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Hospital Charge Code 41655405
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 41645405
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 41640704
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 41650704
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 41655077
Hospital Revenue Code 250
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.06
Rate for Payer: Aetna Government $0.06
Rate for Payer: Brighton Health Commercial $0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.09
Rate for Payer: Cigna LocalPlus Benefit Plan $0.07
Rate for Payer: Group Health Inc Commercial $0.06
Rate for Payer: Group Health Inc Medicare $0.04
Rate for Payer: Hamaspik Choice Inc Medicaid $0.06
Rate for Payer: Hamaspik Choice Inc Medicare $0.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.07
Hospital Charge Code 41645077
Hospital Revenue Code 250
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.06
Rate for Payer: Aetna Government $0.06
Rate for Payer: Brighton Health Commercial $0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.09
Rate for Payer: Cigna LocalPlus Benefit Plan $0.07
Rate for Payer: Group Health Inc Commercial $0.06
Rate for Payer: Group Health Inc Medicare $0.04
Rate for Payer: Hamaspik Choice Inc Medicaid $0.06
Rate for Payer: Hamaspik Choice Inc Medicare $0.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.07
Hospital Charge Code 41640805
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 41650805
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 00904655061
Hospital Charge Code 00904655061
Hospital Revenue Code 250
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.18
Rate for Payer: Aetna Government $0.18
Rate for Payer: Brighton Health Commercial $0.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.28
Rate for Payer: Cigna LocalPlus Benefit Plan $0.24
Rate for Payer: Group Health Inc Commercial $0.18
Rate for Payer: Group Health Inc Medicare $0.12
Rate for Payer: Hamaspik Choice Inc Medicaid $0.18
Rate for Payer: Hamaspik Choice Inc Medicare $0.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.23
Service Code NDC 69238207701
Hospital Charge Code 69238207701
Hospital Revenue Code 250
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.20
Rate for Payer: Aetna Government $0.20
Rate for Payer: Brighton Health Commercial $0.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.33
Rate for Payer: Cigna LocalPlus Benefit Plan $0.28
Rate for Payer: Group Health Inc Commercial $0.20
Rate for Payer: Group Health Inc Medicare $0.14
Rate for Payer: Hamaspik Choice Inc Medicaid $0.20
Rate for Payer: Hamaspik Choice Inc Medicare $0.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.27
Service Code NDC 00378018201
Hospital Charge Code 00378018201
Hospital Revenue Code 250
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.20
Rate for Payer: Aetna Government $0.20
Rate for Payer: Brighton Health Commercial $0.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.33
Rate for Payer: Cigna LocalPlus Benefit Plan $0.28
Rate for Payer: Group Health Inc Commercial $0.20
Rate for Payer: Group Health Inc Medicare $0.14
Rate for Payer: Hamaspik Choice Inc Medicaid $0.20
Rate for Payer: Hamaspik Choice Inc Medicare $0.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.27
Service Code NDC 00603548221
Hospital Charge Code 00603548221
Hospital Revenue Code 250
Min. Negotiated Rate $0.14
Max. Negotiated Rate $0.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.20
Rate for Payer: Aetna Government $0.20
Rate for Payer: Brighton Health Commercial $0.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.33
Rate for Payer: Cigna LocalPlus Benefit Plan $0.28
Rate for Payer: Group Health Inc Commercial $0.20
Rate for Payer: Group Health Inc Medicare $0.14
Rate for Payer: Hamaspik Choice Inc Medicaid $0.20
Rate for Payer: Hamaspik Choice Inc Medicare $0.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.27
