|
ATRIUM C-QUR V-PATCH MESH 16.4
|
Facility
OP
|
$978.25
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40205900
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$1,027.16 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$538.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.35
|
| Rate for Payer: Aetna Government |
$69.35
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$489.12
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$562.49
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,027.16
|
| Rate for Payer: Group Health Inc Commercial |
$489.12
|
| Rate for Payer: Group Health Inc Medicare |
$342.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$489.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$489.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$635.86
|
|
|
ATRIUM D-QUR MESH 15X20CM
|
Facility
OP
|
$1,453.50
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40205225
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$1,526.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$799.42
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.35
|
| Rate for Payer: Aetna Government |
$69.35
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$726.75
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$835.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,526.18
|
| Rate for Payer: Group Health Inc Commercial |
$726.75
|
| Rate for Payer: Group Health Inc Medicare |
$508.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$726.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$726.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$944.78
|
|
|
ATRIUM D-QUR MESH 15X20CM
|
Facility
IP
|
$1,453.50
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40205225
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$726.75 |
| Max. Negotiated Rate |
$726.75 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$726.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$726.75
|
|
|
ATRIUM MEDICAL PROLOOP MESH MED
|
Facility
OP
|
$316.94
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40205677
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$332.79 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$174.32
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.35
|
| Rate for Payer: Aetna Government |
$69.35
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$158.47
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$182.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$332.79
|
| Rate for Payer: Group Health Inc Commercial |
$158.47
|
| Rate for Payer: Group Health Inc Medicare |
$110.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$158.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$158.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$206.01
|
|
|
ATRIUM MEDICAL PROLOOP MESH MED
|
Facility
IP
|
$316.94
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40205677
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$158.47 |
| Max. Negotiated Rate |
$158.47 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$158.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$158.47
|
|
|
ATRIUM PRO-LITE MESH 30.5X 45.7CM
|
Facility
OP
|
$361.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40205765
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$379.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$198.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.35
|
| Rate for Payer: Aetna Government |
$69.35
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$180.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$207.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$379.05
|
| Rate for Payer: Group Health Inc Commercial |
$180.50
|
| Rate for Payer: Group Health Inc Medicare |
$126.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$180.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$180.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$234.65
|
|
|
ATRIUM PRO-LITE MESH 30.5X 45.7CM
|
Facility
IP
|
$361.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40205765
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.50 |
| Max. Negotiated Rate |
$180.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$180.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$180.50
|
|
|
ATRIUM PRO-LITE MESH 6X6
|
Facility
IP
|
$128.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40206253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$64.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$64.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$64.00
|
|
|
ATRIUM PRO-LITE MESH 6X6
|
Facility
OP
|
$128.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40206253
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$44.80 |
| Max. Negotiated Rate |
$134.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$70.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.35
|
| Rate for Payer: Aetna Government |
$69.35
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$64.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$73.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$134.40
|
| Rate for Payer: Group Health Inc Commercial |
$64.00
|
| Rate for Payer: Group Health Inc Medicare |
$44.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$64.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$64.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$83.20
|
|
|
ATRIUM V-PATCH MESH 8.0 X8.0CM LG
|
Facility
OP
|
$1,146.60
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40200003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$1,203.93 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$630.63
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.35
|
| Rate for Payer: Aetna Government |
$69.35
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$573.30
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$659.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,203.93
|
| Rate for Payer: Group Health Inc Commercial |
$573.30
|
| Rate for Payer: Group Health Inc Medicare |
$401.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$573.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$573.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$745.29
|
|
|
ATRIUM V-PATCH MESH 8.0 X8.0CM LG
|
Facility
IP
|
$1,146.60
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40200003
