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Service Code NDC 09999123474
Hospital Charge Code 00338105548
Hospital Revenue Code 278
Min. Negotiated Rate $0.01
Max. Negotiated Rate $0.01
Rate for Payer: Hamaspik Choice Inc Medicaid $0.01
Rate for Payer: Hamaspik Choice Inc Medicare $0.01
Hospital Charge Code 41644900
Hospital Revenue Code 250
Min. Negotiated Rate $14.97
Max. Negotiated Rate $34.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial $23.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $21.39
Rate for Payer: Aetna Government $21.39
Rate for Payer: Brighton Health Commercial $32.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $34.22
Rate for Payer: Cigna LocalPlus Benefit Plan $29.09
Rate for Payer: Group Health Inc Commercial $21.39
Rate for Payer: Group Health Inc Medicare $14.97
Rate for Payer: Hamaspik Choice Inc Medicaid $21.39
Rate for Payer: Hamaspik Choice Inc Medicare $21.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $27.81
Hospital Charge Code 41654900
Hospital Revenue Code 250
Min. Negotiated Rate $14.97
Max. Negotiated Rate $34.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial $23.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $21.39
Rate for Payer: Aetna Government $21.39
Rate for Payer: Brighton Health Commercial $32.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $34.22
Rate for Payer: Cigna LocalPlus Benefit Plan $29.09
Rate for Payer: Group Health Inc Commercial $21.39
Rate for Payer: Group Health Inc Medicare $14.97
Rate for Payer: Hamaspik Choice Inc Medicaid $21.39
Rate for Payer: Hamaspik Choice Inc Medicare $21.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $27.81
Hospital Charge Code 41644044
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Brighton Health Commercial $0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Hospital Charge Code 41654044
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Brighton Health Commercial $0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Hospital Charge Code 41644045
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Brighton Health Commercial $0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Hospital Charge Code 41654045
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Brighton Health Commercial $0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Service Code NDC 00093873901
Hospital Charge Code 00093873901
Hospital Revenue Code 250
Min. Negotiated Rate $0.89
Max. Negotiated Rate $2.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.27
Rate for Payer: Aetna Government $1.27
Rate for Payer: Brighton Health Commercial $1.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2.03
Rate for Payer: Cigna LocalPlus Benefit Plan $1.72
Rate for Payer: Group Health Inc Commercial $1.27
Rate for Payer: Group Health Inc Medicare $0.89
Rate for Payer: Hamaspik Choice Inc Medicaid $1.27
Rate for Payer: Hamaspik Choice Inc Medicare $1.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.65
Service Code NDC 00093874001
Hospital Charge Code 00093874001
Hospital Revenue Code 250
Min. Negotiated Rate $1.06
Max. Negotiated Rate $2.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.51
Rate for Payer: Aetna Government $1.51
Rate for Payer: Brighton Health Commercial $2.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2.42
Rate for Payer: Cigna LocalPlus Benefit Plan $2.06
Rate for Payer: Group Health Inc Commercial $1.51
Rate for Payer: Group Health Inc Medicare $1.06
Rate for Payer: Hamaspik Choice Inc Medicaid $1.51
Rate for Payer: Hamaspik Choice Inc Medicare $1.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.97
Service Code HCPCS 99457
Hospital Charge Code 30302524
Hospital Revenue Code 988
Max. Negotiated Rate $23.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $23.85
Rate for Payer: Aetna Government $23.85
Rate for Payer: Brighton Health Commercial $0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.01
Rate for Payer: Cigna LocalPlus Benefit Plan $0.01
Rate for Payer: Group Health Inc Commercial $0.01
Rate for Payer: Group Health Inc Medicare $0.00
Rate for Payer: Hamaspik Choice Inc Medicaid $0.01
Rate for Payer: Hamaspik Choice Inc Medicare $0.01
Service Code HCPCS 86780
Hospital Charge Code 40721320
Hospital Revenue Code 302
Min. Negotiated Rate $9.27
Max. Negotiated Rate $24.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial $18.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $13.24