Service Code HCPCS J1800
Hospital Charge Code 63323060401
Hospital Revenue Code 278
Min. Negotiated Rate $6.04
Max. Negotiated Rate $6.04
Rate for Payer: Hamaspik Choice Inc Medicaid $6.04
Rate for Payer: Hamaspik Choice Inc Medicare $6.04
Service Code HCPCS J1800
Hospital Charge Code 63323060401
Hospital Revenue Code 278
Min. Negotiated Rate $4.23
Max. Negotiated Rate $12.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial $6.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $6.62
Rate for Payer: Aetna Government $6.62
Rate for Payer: Brighton Health Commercial $7.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $6.04
Rate for Payer: Cigna LocalPlus Benefit Plan $6.95
Rate for Payer: EmblemHealth Commercial $6.04
Rate for Payer: Fidelis Medicare Advantage $12.69
Rate for Payer: Group Health Inc Commercial $6.04
Rate for Payer: Group Health Inc Medicare $4.23
Rate for Payer: Hamaspik Choice Inc Medicaid $6.04
Rate for Payer: Hamaspik Choice Inc Medicare $6.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $7.85
Service Code HCPCS J1800
Hospital Charge Code 00143987210
Hospital Revenue Code 278
Min. Negotiated Rate $3.36
Max. Negotiated Rate $10.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial $5.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $6.62
Rate for Payer: Aetna Government $6.62
Rate for Payer: Brighton Health Commercial $5.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $4.80
Rate for Payer: Cigna LocalPlus Benefit Plan $5.52
Rate for Payer: EmblemHealth Commercial $4.80
Rate for Payer: Fidelis Medicare Advantage $10.08
Rate for Payer: Group Health Inc Commercial $4.80
Rate for Payer: Group Health Inc Medicare $3.36
Rate for Payer: Hamaspik Choice Inc Medicaid $4.80
Rate for Payer: Hamaspik Choice Inc Medicare $4.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $6.24
Service Code HCPCS J1800
Hospital Charge Code 00143987210
Hospital Revenue Code 278
Min. Negotiated Rate $4.80
Max. Negotiated Rate $4.80
Rate for Payer: Hamaspik Choice Inc Medicaid $4.80
Rate for Payer: Hamaspik Choice Inc Medicare $4.80
Service Code NDC 00121090805
Hospital Charge Code 00121090805
Hospital Revenue Code 250
Min. Negotiated Rate $0.30
Max. Negotiated Rate $0.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.42
Rate for Payer: Aetna Government $0.42
Rate for Payer: Brighton Health Commercial $0.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.68
Rate for Payer: Cigna LocalPlus Benefit Plan $0.57
Rate for Payer: Group Health Inc Commercial $0.42
Rate for Payer: Group Health Inc Medicare $0.30
Rate for Payer: Hamaspik Choice Inc Medicaid $0.42
Rate for Payer: Hamaspik Choice Inc Medicare $0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.55
Service Code NDC 09999123472
Hospital Charge Code 00054372763
Hospital Revenue Code 250
Min. Negotiated Rate $0.05
Max. Negotiated Rate $0.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.07
Rate for Payer: Aetna Government $0.07
Rate for Payer: Brighton Health Commercial $0.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.11
Rate for Payer: Cigna LocalPlus Benefit Plan $0.09
Rate for Payer: Group Health Inc Commercial $0.07
Rate for Payer: Group Health Inc Medicare $0.05
Rate for Payer: Hamaspik Choice Inc Medicaid $0.07
Rate for Payer: Hamaspik Choice Inc Medicare $0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.09
Service Code NDC 00904670561
Hospital Charge Code 00904670561
Hospital Revenue Code 250
Min. Negotiated Rate $0.47
Max. Negotiated Rate $1.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.67
Rate for Payer: Aetna Government $0.67
Rate for Payer: Brighton Health Commercial $1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.07
Rate for Payer: Cigna LocalPlus Benefit Plan $0.91
Rate for Payer: Group Health Inc Commercial $0.67
Rate for Payer: Group Health Inc Medicare $0.47
Rate for Payer: Hamaspik Choice Inc Medicaid $0.67
