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Service Code NDC 1672944010
Hospital Charge Code 1672944010
Hospital Revenue Code 250
Min. Negotiated Rate $15.33
Max. Negotiated Rate $15.33
Rate for Payer: Hamaspik Choice Inc Medicaid $15.33
Service Code NDC 4733537983
Hospital Charge Code 4733537983
Hospital Revenue Code 250
Min. Negotiated Rate $10.73
Max. Negotiated Rate $24.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial $16.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $15.33
Rate for Payer: Aetna Government $15.33
Rate for Payer: Brighton Health Commercial $22.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $24.52
Rate for Payer: Cigna LocalPlus Benefit Plan $20.85
Rate for Payer: EmblemHealth Commercial $15.33
Rate for Payer: Group Health Inc Commercial $15.33
Rate for Payer: Group Health Inc Medicare $10.73
Rate for Payer: Hamaspik Choice Inc Medicaid $15.33
Rate for Payer: Hamaspik Choice Inc Medicare $15.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $19.93
Service Code NDC 5551307330
Hospital Charge Code 5551307330
Hospital Revenue Code 250
Min. Negotiated Rate $11.29
Max. Negotiated Rate $25.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial $17.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $16.13
Rate for Payer: Aetna Government $16.13
Rate for Payer: Brighton Health Commercial $24.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $25.81
Rate for Payer: Cigna LocalPlus Benefit Plan $21.94
Rate for Payer: EmblemHealth Commercial $16.13
Rate for Payer: Group Health Inc Commercial $16.13
Rate for Payer: Group Health Inc Medicare $11.29
Rate for Payer: Hamaspik Choice Inc Medicaid $16.13
Rate for Payer: Hamaspik Choice Inc Medicare $16.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $20.97
Service Code NDC 4733537983
Hospital Charge Code 4733537983
Hospital Revenue Code 250
Min. Negotiated Rate $15.33
Max. Negotiated Rate $15.33
Rate for Payer: Hamaspik Choice Inc Medicaid $15.33
Service Code NDC 4359836730
Hospital Charge Code 4359836730
Hospital Revenue Code 250
Min. Negotiated Rate $10.73
Max. Negotiated Rate $24.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial $16.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $15.33
Rate for Payer: Aetna Government $15.33
Rate for Payer: Brighton Health Commercial $22.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $24.52
Rate for Payer: Cigna LocalPlus Benefit Plan $20.85
Rate for Payer: EmblemHealth Commercial $15.33
Rate for Payer: Group Health Inc Commercial $15.33
Rate for Payer: Group Health Inc Medicare $10.73
Rate for Payer: Hamaspik Choice Inc Medicaid $15.33
Rate for Payer: Hamaspik Choice Inc Medicare $15.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $19.93
Service Code NDC 1672944010
Hospital Charge Code 1672944010
Hospital Revenue Code 250
Min. Negotiated Rate $10.73
Max. Negotiated Rate $24.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial $16.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $15.33
Rate for Payer: Aetna Government $15.33
Rate for Payer: Brighton Health Commercial $22.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $24.52
Rate for Payer: Cigna LocalPlus Benefit Plan $20.85
Rate for Payer: EmblemHealth Commercial $15.33
Rate for Payer: Group Health Inc Commercial $15.33
Rate for Payer: Group Health Inc Medicare $10.73
Rate for Payer: Hamaspik Choice Inc Medicaid $15.33
Rate for Payer: Hamaspik Choice Inc Medicare $15.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $19.93
Service Code NDC 5551307330
Hospital Charge Code 5551307330
Hospital Revenue Code 250
Min. Negotiated Rate $16.13
Max. Negotiated Rate $16.13
Rate for Payer: Hamaspik Choice Inc Medicaid $16.13
Service Code NDC 6438088404
Hospital Charge Code 6438088404
Hospital Revenue Code 250
Min. Negotiated Rate $21.46
Max. Negotiated Rate $49.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial $33.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $30.65
Rate for Payer: Aetna Government $30.65
Rate for Payer: Brighton Health Commercial $45.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $49.05
