.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$769.60
|
| Rate for Payer: EmblemHealth Medicaid |
$769.60
|
| Rate for Payer: EmblemHealth Medicare |
$327.08
|
| Rate for Payer: EmblemHealth Select Care |
$692.64
|
| Rate for Payer: Fidelis Medicare |
$366.62
|
| Rate for Payer: Galaxy Health Commercial |
$625.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$355.94
|
| Rate for Payer: Humana Medicare |
$355.94
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$673.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$442.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$721.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$541.61
|
| Rate for Payer: MVP Health Care of NY Medicare |
$373.74
|
| Rate for Payer: United Healthcare Medicare |
$355.94
|
| Rate for Payer: WellCare Medicare |
$529.10
|
|
|
HALOPERIDOL 1MG TABS 100 EA
|
Facility
OP
|
$6.18
|
|
| Hospital Charge Code |
4400340
|
|
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
|
|
|
HALOPERIDOL INJ, UP TO 5 MG
|
Facility
OP
|
$110.98
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
4400341
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$89.34 |
| Rate for Payer: Aetna of NY Commercial |
$61.04
|
| Rate for Payer: Aetna of NY Medicare |
$51.05
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1.26
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1.26
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$41.06
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$55.49
|
| Rate for Payer: Cash Price |
$83.24
|
| Rate for Payer: Cash Price |
$83.24
|
| Rate for Payer: CDPHP Commercial |
$89.34
|
| Rate for Payer: CDPHP Medicare |
$41.06
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1.26
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$88.78
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$88.78
|
| Rate for Payer: EmblemHealth Medicaid |
$88.78
|
| Rate for Payer: EmblemHealth Medicare |
$37.73
|
| Rate for Payer: EmblemHealth Select Care |
$1.26
|
| Rate for Payer: Fidelis Medicare |
$42.29
|
| Rate for Payer: Galaxy Health Commercial |
$72.14
|
| Rate for Payer: Hamaspik Choice Medicare |
$41.06
|
| Rate for Payer: Humana Medicare |
$41.06
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$61.04
|
| Rate for Payer: Local 1199SEIU Medicare |
$51.05
|
| Rate for Payer: MVP Health Care of NY Commercial |
$83.24
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$62.48
|
| Rate for Payer: MVP Health Care of NY Medicare |
$43.12
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$2.28
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1.26
|
| Rate for Payer: United Healthcare Commercial |
$2.28
|
| Rate for Payer: United Healthcare Medicare |
$41.06
|
| Rate for Payer: WellCare Medicare |
$61.04
|
|
|
HAMMERTOE OP ONE TOE
|
Facility
OP
|
$9,262.00
|
|
|
Service Code
|
HCPCS 28285
|
| Hospital Charge Code |
4856716
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,017.33 |
| Max. Negotiated Rate |
$7,455.91 |
| Rate for Payer: Aetna of NY Commercial |
$6,483.40
|
| Rate for Payer: Aetna of NY Medicare |
$4,260.52
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$2,017.33
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$2,521.93
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$3,426.94
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$4,631.00
|
| Rate for Payer: Cash Price |
$6,946.50
|
| Rate for Payer: Cash Price |
$6,946.50
|
| Rate for Payer: Cash Price |
$6,946.50
|
| Rate for Payer: CDPHP Commercial |
$7,455.91
|
| Rate for Payer: CDPHP Medicare |
$3,426.94
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$7,409.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$7,409.60
|
| Rate for Payer: EmblemHealth Medicaid |
$7,409.60
|
| Rate for Payer: EmblemHealth Medicare |
$3,149.08
|
| Rate for Payer: Fidelis Medicare |
$3,529.75
|
| Rate for Payer: Galaxy Health Commercial |
$6,020.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$3,426.94
|
| Rate for Payer: Humana Medicare |
$3,426.94
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$6,483.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$4,260.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$6,946.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$5,214.51
|
| Rate for Payer: MVP Health Care of NY Medicare |
$3,598.29
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$3,084.03
|
| Rate for Payer: United Healthcare Medicare |
$3,426.94
|
| Rate for Payer: WellCare Medicare |
$5,094.10
|
|
|
HAPTOGLOBIN
|
Facility
OP
|
$86.00
|
|
|
Service Code
|
HCPCS 83010
|
| Hospital Charge Code |
4300396
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.58 |
| Max. Negotiated Rate |
$69.23 |
| Rate for Payer: Aetna of NY Commercial |
$55.90
|
| Rate for Payer: Aetna of NY Medicare |
$39.56
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$64.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$64.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$31.82
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$43.00
|
| Rate for Payer: Cash Price |
$64.50
|
| Rate for Payer: Cash Price |
$64.50
|
| Rate for Payer: CDPHP Commercial |
$69.23
|
| Rate for Payer: CDPHP Medicare |
$31.82
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$68.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$68.80
|
| Rate for Payer: EmblemHealth Medicaid |
$68.80
|
| Rate for Payer: EmblemHealth Medicare |
$29.24
|
| Rate for Payer: Fidelis Medicare |
$32.77
|
| Rate for Payer: Galaxy Health Commercial |
$55.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$31.82
|
| Rate for Payer: Humana Medicare |
$31.82
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$55.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$39.56
|
| Rate for Payer: MVP Health Care of NY Commercial |
$64.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$48.42
|
| Rate for Payer: MVP Health Care of NY Medicare |
$33.41
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$64.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$12.58
|
| Rate for Payer: United Healthcare Commercial |
$64.50
|
| Rate for Payer: United Healthcare Medicare |
$31.82
|
| Rate for Payer: WellCare Medicare |
$47.30
|
|
|
HCG; QUAN
|
Facility
OP
|
$77.00
|
|
|
Service Code
|
HCPCS 84702
|
| Hospital Charge Code |
4300126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$61.98 |