Rate for Payer: Hamaspik Choice Inc Medicare $0.67
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.87
Service Code NDC 60687059801
Hospital Charge Code 60687059801
Hospital Revenue Code 250
Min. Negotiated Rate $0.19
Max. Negotiated Rate $0.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.28
Rate for Payer: Aetna Government $0.28
Rate for Payer: Brighton Health Commercial $0.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.44
Rate for Payer: Cigna LocalPlus Benefit Plan $0.38
Rate for Payer: Group Health Inc Commercial $0.28
Rate for Payer: Group Health Inc Medicare $0.19
Rate for Payer: Hamaspik Choice Inc Medicaid $0.28
Rate for Payer: Hamaspik Choice Inc Medicare $0.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.36
Service Code NDC 60687059811
Hospital Charge Code 60687059811
Hospital Revenue Code 250
Min. Negotiated Rate $0.19
Max. Negotiated Rate $0.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.28
Rate for Payer: Aetna Government $0.28
Rate for Payer: Brighton Health Commercial $0.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.44
Rate for Payer: Cigna LocalPlus Benefit Plan $0.38
Rate for Payer: Group Health Inc Commercial $0.28
Rate for Payer: Group Health Inc Medicare $0.19
Rate for Payer: Hamaspik Choice Inc Medicaid $0.28
Rate for Payer: Hamaspik Choice Inc Medicare $0.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.36
Service Code NDC 00603548321
Hospital Charge Code 00603548321
Hospital Revenue Code 250
Min. Negotiated Rate $0.18
Max. Negotiated Rate $0.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.26
Rate for Payer: Aetna Government $0.26
Rate for Payer: Brighton Health Commercial $0.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.41
Rate for Payer: Cigna LocalPlus Benefit Plan $0.35
Rate for Payer: Group Health Inc Commercial $0.26
Rate for Payer: Group Health Inc Medicare $0.18
Rate for Payer: Hamaspik Choice Inc Medicaid $0.26
Rate for Payer: Hamaspik Choice Inc Medicare $0.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.33
Service Code NDC 00603548421
Hospital Charge Code 00603548421
Hospital Revenue Code 250
Min. Negotiated Rate $0.25
Max. Negotiated Rate $0.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.36
Rate for Payer: Aetna Government $0.36
Rate for Payer: Brighton Health Commercial $0.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.57
Rate for Payer: Cigna LocalPlus Benefit Plan $0.49
Rate for Payer: Group Health Inc Commercial $0.36
Rate for Payer: Group Health Inc Medicare $0.25
Rate for Payer: Hamaspik Choice Inc Medicaid $0.36
Rate for Payer: Hamaspik Choice Inc Medicare $0.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.47
Service Code NDC 60687060901
Hospital Charge Code 60687060901
Hospital Revenue Code 250
Min. Negotiated Rate $0.23
Max. Negotiated Rate $0.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.34
Rate for Payer: Aetna Government $0.34
Rate for Payer: Brighton Health Commercial $0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.54
Rate for Payer: Cigna LocalPlus Benefit Plan $0.46
Rate for Payer: Group Health Inc Commercial $0.34
Rate for Payer: Group Health Inc Medicare $0.23
Rate for Payer: Hamaspik Choice Inc Medicaid $0.34
Rate for Payer: Hamaspik Choice Inc Medicare $0.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.44
Service Code NDC 60687060911
Hospital Charge Code 60687060911
Hospital Revenue Code 250
Min. Negotiated Rate $0.23
Max. Negotiated Rate $0.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.34
Rate for Payer: Aetna Government $0.34
Rate for Payer: Brighton Health Commercial $0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.54
Rate for Payer: Cigna LocalPlus Benefit Plan $0.46
Rate for Payer: Group Health Inc Commercial $0.34
Rate for Payer: Group Health Inc Medicare $0.23
Rate for Payer: Hamaspik Choice Inc Medicaid $0.34
Rate for Payer: Hamaspik Choice Inc Medicare $0.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.44