Rate for Payer: Cigna LocalPlus Benefit Plan $41.69
Rate for Payer: EmblemHealth Commercial $30.65
Rate for Payer: Group Health Inc Commercial $30.65
Rate for Payer: Group Health Inc Medicare $21.46
Rate for Payer: Hamaspik Choice Inc Medicaid $30.65
Rate for Payer: Hamaspik Choice Inc Medicare $30.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $39.85
Service Code NDC 6438088404
Hospital Charge Code 6438088404
Hospital Revenue Code 250
Min. Negotiated Rate $30.65
Max. Negotiated Rate $30.65
Rate for Payer: Hamaspik Choice Inc Medicaid $30.65
Service Code NDC 4733538083
Hospital Charge Code 4733538083
Hospital Revenue Code 250
Min. Negotiated Rate $30.65
Max. Negotiated Rate $30.65
Rate for Payer: Hamaspik Choice Inc Medicaid $30.65
Service Code NDC 1672944110
Hospital Charge Code 1672944110
Hospital Revenue Code 250
Min. Negotiated Rate $21.46
Max. Negotiated Rate $49.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial $33.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $30.65
Rate for Payer: Aetna Government $30.65
Rate for Payer: Brighton Health Commercial $45.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $49.05
Rate for Payer: Cigna LocalPlus Benefit Plan $41.69
Rate for Payer: EmblemHealth Commercial $30.65
Rate for Payer: Group Health Inc Commercial $30.65
Rate for Payer: Group Health Inc Medicare $21.46
Rate for Payer: Hamaspik Choice Inc Medicaid $30.65
Rate for Payer: Hamaspik Choice Inc Medicare $30.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $39.85
Service Code NDC 1672944110
Hospital Charge Code 1672944110
Hospital Revenue Code 250
Min. Negotiated Rate $30.65
Max. Negotiated Rate $30.65
Rate for Payer: Hamaspik Choice Inc Medicaid $30.65
Service Code NDC 4733538083
Hospital Charge Code 4733538083
Hospital Revenue Code 250
Min. Negotiated Rate $21.46
Max. Negotiated Rate $49.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial $33.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $30.65
Rate for Payer: Aetna Government $30.65
Rate for Payer: Brighton Health Commercial $45.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $49.05
Rate for Payer: Cigna LocalPlus Benefit Plan $41.69
Rate for Payer: EmblemHealth Commercial $30.65
Rate for Payer: Group Health Inc Commercial $30.65
Rate for Payer: Group Health Inc Medicare $21.46
Rate for Payer: Hamaspik Choice Inc Medicaid $30.65
Rate for Payer: Hamaspik Choice Inc Medicare $30.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $39.85
Service Code NDC 6909741102
Hospital Charge Code 6909741102
Hospital Revenue Code 250
Min. Negotiated Rate $21.46
Max. Negotiated Rate $49.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial $33.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $30.65
Rate for Payer: Aetna Government $30.65
Rate for Payer: Brighton Health Commercial $45.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $49.05
Rate for Payer: Cigna LocalPlus Benefit Plan $41.69
Rate for Payer: EmblemHealth Commercial $30.65
Rate for Payer: Group Health Inc Commercial $30.65
Rate for Payer: Group Health Inc Medicare $21.46
Rate for Payer: Hamaspik Choice Inc Medicaid $30.65
Rate for Payer: Hamaspik Choice Inc Medicare $30.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $39.85
Service Code NDC 6909741102
Hospital Charge Code 6909741102
Hospital Revenue Code 250
Min. Negotiated Rate $30.65
Max. Negotiated Rate $30.65
Rate for Payer: Hamaspik Choice Inc Medicaid $30.65
Service Code NDC 5551307430
Hospital Charge Code 5551307430
Hospital Revenue Code 250
Min. Negotiated Rate $32.27
Max. Negotiated Rate $32.27
Rate for Payer: Hamaspik Choice Inc Medicaid $32.27
Service Code NDC 5551307430
Hospital Charge Code 5551307430
Hospital Revenue Code 250
Min. Negotiated Rate $22.59
Max. Negotiated Rate $51.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial $35.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $32.27
Rate for Payer: Aetna Government $32.27
Rate for Payer: Brighton Health Commercial $48.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $51.63
Rate for Payer: Cigna LocalPlus Benefit Plan $43.88
Rate for Payer: EmblemHealth Commercial $32.27
