|
PNEUMOTHORAX WITH CC
|
Facility
|
IP
|
$30,611.67
|
|
|
Service Code
|
MSDRG 200
|
| Min. Negotiated Rate |
$9,235.28 |
| Max. Negotiated Rate |
$30,611.67 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15,880.37
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$22,263.03
|
| Rate for Payer: Aetna Government |
$22,263.03
|
| Rate for Payer: Brighton Health Commercial |
$15,616.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22,708.29
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18,598.71
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15,348.46
|
| Rate for Payer: Elderplan Medicare Advantage |
$21,149.88
|
| Rate for Payer: EmblemHealth Commercial |
$9,235.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$22,263.03
|
| Rate for Payer: Group Health Inc Commercial |
$22,263.03
|
| Rate for Payer: Group Health Inc Medicare |
$22,263.03
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22,263.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,352.31
|
| Rate for Payer: Humana Medicare |
$30,611.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22,263.03
|
| Rate for Payer: United Healthcare Commercial |
$21,418.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,263.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22,263.03
|
| Rate for Payer: Wellcare Medicare |
$21,149.88
|
|
|
PNEUMOTHORAX WITH MCC
|
Facility
|
IP
|
$43,903.71
|
|
|
Service Code
|
MSDRG 199
|
| Min. Negotiated Rate |
$14,847.44 |
| Max. Negotiated Rate |
$43,903.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$26,159.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$31,929.97
|
| Rate for Payer: Aetna Government |
$31,929.97
|
| Rate for Payer: Brighton Health Commercial |
$25,724.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$32,568.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$30,636.93
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$25,282.91
|
| Rate for Payer: Elderplan Medicare Advantage |
$30,333.47
|
| Rate for Payer: EmblemHealth Commercial |
$15,212.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$31,929.97
|
| Rate for Payer: Group Health Inc Commercial |
$31,929.97
|
| Rate for Payer: Group Health Inc Medicare |
$31,929.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31,929.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14,847.44
|
| Rate for Payer: Humana Medicare |
$43,903.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$31,929.97
|
| Rate for Payer: United Healthcare Commercial |
$35,281.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31,929.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$31,929.97
|
| Rate for Payer: Wellcare Medicare |
$30,333.47
|
|
|
PNEUMOTHORAX WITHOUT CC/MCC
|
Facility
|
IP
|
$23,539.45
|
|
|
Service Code
|
MSDRG 201
|
| Min. Negotiated Rate |
$6,054.81 |
| Max. Negotiated Rate |
$23,539.45 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$10,411.44
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17,119.60
|
| Rate for Payer: Aetna Government |
$17,119.60
|
| Rate for Payer: Brighton Health Commercial |
$10,238.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17,461.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$12,193.64
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$10,062.72
|
| Rate for Payer: Elderplan Medicare Advantage |
$16,263.62
|
| Rate for Payer: EmblemHealth Commercial |
$6,054.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$17,119.60
|
| Rate for Payer: Group Health Inc Commercial |
$17,119.60
|
| Rate for Payer: Group Health Inc Medicare |
$17,119.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17,119.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,960.61
|
| Rate for Payer: Humana Medicare |
$23,539.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17,119.60
|
| Rate for Payer: United Healthcare Commercial |
$14,042.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17,119.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17,119.60
|
| Rate for Payer: Wellcare Medicare |
$16,263.62
|
|
|
PNUEMO VACCINE
|
Facility
|
OP
|
$222.08
|
|
| Hospital Charge Code |
40501003
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$77.73 |
| Max. Negotiated Rate |
$177.66 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.14
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$111.04
|
| Rate for Payer: Aetna Government |
$111.04
|
| Rate for Payer: Brighton Health Commercial |
$166.56
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$177.66
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$151.01
|
| Rate for Payer: Group Health Inc Commercial |
$111.04
|
| Rate for Payer: Group Health Inc Medicare |
$77.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$111.04
|
| Rate for Payer: United Healthcare Commercial |
$111.04
|
|
|
POC COVID ID NOW
|
Facility
|
OP
|
$130.00
|
|
|
Service Code
|
HCPCS 87635
|
| Hospital Charge Code |
40601997
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$104.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$71.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$51.31
|
| Rate for Payer: Aetna Government |
$51.31
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$35.92
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$35.92
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$35.92
|
| Rate for Payer: Brighton Health Commercial |
$97.50
|
| Rate for Payer: Cash Price |
$51.31
|
| Rate for Payer: Cash Price |
$51.31
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$51.31
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$104.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$88.40
|
| Rate for Payer: Elderplan Medicare Advantage |
$51.31
|
| Rate for Payer: EmblemHealth Commercial |
$51.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$43.61
|
| Rate for Payer: Fidelis Essential Plan QHP |
$45.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$51.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$45.67
|
| Rate for Payer: Group Health Inc Commercial |
$51.31
|
| Rate for Payer: Group Health Inc Medicare |
