SENNA 8.6 MG TAB
|
Facility
OP
|
$0.06
|
|
Hospital Charge Code |
41654092
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.03
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.03
|
Rate for Payer: Aetna Government |
$0.03
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.05
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.04
|
Rate for Payer: Group Health Inc Commercial |
$0.03
|
Rate for Payer: Group Health Inc Medicare |
$0.02
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.03
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.03
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.04
|
|
SENN RETRACTOR SHARP DEL DBL END
|
Facility
OP
|
$21.15
|
|
Hospital Charge Code |
64905587
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$7.40 |
Max. Negotiated Rate |
$16.92 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.63
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$10.58
|
Rate for Payer: Aetna Government |
$10.58
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$16.92
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$14.38
|
Rate for Payer: Group Health Inc Commercial |
$10.58
|
Rate for Payer: Group Health Inc Medicare |
$7.40
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.58
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$10.58
|
|
SENORINEURAL ACUITY LEVEL TEST
|
Facility
OP
|
$101.25
|
|
Service Code
|
HCPCS 92575
|
Hospital Charge Code |
42004509
|
Hospital Revenue Code
|
471
|
Min. Negotiated Rate |
$37.10 |
Max. Negotiated Rate |
$92.33 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$55.69
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$46.38
|
Rate for Payer: Aetna Government |
$46.38
|
Rate for Payer: Cash Price |
$46.38
|
Rate for Payer: Cash Price |
$46.38
|
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$46.38
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$81.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$68.85
|
Rate for Payer: Elderplan Medicare Advantage |
$46.38
|
Rate for Payer: EmblemHealth Commercial |
$46.38
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$83.10
|
Rate for Payer: Fidelis Essential Plan Aliesa |
$39.42
|
Rate for Payer: Fidelis Essential Plan QHP |
$41.28
|
Rate for Payer: Fidelis Medicare Advantage |
$46.38
|
Rate for Payer: Fidelis Qualified Health Plan |
$41.28
|
Rate for Payer: Group Health Inc Commercial |
$46.38
|
Rate for Payer: Group Health Inc Medicare |
$46.38
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.62
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$46.38
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$92.33
|
Rate for Payer: Healthfirst Medicare Advantage |
$39.42
|
Rate for Payer: Healthfirst QHP |
$46.38
|
Rate for Payer: Senior Whole Health Medicare Advantage |
$46.38
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$46.38
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$37.10
|
Rate for Payer: Wellcare Medicare |
$44.06
|
|
SENSIA PACEMAKER
|
Facility
OP
|
$7,484.00
|
|
Service Code
|
HCPCS C1786
|
Hospital Charge Code |
66574668
|
Hospital Revenue Code
|
275
|
Min. Negotiated Rate |
$1,116.69 |
Max. Negotiated Rate |
$7,858.20 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,116.20
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,116.69
|
Rate for Payer: Aetna Government |
$1,116.69
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,742.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,303.30
|
Rate for Payer: Fidelis Medicare Advantage |
$7,858.20
|
Rate for Payer: Group Health Inc Commercial |
$3,742.00
|
Rate for Payer: Group Health Inc Medicare |
$2,619.40
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,742.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$3,742.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,864.60
|
|
SENSIA SEDRO 1 PACEMAKER
|
Facility
OP
|
$10,600.00
|
|
Service Code
|
HCPCS C2621
|
Hospital Charge Code |
40209641
|
Hospital Revenue Code
|
275
|
Min. Negotiated Rate |
$3,640.47 |
Max. Negotiated Rate |
$11,130.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5,830.00
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,640.47
|
Rate for Payer: Aetna Government |
$3,640.47
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5,300.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$6,095.00
|
Rate for Payer: Fidelis Medicare Advantage |
$11,130.00
|
Rate for Payer: Group Health Inc Commercial |
$5,300.00
|
Rate for Payer: Group Health Inc Medicare |
$3,710.00
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,300.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$5,300.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,890.00
|
|
SENSITIVITY TEST SOLUTION FT-12
|
Facility
OP
|
$117.10
|
|
Hospital Charge Code |
64903045
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$40.98 |
Max. Negotiated Rate |
$93.68 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$64.40
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$58.55
|
Rate for Payer: Aetna Government |
$58.55
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$93.68
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$79.63
|
Rate for Payer: Group Health Inc Commercial |
$58.55
|
Rate for Payer: Group Health Inc Medicare |
$40.98
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$58.55
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$58.55
|
|
SENSOR ACUMEN IQ
|
Facility
OP
|
$217.50
|
|
Hospital Charge Code |
64907174
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$76.12 |
Max. Negotiated Rate |
$174.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$119.62
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$108.75
|
Rate for Payer: Aetna Government |
$108.75
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$174.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$147.90
|
Rate for Payer: Group Health Inc Commercial |
$108.75
|
Rate for Payer: Group Health Inc Medicare |
$76.12