Rate for Payer: Group Health Inc Commercial $32.27
Rate for Payer: Group Health Inc Medicare $22.59
Rate for Payer: Hamaspik Choice Inc Medicaid $32.27
Rate for Payer: Hamaspik Choice Inc Medicare $32.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $41.95
Service Code NDC 1672944210
Hospital Charge Code 1672944210
Hospital Revenue Code 250
Min. Negotiated Rate $32.19
Max. Negotiated Rate $73.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial $50.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $45.98
Rate for Payer: Aetna Government $45.98
Rate for Payer: Brighton Health Commercial $68.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $73.57
Rate for Payer: Cigna LocalPlus Benefit Plan $62.54
Rate for Payer: EmblemHealth Commercial $45.98
Rate for Payer: Group Health Inc Commercial $45.98
Rate for Payer: Group Health Inc Medicare $32.19
Rate for Payer: Hamaspik Choice Inc Medicaid $45.98
Rate for Payer: Hamaspik Choice Inc Medicare $45.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $59.78
Service Code NDC 1672944210
Hospital Charge Code 1672944210
Hospital Revenue Code 250
Min. Negotiated Rate $45.98
Max. Negotiated Rate $45.98
Rate for Payer: Hamaspik Choice Inc Medicaid $45.98
Service Code NDC 6438088504
Hospital Charge Code 6438088504
Hospital Revenue Code 250
Min. Negotiated Rate $32.19
Max. Negotiated Rate $73.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial $50.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $45.98
Rate for Payer: Aetna Government $45.98
Rate for Payer: Brighton Health Commercial $68.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $73.57
Rate for Payer: Cigna LocalPlus Benefit Plan $62.54
Rate for Payer: EmblemHealth Commercial $45.98
Rate for Payer: Group Health Inc Commercial $45.98
Rate for Payer: Group Health Inc Medicare $32.19
Rate for Payer: Hamaspik Choice Inc Medicaid $45.98
Rate for Payer: Hamaspik Choice Inc Medicare $45.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $59.78
Service Code NDC 4733560083
Hospital Charge Code 4733560083
Hospital Revenue Code 250
Min. Negotiated Rate $32.19
Max. Negotiated Rate $73.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial $50.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $45.98
Rate for Payer: Aetna Government $45.98
Rate for Payer: Brighton Health Commercial $68.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $73.57
Rate for Payer: Cigna LocalPlus Benefit Plan $62.54
Rate for Payer: EmblemHealth Commercial $45.98
Rate for Payer: Group Health Inc Commercial $45.98
Rate for Payer: Group Health Inc Medicare $32.19
Rate for Payer: Hamaspik Choice Inc Medicaid $45.98
Rate for Payer: Hamaspik Choice Inc Medicare $45.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $59.78
Service Code NDC 5551307530
Hospital Charge Code 5551307530
Hospital Revenue Code 250
Min. Negotiated Rate $48.40
Max. Negotiated Rate $48.40
Rate for Payer: Hamaspik Choice Inc Medicaid $48.40
Service Code NDC 5551307530
Hospital Charge Code 5551307530
Hospital Revenue Code 250
Min. Negotiated Rate $33.88
Max. Negotiated Rate $77.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial $53.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $48.40
Rate for Payer: Aetna Government $48.40
Rate for Payer: Brighton Health Commercial $72.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $77.44
Rate for Payer: Cigna LocalPlus Benefit Plan $65.83
Rate for Payer: EmblemHealth Commercial $48.40
Rate for Payer: Group Health Inc Commercial $48.40
Rate for Payer: Group Health Inc Medicare $33.88
Rate for Payer: Hamaspik Choice Inc Medicaid $48.40
Rate for Payer: Hamaspik Choice Inc Medicare $48.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $62.92
Service Code NDC 4733560083
Hospital Charge Code 4733560083
Hospital Revenue Code 250
Min. Negotiated Rate $45.98
Max. Negotiated Rate $45.98
Rate for Payer: Hamaspik Choice Inc Medicaid $45.98
Service Code NDC 6438088504
Hospital Charge Code 6438088504
Hospital Revenue Code 250
Min. Negotiated Rate $45.98
Max. Negotiated Rate $45.98
Rate for Payer: Hamaspik Choice Inc Medicaid $45.98