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$573.30 |
| Max. Negotiated Rate |
$573.30 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$573.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$573.30
|
|
|
ATROPINE 0.1 MG/ML SYRINGE INJ 10 ML
|
Facility
IP
|
$21.40
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41645521
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.70 |
| Max. Negotiated Rate |
$10.70 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.70
|
|
|
ATROPINE 0.1 MG/ML SYRINGE INJ 10 ML
|
Facility
IP
|
$21.40
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41655521
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.70 |
| Max. Negotiated Rate |
$10.70 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.70
|
|
|
ATROPINE 0.1 MG/ML SYRINGE INJ 10 ML
|
Facility
OP
|
$21.40
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41645521
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$13.91 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.77
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.08
|
| Rate for Payer: Aetna Government |
$0.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$10.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$0.08
|
| Rate for Payer: Group Health Inc Commercial |
$10.70
|
| Rate for Payer: Group Health Inc Medicare |
$7.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.07
|
| Rate for Payer: SOMOS Essential |
$0.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.91
|
|
|
ATROPINE 0.1 MG/ML SYRINGE INJ 10 ML
|
Facility
OP
|
$21.40
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41655521
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$13.91 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.77
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.08
|
| Rate for Payer: Aetna Government |
$0.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$10.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$0.08
|
| Rate for Payer: Group Health Inc Commercial |
$10.70
|
| Rate for Payer: Group Health Inc Medicare |
$7.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.07
|
| Rate for Payer: SOMOS Essential |
$0.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.91
|
|
|
ATROPINE 0.4 MG/ML INJ
|
Facility
IP
|
$2.98
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41651489
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$1.49 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.49
|
|
|
ATROPINE 0.4 MG/ML INJ
|
Facility
OP
|
$2.98
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41651489
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.64
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.08
|
| Rate for Payer: Aetna Government |
$0.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.49
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$0.08
|
| Rate for Payer: Group Health Inc Commercial |
$1.49
|
| Rate for Payer: Group Health Inc Medicare |
$1.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.07
|
| Rate for Payer: SOMOS Essential |
$0.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.94
|
|
|
ATROPINE 0.4 MG/ML INJ
|
Facility
OP
|
$2.98
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41641489
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.64
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.08
|
| Rate for Payer: Aetna Government |
$0.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.49
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$0.08
|
| Rate for Payer: Group Health Inc Commercial |
$1.49
|
| Rate for Payer: Group Health Inc Medicare |
$1.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.07
|
| Rate for Payer: SOMOS Essential |
$0.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.94
|
|
|
ATROPINE 0.4 MG/ML INJ
|
Facility
IP
|
$2.98
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41641489
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$1.49 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.49
|
|
|
ATROPINE 1 MG/ML INJ
|
Facility
OP
|
$3.00
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41643819
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.08
|
| Rate for Payer: Aetna Government |
$0.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$0.08
|
| Rate for Payer: Group Health Inc Commercial |
$1.50
|
| Rate for Payer: Group Health Inc Medicare |
$1.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.07
|
| Rate for Payer: SOMOS Essential |
$0.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.95
|
|
|
ATROPINE 1 MG/ML INJ
|
Facility
IP
|
$3.00
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41653819
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.50
|
|
|
ATROPINE 1 MG/ML INJ
|
Facility
OP
|
$3.00
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41653819
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.08
|
| Rate for Payer: Aetna Government |
$0.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$0.08
|
| Rate for Payer: Group Health Inc Commercial |
$1.50
|
| Rate for Payer: Group Health Inc Medicare |
$1.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.07
|
| Rate for Payer: SOMOS Essential |
$0.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.95
|
|
|
ATROPINE 1 MG/ML INJ
|
Facility
IP
|
$3.00
|
|
|
Service Code
|
HCPCS J0461
|
| Hospital Charge Code |
41643819
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.50
|
|
|
ATROPINE 1% OPHTHALMIC OINT
|
Facility
OP
|
$3.00
|
|
| Hospital Charge Code |
41642198
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$2.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.50
|
| Rate for Payer: Aetna Government |
$1.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2.04
|
| Rate for Payer: Group Health Inc Commercial |
$1.50
|
| Rate for Payer: Group Health Inc Medicare |
$1.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.95
|
|
|
ATROPINE 1% OPHTHALMIC OINT
|
Facility
OP
|
$3.00
|
|
| Hospital Charge Code |
41652198
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$2.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.50
|
| Rate for Payer: Aetna Government |
$1.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2.04
|
| Rate for Payer: Group Health Inc Commercial |
$1.50
|
| Rate for Payer: Group Health Inc Medicare |
$1.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.95
|
|