Rate for Payer: Aetna Government $13.24
Rate for Payer: Affinity Essential Plan 1&2 $9.27
Rate for Payer: Affinity Essential Plan 3&4 $9.27
Rate for Payer: Affinity Medicaid/CHP/HARP $9.27
Rate for Payer: Brighton Health Commercial $24.82
Rate for Payer: Cash Price $13.24
Rate for Payer: Cash Price $13.24
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $13.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $21.05
Rate for Payer: Cigna LocalPlus Benefit Plan $17.81
Rate for Payer: Elderplan Medicare Advantage $13.24
Rate for Payer: EmblemHealth Commercial $13.24
Rate for Payer: Fidelis Essential Plan Aliesa $11.25
Rate for Payer: Fidelis Essential Plan QHP $11.78
Rate for Payer: Fidelis Medicare Advantage $13.24
Rate for Payer: Fidelis Qualified Health Plan $11.78
Rate for Payer: Group Health Inc Commercial $13.24
Rate for Payer: Group Health Inc Medicare $13.24
Rate for Payer: Hamaspik Choice Inc Medicaid $16.55
Rate for Payer: Hamaspik Choice Inc Medicare $13.24
Rate for Payer: Healthfirst Medicare Advantage $13.24
Rate for Payer: Healthfirst QHP $13.24
Rate for Payer: Humana Medicare $13.50
Rate for Payer: Senior Whole Health Medicare Advantage $13.24
Rate for Payer: United Healthcare Commercial $16.77
Rate for Payer: United Healthcare Medicare Advantage $13.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $13.24
Rate for Payer: Wellcare CHP/FHP/Medicaid $10.59
Rate for Payer: Wellcare Medicare $11.92
Service Code HCPCS 86780
Hospital Charge Code 40721320
Hospital Revenue Code 302
Rate for Payer: Cash Price $13.24
Hospital Charge Code 41646082
Hospital Revenue Code 250
Min. Negotiated Rate $0.66
Max. Negotiated Rate $1.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.95
Rate for Payer: Aetna Government $0.95
Rate for Payer: Brighton Health Commercial $1.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.51
Rate for Payer: Cigna LocalPlus Benefit Plan $1.29
Rate for Payer: Group Health Inc Commercial $0.95
Rate for Payer: Group Health Inc Medicare $0.66
Rate for Payer: Hamaspik Choice Inc Medicaid $0.95
Rate for Payer: Hamaspik Choice Inc Medicare $0.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.23
Hospital Charge Code 41646081
Hospital Revenue Code 250
Min. Negotiated Rate $0.66
Max. Negotiated Rate $1.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.95
Rate for Payer: Aetna Government $0.95
Rate for Payer: Brighton Health Commercial $1.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.51
Rate for Payer: Cigna LocalPlus Benefit Plan $1.29
Rate for Payer: Group Health Inc Commercial $0.95
Rate for Payer: Group Health Inc Medicare $0.66
Rate for Payer: Hamaspik Choice Inc Medicaid $0.95
Rate for Payer: Hamaspik Choice Inc Medicare $0.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.23
Service Code HCPCS J2248
Hospital Charge Code 63323072901
Hospital Revenue Code 278
Min. Negotiated Rate $28.80
Max. Negotiated Rate $28.80
Rate for Payer: Hamaspik Choice Inc Medicaid $28.80
Rate for Payer: Hamaspik Choice Inc Medicare $28.80
Service Code HCPCS J2248
Hospital Charge Code 63323072910
Hospital Revenue Code 278
Min. Negotiated Rate $0.97
Max. Negotiated Rate $60.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial $31.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.97
Rate for Payer: Aetna Government $0.97
Rate for Payer: Brighton Health Commercial $34.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $28.80
Rate for Payer: Cigna LocalPlus Benefit Plan $33.12
Rate for Payer: EmblemHealth Commercial $28.80
Rate for Payer: Fidelis Medicare Advantage $60.48
Rate for Payer: Group Health Inc Commercial $28.80
Rate for Payer: Group Health Inc Medicare $20.16
Rate for Payer: Hamaspik Choice Inc Medicaid $28.80
Rate for Payer: Hamaspik Choice Inc Medicare $28.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $37.44
Service Code HCPCS J2248
Hospital Charge Code 42023023010
Hospital Revenue Code 278
Min. Negotiated Rate $89.76
Max. Negotiated Rate $89.76
Rate for Payer: Hamaspik Choice Inc Medicaid $89.76
Rate for Payer: Hamaspik Choice Inc Medicare $89.76
Service Code HCPCS J2248
Hospital Charge Code 63323072910
Hospital Revenue Code 278
Min. Negotiated Rate $28.80
Max. Negotiated Rate $28.80
Rate for Payer: Hamaspik Choice Inc Medicaid $28.80
Rate for Payer: Hamaspik Choice Inc Medicare $28.80