$51.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$65.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$51.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$51.31
|
| Rate for Payer: Healthfirst QHP |
$51.31
|
| Rate for Payer: Humana Medicare |
$52.34
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$51.31
|
| Rate for Payer: United Healthcare Commercial |
$46.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$51.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$51.31
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$41.05
|
| Rate for Payer: Wellcare Medicare |
$46.18
|
|
|
POC COVID ID NOW
|
Facility
|
IP
|
$130.00
|
|
|
Service Code
|
HCPCS 87635
|
| Hospital Charge Code |
40601997
|
|
Hospital Revenue Code
|
306
|
| Rate for Payer: Cash Price |
$51.31
|
|
|
POCT ACTIVATED CLOTTING TIME
|
Facility
|
OP
|
$10.70
|
|
|
Service Code
|
HCPCS 85347
|
| Hospital Charge Code |
40626017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$6.76 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.28
|
| Rate for Payer: Aetna Government |
$4.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.00
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.00
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.00
|
| Rate for Payer: Brighton Health Commercial |
$4.28
|
| Rate for Payer: Cash Price |
$4.28
|
| Rate for Payer: Cash Price |
$4.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4.28
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.72
|
| Rate for Payer: Elderplan Medicare Advantage |
$4.28
|
| Rate for Payer: EmblemHealth Commercial |
$4.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$4.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.81
|
| Rate for Payer: Group Health Inc Commercial |
$4.28
|
| Rate for Payer: Group Health Inc Medicare |
$4.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$4.28
|
| Rate for Payer: Healthfirst QHP |
$4.28
|
| Rate for Payer: Humana Medicare |
$4.37
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.42
|
| Rate for Payer: Wellcare Medicare |
$3.85
|
|
|
POCT ACTIVATED CLOTTING TIME
|
Facility
|
IP
|
$10.70
|
|
|
Service Code
|
HCPCS 85347
|
| Hospital Charge Code |
40626017
|
|
Hospital Revenue Code
|
310
|
| Rate for Payer: Cash Price |
$4.28
|
|
|
POCT ARTERIAL BLOOD OXIMETERY
|
Facility
|
IP
|
$24.43
|
|
|
Service Code
|
HCPCS 82810
|
| Hospital Charge Code |
40602790
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$9.77
|
|
|
POCT ARTERIAL BLOOD OXIMETERY
|
Facility
|
OP
|
$24.43
|
|
|
Service Code
|
HCPCS 82810
|
| Hospital Charge Code |
40602790
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$18.32 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.44
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.77
|
| Rate for Payer: Aetna Government |
$9.77
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.84
|
| Rate for Payer: Brighton Health Commercial |
$18.32
|
| Rate for Payer: Cash Price |
$9.77
|
| Rate for Payer: Cash Price |
$9.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.77
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.87
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.74
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.77
|
| Rate for Payer: EmblemHealth Commercial |
$9.77
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.70
|
| Rate for Payer: Group Health Inc Commercial |
$9.77
|
| Rate for Payer: Group Health Inc Medicare |
$9.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.77
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.77
|
| Rate for Payer: Healthfirst QHP |
$9.77
|
| Rate for Payer: Humana Medicare |
$9.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.77
|
| Rate for Payer: United Healthcare Commercial |
$11.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.77
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7.82
|
| Rate for Payer: Wellcare Medicare |
$8.79
|
|
|
POCT GLUCOSE ACCU CHEK INFORM II
|
Facility
|
IP
|
$8.20
|
|
|
Service Code
|
HCPCS 82962
|
| Hospital Charge Code |
40608849
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$3.28
|
|
|
POCT GLUCOSE ACCU CHEK INFORM II
|
Facility
|
OP
|
$8.20
|
|
|
Service Code
|
HCPCS 82962
|
| Hospital Charge Code |
40608849
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$6.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.51
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.28
|
| Rate for Payer: Aetna Government |
$3.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2.30
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2.30
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2.30
|
| Rate for Payer: Brighton Health Commercial |
$6.15
|
| Rate for Payer: Cash Price |
$3.28
|
| Rate for Payer: Cash Price |
$3.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.28
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.72
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.15
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.28
|
| Rate for Payer: EmblemHealth Commercial |
$3.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2.79
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2.92
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2.92
|
| Rate for Payer: Group Health Inc Commercial |
$3.28
|
| Rate for Payer: Group Health Inc Medicare |
$3.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.28
|
| Rate for Payer: Healthfirst QHP |
$3.28
|
| Rate for Payer: Humana Medicare |
$3.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.28
|
| Rate for Payer: United Healthcare Commercial |
$2.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2.62
|
| Rate for Payer: Wellcare Medicare |
$2.95
|
|
|
POCT GLUCOSE HEMOCUE
|
Facility
|
IP
|
$9.83
|
|
|
Service Code
|
HCPCS 82947 QW
|
| Hospital Charge Code |
40608848
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$3.93
|
|
|
POCT GLUCOSE HEMOCUE
|
Facility
|
OP
|
$9.83
|
|
|
Service Code
|
HCPCS 82947 QW
|
| Hospital Charge Code |
40608848