| Rate for Payer: Aetna of NY Commercial |
$50.05
|
| Rate for Payer: Aetna of NY Medicare |
$35.42
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$57.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$57.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$28.49
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$38.50
|
| Rate for Payer: Cash Price |
$57.75
|
| Rate for Payer: Cash Price |
$57.75
|
| Rate for Payer: CDPHP Commercial |
$61.98
|
| Rate for Payer: CDPHP Medicare |
$28.49
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$61.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$61.60
|
| Rate for Payer: EmblemHealth Medicaid |
$61.60
|
| Rate for Payer: EmblemHealth Medicare |
$26.18
|
| Rate for Payer: Fidelis Medicare |
$29.34
|
| Rate for Payer: Galaxy Health Commercial |
$50.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$28.49
|
| Rate for Payer: Humana Medicare |
$28.49
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$50.05
|
| Rate for Payer: Local 1199SEIU Medicare |
$35.42
|
| Rate for Payer: MVP Health Care of NY Commercial |
$57.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$43.35
|
| Rate for Payer: MVP Health Care of NY Medicare |
$29.91
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$57.75
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$12.49
|
| Rate for Payer: United Healthcare Commercial |
$57.75
|
| Rate for Payer: United Healthcare Medicare |
$28.49
|
| Rate for Payer: WellCare Medicare |
$42.35
|
|
|
HCV QUANT
|
Facility
OP
|
$316.00
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
4300398
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$107.44 |
| Max. Negotiated Rate |
$254.38 |
| Rate for Payer: Aetna of NY Commercial |
$205.40
|
| Rate for Payer: Aetna of NY Medicare |
$145.36
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$237.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$237.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$116.92
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$158.00
|
| Rate for Payer: Cash Price |
$237.00
|
| Rate for Payer: CDPHP Commercial |
$254.38
|
| Rate for Payer: CDPHP Medicare |
$116.92
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$252.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$252.80
|
| Rate for Payer: EmblemHealth Medicaid |
$252.80
|
| Rate for Payer: EmblemHealth Medicare |
$107.44
|
| Rate for Payer: Fidelis Medicare |
$120.43
|
| Rate for Payer: Galaxy Health Commercial |
$205.40
|
| Rate for Payer: Hamaspik Choice Medicare |
$116.92
|
| Rate for Payer: Humana Medicare |
$116.92
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$205.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$145.36
|
| Rate for Payer: MVP Health Care of NY Commercial |
$237.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$177.91
|
| Rate for Payer: MVP Health Care of NY Medicare |
$122.77
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$237.00
|
| Rate for Payer: United Healthcare Commercial |
$237.00
|
| Rate for Payer: United Healthcare Medicare |
$116.92
|
| Rate for Payer: WellCare Medicare |
$173.80
|
|
|
HEAD DRILL4.3MM COMPRS SCREW
|
Facility
OP
|
$280.00
|
|
| Hospital Charge Code |
4471371
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$95.20 |
| Max. Negotiated Rate |
$225.40 |
| Rate for Payer: Aetna of NY Commercial |
$196.00
|
| Rate for Payer: Aetna of NY Medicare |
$128.80
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$210.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$103.60
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$140.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: CDPHP Commercial |
$225.40
|
| Rate for Payer: CDPHP Medicare |
$103.60
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$224.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$224.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$224.00
|
| Rate for Payer: EmblemHealth Medicaid |
$224.00
|
| Rate for Payer: EmblemHealth Medicare |
$95.20
|
| Rate for Payer: EmblemHealth Select Care |
$201.60
|
| Rate for Payer: Fidelis Medicare |
$106.71
|
| Rate for Payer: Galaxy Health Commercial |
$182.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$103.60
|
| Rate for Payer: Humana Medicare |
$103.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$196.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$128.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$210.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$157.64
|
| Rate for Payer: MVP Health Care of NY Medicare |
$108.78
|
| Rate for Payer: United Healthcare Medicare |
$103.60
|
| Rate for Payer: WellCare Medicare |
$154.00
|
|
|
HEART/LUNG RESUSCITATION CPR
|
Facility
OP
|
$898.00
|
|
|
Service Code
|
HCPCS 92950
|
| Hospital Charge Code |
4480090
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$299.06 |
| Max. Negotiated Rate |
$722.89 |
| Rate for Payer: Aetna of NY Commercial |
$628.60
|
| Rate for Payer: Aetna of NY Medicare |
$413.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$673.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$673.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$332.26
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$449.00
|
| Rate for Payer: Cash Price |
$673.50
|
| Rate for Payer: Cash Price |
$673.50
|
| Rate for Payer: CDPHP Commercial |
$722.89
|
| Rate for Payer: CDPHP Medicare |
$332.26
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$718.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$718.40
|
| Rate for Payer: EmblemHealth Medicaid |
$718.40
|
| Rate for Payer: EmblemHealth Medicare |
$305.32
|
| Rate for Payer: Fidelis Medicare |
$342.23
|
| Rate for Payer: Galaxy Health Commercial |
$583.70
|
| Rate for Payer: Hamaspik Choice Medicare |
$332.26
|
| Rate for Payer: Humana Medicare |
$332.26
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$628.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$413.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$673.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$505.57
|
| Rate for Payer: MVP Health Care of NY Medicare |
$348.87
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$673.50
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$299.06
|
| Rate for Payer: United Healthcare Commercial |
$673.50
|
| Rate for Payer: United Healthcare Medicare |
$332.26
|
| Rate for Payer: WellCare Medicare |
$493.90
|
|