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$108.75
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$108.75
|
|
SENSOR, ADHESIVE, ADULT, 18IN 1U
|
Facility
OP
|
$18.13
|
|
Hospital Charge Code |
64906205
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$6.35 |
Max. Negotiated Rate |
$14.50 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9.97
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.06
|
Rate for Payer: Aetna Government |
$9.06
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.33
|
Rate for Payer: Group Health Inc Commercial |
$9.06
|
Rate for Payer: Group Health Inc Medicare |
$6.35
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.06
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$9.06
|
|
SENSOR, ADHESIVE, NEO / ADULT 1U
|
Facility
OP
|
$14.38
|
|
Hospital Charge Code |
64906211
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$5.03 |
Max. Negotiated Rate |
$11.50 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.91
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7.19
|
Rate for Payer: Aetna Government |
$7.19
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$9.78
|
Rate for Payer: Group Health Inc Commercial |
$7.19
|
Rate for Payer: Group Health Inc Medicare |
$5.03
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.19
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$7.19
|
|
SENSOR, ADHESIVE, NEONATAL,RD SET
|
Facility
OP
|
$89.12
|
|
Hospital Charge Code |
64902155
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$31.19 |
Max. Negotiated Rate |
$71.30 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$49.02
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$44.56
|
Rate for Payer: Aetna Government |
$44.56
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$71.30
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$60.60
|
Rate for Payer: Group Health Inc Commercial |
$44.56
|
Rate for Payer: Group Health Inc Medicare |
$31.19
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$44.56
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$44.56
|
|
SENSOR, ADHESIVE, PEDI, 18IN 1U
|
Facility
OP
|
$23.75
|
|
Hospital Charge Code |
64906207
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$8.31 |
Max. Negotiated Rate |
$19.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.06
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.88
|
Rate for Payer: Aetna Government |
$11.88
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.15
|
Rate for Payer: Group Health Inc Commercial |
$11.88
|
Rate for Payer: Group Health Inc Medicare |
$8.31
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.88
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$11.88
|
|
SENSOR, ADHESIVE, PEDI, 3',SNGL
|
Facility
OP
|
$475.00
|
|
Hospital Charge Code |
64906208
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$166.25 |
Max. Negotiated Rate |
$380.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$261.25
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$237.50
|
Rate for Payer: Aetna Government |
$237.50
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$380.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$323.00
|
Rate for Payer: Group Health Inc Commercial |
$237.50
|
Rate for Payer: Group Health Inc Medicare |
$166.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$237.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$237.50
|
|
SENSOR DISPOSABLE NEOTEMP A
|
Facility
OP
|
$10.00
|
|
Hospital Charge Code |
64903431
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$3.50 |
Max. Negotiated Rate |
$8.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.50
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.00
|
Rate for Payer: Aetna Government |
$5.00
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.80
|
Rate for Payer: Group Health Inc Commercial |
$5.00
|
Rate for Payer: Group Health Inc Medicare |
$3.50
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$5.00
|
|
SENSOR DISPOSABLE NEOTEMP B
|
Facility
OP
|
$10.00
|
|
Hospital Charge Code |
64903433
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$3.50 |
Max. Negotiated Rate |
$8.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.50
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.00
|
Rate for Payer: Aetna Government |
$5.00
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.80
|
Rate for Payer: Group Health Inc Commercial |
$5.00
|
Rate for Payer: Group Health Inc Medicare |
$3.50
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$5.00
|
|
SENSOR DISPOSABLE NEOTEMP C
|
Facility
OP
|
$22.50
|
|
Hospital Charge Code |
64903435
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$7.88 |
Max. Negotiated Rate |
$18.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$12.38
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.25
|
Rate for Payer: Aetna Government |
$11.25
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$15.30
|
Rate for Payer: Group Health Inc Commercial |
$11.25
|
Rate for Payer: Group Health Inc Medicare |
$7.88
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.25
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$11.25
|
|
SENSOR ELITE
|
Facility
OP
|
$13.12
|
|
Hospital Charge Code |
64907175
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$4.59 |
Max. Negotiated Rate |
$10.50 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.22
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.56
|
Rate for Payer: Aetna Government |
$6.56
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$10.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$8.92
|
Rate for Payer: Group Health Inc Commercial |
$6.56
|
Rate for Payer: Group Health Inc Medicare |
$4.59
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.56
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$6.56
|
|
SENSOR FLOTRAC AC SENSOR
|
Facility
OP
|
$832.00
|
|
Hospital Charge Code |
64901649
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$291.20 |