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$7.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.93
|
| Rate for Payer: Aetna Government |
$3.93
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2.75
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2.75
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2.75
|
| Rate for Payer: Brighton Health Commercial |
$7.37
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.24
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.93
|
| Rate for Payer: EmblemHealth Commercial |
$3.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.50
|
| Rate for Payer: Group Health Inc Commercial |
$3.93
|
| Rate for Payer: Group Health Inc Medicare |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.93
|
| Rate for Payer: Healthfirst QHP |
$3.93
|
| Rate for Payer: Humana Medicare |
$4.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare Commercial |
$4.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.14
|
| Rate for Payer: Wellcare Medicare |
$3.54
|
|
|
POCT HEMOGLOBIN A1C
|
Facility
|
OP
|
$24.28
|
|
|
Service Code
|
HCPCS 83036 QW
|
| Hospital Charge Code |
40602591
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$18.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.71
|
| Rate for Payer: Aetna Government |
$9.71
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.80
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.80
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.80
|
| Rate for Payer: Brighton Health Commercial |
$18.21
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.71
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$15.43
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$13.06
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.71
|
| Rate for Payer: EmblemHealth Commercial |
$9.71
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.25
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.64
|
| Rate for Payer: Group Health Inc Commercial |
$9.71
|
| Rate for Payer: Group Health Inc Medicare |
$9.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.71
|
| Rate for Payer: Healthfirst QHP |
$9.71
|
| Rate for Payer: Humana Medicare |
$9.90
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.71
|
| Rate for Payer: United Healthcare Commercial |
$12.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.71
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7.77
|
| Rate for Payer: Wellcare Medicare |
$8.74
|
|
|
POCT HEMOGLOBIN A1C
|
Facility
|
IP
|
$24.28
|
|
|
Service Code
|
HCPCS 83036 QW
|
| Hospital Charge Code |
40602591
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$9.71
|
|
|
POCT INFLUENZA A&B RNA MOLECULAR
|
Facility
|
OP
|
$239.50
|
|
|
Service Code
|
HCPCS 87502
|
| Hospital Charge Code |
40611156
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.06 |
| Max. Negotiated Rate |
$179.62 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$131.72
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$95.80
|
| Rate for Payer: Aetna Government |
$95.80
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$67.06
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$67.06
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$67.06
|
| Rate for Payer: Brighton Health Commercial |
$179.62
|
| Rate for Payer: Cash Price |
$95.80
|
| Rate for Payer: Cash Price |
$95.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$95.80
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$135.26
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$114.46
|
| Rate for Payer: Elderplan Medicare Advantage |
$95.80
|
| Rate for Payer: EmblemHealth Commercial |
$95.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$81.43
|
| Rate for Payer: Fidelis Essential Plan QHP |
$85.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$95.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$85.26
|
| Rate for Payer: Group Health Inc Commercial |
$95.80
|
| Rate for Payer: Group Health Inc Medicare |
$95.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$119.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$95.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$95.80
|
| Rate for Payer: Healthfirst QHP |
$95.80
|
| Rate for Payer: Humana Medicare |
$97.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$95.80
|
| Rate for Payer: United Healthcare Commercial |
$107.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$95.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$95.80
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$76.64
|
| Rate for Payer: Wellcare Medicare |
$86.22
|
|
|
POCT INFLUENZA A&B RNA MOLECULAR
|
Facility
|
IP
|
$239.50
|
|
|
Service Code
|
HCPCS 87502
|
| Hospital Charge Code |
40611156
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$95.80
|
|
|
POC/TISSUE MICROARRAY
|
Facility
|
IP
|
$3,000.00
|
|
|
Service Code
|
HCPCS 81229
|
| Hospital Charge Code |
40639229
|
|
Hospital Revenue Code
|
310
|
| Rate for Payer: Cash Price |
$1,160.00
|
|
|
POC/TISSUE MICROARRAY
|
Facility
|
OP
|
$3,000.00
|
|
|
Service Code
|
HCPCS 81229
|
| Hospital Charge Code |
40639229
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$812.00 |
| Max. Negotiated Rate |
$2,400.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,650.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,160.00
|
| Rate for Payer: Aetna Government |
$1,160.00
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$812.00
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$812.00
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$812.00
|
| Rate for Payer: Brighton Health Commercial |
$1,160.00
|
| Rate for Payer: Cash Price |
$1,160.00
|
| Rate for Payer: Cash Price |
$1,160.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,160.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,400.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,040.00
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,160.00
|
| Rate for Payer: EmblemHealth Commercial |