Service Code HCPCS J2248
Hospital Charge Code 63323072901
Hospital Revenue Code 278
Min. Negotiated Rate $0.97
Max. Negotiated Rate $60.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial $31.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.97
Rate for Payer: Aetna Government $0.97
Rate for Payer: Brighton Health Commercial $34.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $28.80
Rate for Payer: Cigna LocalPlus Benefit Plan $33.12
Rate for Payer: EmblemHealth Commercial $28.80
Rate for Payer: Fidelis Medicare Advantage $60.48
Rate for Payer: Group Health Inc Commercial $28.80
Rate for Payer: Group Health Inc Medicare $20.16
Rate for Payer: Hamaspik Choice Inc Medicaid $28.80
Rate for Payer: Hamaspik Choice Inc Medicare $28.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $37.44
Service Code HCPCS J2248
Hospital Charge Code 42023023010
Hospital Revenue Code 278
Min. Negotiated Rate $0.97
Max. Negotiated Rate $188.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $98.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.97
Rate for Payer: Aetna Government $0.97
Rate for Payer: Brighton Health Commercial $107.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $89.76
Rate for Payer: Cigna LocalPlus Benefit Plan $103.22
Rate for Payer: EmblemHealth Commercial $89.76
Rate for Payer: Fidelis Medicare Advantage $188.50
Rate for Payer: Group Health Inc Commercial $89.76
Rate for Payer: Group Health Inc Medicare $62.83
Rate for Payer: Hamaspik Choice Inc Medicaid $89.76
Rate for Payer: Hamaspik Choice Inc Medicare $89.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $116.69
Service Code HCPCS J2248
Hospital Charge Code 42023022910
Hospital Revenue Code 278
Min. Negotiated Rate $44.88
Max. Negotiated Rate $44.88
Rate for Payer: Hamaspik Choice Inc Medicaid $44.88
Rate for Payer: Hamaspik Choice Inc Medicare $44.88
Service Code HCPCS J2248
Hospital Charge Code 42023022901
Hospital Revenue Code 278
Min. Negotiated Rate $44.88
Max. Negotiated Rate $44.88
Rate for Payer: Hamaspik Choice Inc Medicaid $44.88
Rate for Payer: Hamaspik Choice Inc Medicare $44.88
Service Code HCPCS J2248
Hospital Charge Code 42023022910
Hospital Revenue Code 278
Min. Negotiated Rate $0.97
Max. Negotiated Rate $94.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial $49.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.97
Rate for Payer: Aetna Government $0.97
Rate for Payer: Brighton Health Commercial $53.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $44.88
Rate for Payer: Cigna LocalPlus Benefit Plan $51.61
Rate for Payer: EmblemHealth Commercial $44.88
Rate for Payer: Fidelis Medicare Advantage $94.25
Rate for Payer: Group Health Inc Commercial $44.88
Rate for Payer: Group Health Inc Medicare $31.42
Rate for Payer: Hamaspik Choice Inc Medicaid $44.88
Rate for Payer: Hamaspik Choice Inc Medicare $44.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $58.34
Service Code HCPCS J2248
Hospital Charge Code 42023022901
Hospital Revenue Code 278
Min. Negotiated Rate $0.97
Max. Negotiated Rate $94.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial $49.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.97
Rate for Payer: Aetna Government $0.97
Rate for Payer: Brighton Health Commercial $53.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $44.88
Rate for Payer: Cigna LocalPlus Benefit Plan $51.61
Rate for Payer: EmblemHealth Commercial $44.88
Rate for Payer: Fidelis Medicare Advantage $94.25
Rate for Payer: Group Health Inc Commercial $44.88
Rate for Payer: Group Health Inc Medicare $31.42
Rate for Payer: Hamaspik Choice Inc Medicaid $44.88
Rate for Payer: Hamaspik Choice Inc Medicare $44.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $58.34
Hospital Charge Code 41641264
Hospital Revenue Code 250
Min. Negotiated Rate $1.81
Max. Negotiated Rate $4.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $2.58
Rate for Payer: Aetna Government $2.58
Rate for Payer: Brighton Health Commercial $3.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $4.13
Rate for Payer: Cigna LocalPlus Benefit Plan $3.51
Rate for Payer: Group Health Inc Commercial $2.58
Rate for Payer: Group Health Inc Medicare $1.81
Rate for Payer: Hamaspik Choice Inc Medicaid $2.58
Rate for Payer: Hamaspik Choice Inc Medicare $2.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $3.35