Max. Negotiated Rate |
$665.60 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$457.60
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$416.00
|
Rate for Payer: Aetna Government |
$416.00
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$665.60
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$565.76
|
Rate for Payer: Group Health Inc Commercial |
$416.00
|
Rate for Payer: Group Health Inc Medicare |
$291.20
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$416.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$416.00
|
|
SENSOR, INFANT, ADHES, M-LNCS 18
|
Facility
OP
|
$23.75
|
|
Hospital Charge Code |
64906209
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$8.31 |
Max. Negotiated Rate |
$19.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.06
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.88
|
Rate for Payer: Aetna Government |
$11.88
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.15
|
Rate for Payer: Group Health Inc Commercial |
$11.88
|
Rate for Payer: Group Health Inc Medicare |
$8.31
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.88
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$11.88
|
|
SENSOR, MASIMO, RED, SET,NEONATAL
|
Facility
OP
|
$24.88
|
|
Hospital Charge Code |
64902153
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$8.71 |
Max. Negotiated Rate |
$19.90 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.68
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.44
|
Rate for Payer: Aetna Government |
$12.44
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.90
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.92
|
Rate for Payer: Group Health Inc Commercial |
$12.44
|
Rate for Payer: Group Health Inc Medicare |
$8.71
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.44
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$12.44
|
|
SENSOR MAX-A ADULT DIGIT
|
Facility
OP
|
$21.75
|
|
Hospital Charge Code |
64901002
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$7.61 |
Max. Negotiated Rate |
$17.40 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.96
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$10.88
|
Rate for Payer: Aetna Government |
$10.88
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$17.40
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$14.79
|
Rate for Payer: Group Health Inc Commercial |
$10.88
|
Rate for Payer: Group Health Inc Medicare |
$7.61
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.88
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$10.88
|
|
SENSOR MAX-I INFANT
|
Facility
OP
|
$28.28
|
|
Hospital Charge Code |
64901060
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$9.90 |
Max. Negotiated Rate |
$22.62 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.55
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.14
|
Rate for Payer: Aetna Government |
$14.14
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22.62
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$19.23
|
Rate for Payer: Group Health Inc Commercial |
$14.14
|
Rate for Payer: Group Health Inc Medicare |
$9.90
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.14
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$14.14
|
|
SENSOR MAX-P PEDIATRIC DIGIT
|
Facility
OP
|
$21.75
|
|
Hospital Charge Code |
64901007
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$7.61 |
Max. Negotiated Rate |
$17.40 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.96
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$10.88
|
Rate for Payer: Aetna Government |
$10.88
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$17.40
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$14.79
|
Rate for Payer: Group Health Inc Commercial |
$10.88
|
Rate for Payer: Group Health Inc Medicare |
$7.61
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.88
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$10.88
|
|
SENSOR, M-LNCS, ADLT, SPO2, ADHS
|
Facility
OP
|
$18.13
|
|
Hospital Charge Code |
64906206
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$6.35 |
Max. Negotiated Rate |
$14.50 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9.97
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.06
|
Rate for Payer: Aetna Government |
$9.06
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.33
|
Rate for Payer: Group Health Inc Commercial |
$9.06
|
Rate for Payer: Group Health Inc Medicare |
$6.35
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.06
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$9.06
|
|
SENSOR,M-LNCS,ADLT,SPO2,ADHS SN
|
Facility
OP
|
$595.00
|
|
Hospital Charge Code |
64906214
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$208.25 |
Max. Negotiated Rate |
$476.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$327.25
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$297.50
|
Rate for Payer: Aetna Government |
$297.50
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$476.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$404.60
|
Rate for Payer: Group Health Inc Commercial |
$297.50
|
Rate for Payer: Group Health Inc Medicare |
$208.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$297.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$297.50
|
|
SENSOR,MONITOR,BRAIN,BIS QUAT
|
Facility
OP
|
$48.56
|
|
Hospital Charge Code |
64905336
|
Hospital Revenue Code
|
270
|
Min. Negotiated Rate |
$17.00 |
Max. Negotiated Rate |
$38.85 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$26.71
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$24.28
|
Rate for Payer: Aetna Government |
$24.28
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$38.85
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$33.02
|
Rate for Payer: Group Health Inc Commercial |
$24.28
|
Rate for Payer: Group Health Inc Medicare |
$17.00
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$24.28
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$24.28
|
|