$1,160.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$986.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,032.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,160.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,032.40
|
| Rate for Payer: Group Health Inc Commercial |
$1,160.00
|
| Rate for Payer: Group Health Inc Medicare |
$1,160.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,500.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,160.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,160.00
|
| Rate for Payer: Healthfirst QHP |
$1,160.00
|
| Rate for Payer: Humana Medicare |
$1,183.20
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,160.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,160.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,160.00
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$928.00
|
| Rate for Payer: Wellcare Medicare |
$1,044.00
|
|
|
POCT LIPID PROFILE
|
Facility
|
OP
|
$33.48
|
|
|
Service Code
|
HCPCS 80061 QW
|
| Hospital Charge Code |
40602476
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$25.11 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$18.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13.39
|
| Rate for Payer: Aetna Government |
$13.39
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.37
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.37
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.37
|
| Rate for Payer: Brighton Health Commercial |
$25.11
|
| Rate for Payer: Cash Price |
$13.39
|
| Rate for Payer: Cash Price |
$13.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$13.39
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.51
|
| Rate for Payer: Elderplan Medicare Advantage |
$13.39
|
| Rate for Payer: EmblemHealth Commercial |
$13.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.92
|
| Rate for Payer: Fidelis Medicare Advantage |
$13.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.92
|
| Rate for Payer: Group Health Inc Commercial |
$13.39
|
| Rate for Payer: Group Health Inc Medicare |
$13.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.39
|
| Rate for Payer: Healthfirst QHP |
$13.39
|
| Rate for Payer: Humana Medicare |
$13.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$13.39
|
| Rate for Payer: United Healthcare Commercial |
$16.96
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.39
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.71
|
| Rate for Payer: Wellcare Medicare |
$12.05
|
|
|
POCT LIPID PROFILE
|
Facility
|
IP
|
$33.48
|
|
|
Service Code
|
HCPCS 80061 QW
|
| Hospital Charge Code |
40602476
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$13.39
|
|
|
POCT MICROABMN/CRET RATO RANDOM U
|
Facility
|
OP
|
$15.58
|
|
|
Service Code
|
HCPCS 82044 QW
|
| Hospital Charge Code |
40602602
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$11.68 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.57
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.23
|
| Rate for Payer: Aetna Government |
$6.23
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4.36
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4.36
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4.36
|
| Rate for Payer: Brighton Health Commercial |
$11.68
|
| Rate for Payer: Cash Price |
$6.23
|
| Rate for Payer: Cash Price |
$6.23
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.23
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$7.28
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.16
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.23
|
| Rate for Payer: EmblemHealth Commercial |
$6.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.23
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.54
|
| Rate for Payer: Group Health Inc Commercial |
$6.23
|
| Rate for Payer: Group Health Inc Medicare |
$6.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.23
|
| Rate for Payer: Healthfirst QHP |
$6.23
|
| Rate for Payer: Humana Medicare |
$6.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.23
|
| Rate for Payer: United Healthcare Commercial |
$5.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.23
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.98
|
| Rate for Payer: Wellcare Medicare |
$5.61
|
|
|
POCT MICROABMN/CRET RATO RANDOM U
|
Facility
|
IP
|
$15.58
|
|
|
Service Code
|
HCPCS 82044 QW
|
| Hospital Charge Code |
40602602
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$6.23
|
|
|
POCT RAPID COVID 19 ANTIGEN
|
Facility
|
OP
|
$12.00
|
|
|
Service Code
|
HCPCS 87811 QW
|
| Hospital Charge Code |
40604131
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$42.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$41.38
|
| Rate for Payer: Aetna Government |
$41.38
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$28.97
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$28.97
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$28.97
|
| Rate for Payer: Brighton Health Commercial |
$9.00
|
| Rate for Payer: Cash Price |
$41.38
|
| Rate for Payer: Cash Price |
$41.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$41.38
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$9.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$8.16
|
| Rate for Payer: Elderplan Medicare Advantage |
$41.38
|
| Rate for Payer: EmblemHealth Commercial |
$41.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$35.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$36.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$41.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$36.83
|
| Rate for Payer: Group Health Inc Commercial |
$41.38
|
| Rate for Payer: Group Health Inc Medicare |
$41.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$41.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41.38
|
| Rate for Payer: Healthfirst QHP |
$41.38
|
| Rate for Payer: Humana Medicare |
$42.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$41.38
|
| Rate for Payer: United Healthcare Commercial |
$37.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$41.38
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$33.10
|
| Rate for Payer: Wellcare Medicare |
$37.24
|
|
