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Hospital Charge Code 41653860
Hospital Revenue Code 636
Min. Negotiated Rate $7.62
Max. Negotiated Rate $14.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial $11.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $10.89
Rate for Payer: Aetna Government $10.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $10.89
Rate for Payer: Cigna LocalPlus Benefit Plan $12.52
Rate for Payer: Group Health Inc Commercial $10.89
Rate for Payer: Group Health Inc Medicare $7.62
Rate for Payer: Hamaspik Choice Inc Medicaid $10.89
Rate for Payer: Hamaspik Choice Inc Medicare $10.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $14.16
Hospital Charge Code 41653860
Hospital Revenue Code 636
Min. Negotiated Rate $10.89
Max. Negotiated Rate $10.89
Rate for Payer: Hamaspik Choice Inc Medicaid $10.89
Rate for Payer: Hamaspik Choice Inc Medicare $10.89
Hospital Charge Code 41643860
Hospital Revenue Code 636
Min. Negotiated Rate $7.62
Max. Negotiated Rate $14.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial $11.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $10.89
Rate for Payer: Aetna Government $10.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $10.89
Rate for Payer: Cigna LocalPlus Benefit Plan $12.52
Rate for Payer: Group Health Inc Commercial $10.89
Rate for Payer: Group Health Inc Medicare $7.62
Rate for Payer: Hamaspik Choice Inc Medicaid $10.89
Rate for Payer: Hamaspik Choice Inc Medicare $10.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $14.16
Service Code HCPCS 80299
Hospital Charge Code 40609894
Hospital Revenue Code 301
Min. Negotiated Rate $14.91
Max. Negotiated Rate $25.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial $25.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $18.64
Rate for Payer: Aetna Government $18.64
Rate for Payer: Cash Price $18.64
Rate for Payer: Cash Price $18.64
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $18.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $21.78
Rate for Payer: Cigna LocalPlus Benefit Plan $18.42
Rate for Payer: Elderplan Medicare Advantage $18.64
Rate for Payer: EmblemHealth Commercial $18.64
Rate for Payer: Fidelis CHP/HARP/Medicaid $16.78
Rate for Payer: Fidelis Essential Plan Aliesa $15.84
Rate for Payer: Fidelis Essential Plan QHP $16.59
Rate for Payer: Fidelis Medicare Advantage $18.64
Rate for Payer: Fidelis Qualified Health Plan $16.59
Rate for Payer: Group Health Inc Commercial $18.64
Rate for Payer: Group Health Inc Medicare $18.64
Rate for Payer: Hamaspik Choice Inc Medicaid $23.30
Rate for Payer: Hamaspik Choice Inc Medicare $18.64
Rate for Payer: Healthfirst CHP/FHP/Medicaid $18.64
Rate for Payer: Healthfirst Medicare Advantage $18.64
Rate for Payer: Healthfirst QHP $18.64
Rate for Payer: Senior Whole Health Medicare Advantage $18.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $18.64
Rate for Payer: Wellcare CHP/FHP/Medicaid $14.91
Rate for Payer: Wellcare Medicare $16.78
Service Code HCPCS D6940
Hospital Charge Code 42301590
Hospital Revenue Code 361
Min. Negotiated Rate $87.46
Max. Negotiated Rate $2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $156.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $87.46
Rate for Payer: Aetna Government $87.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan $2,477.75
Rate for Payer: Group Health Inc Commercial $142.00
Rate for Payer: Group Health Inc Medicare $99.40
Rate for Payer: Hamaspik Choice Inc Medicaid $142.00
Rate for Payer: Hamaspik Choice Inc Medicare $142.00
Hospital Charge Code 30301324
Hospital Revenue Code 510
Min. Negotiated Rate $50.62
Max. Negotiated Rate $250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $55.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $50.62
Rate for Payer: Aetna Government $50.62
Rate for Payer: Brighton Health Commercial $233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $204.58
Rate for Payer: Cigna LocalPlus Benefit Plan $173.89
Rate for Payer: Group Health Inc Commercial $250.00
Rate for Payer: Group Health Inc Medicare $250.00
Rate for Payer: Hamaspik Choice Inc Medicaid $50.62
Rate for Payer: Hamaspik Choice Inc Medicare $50.62
Service Code HCPCS 59020 TC
Hospital Charge Code 40250200
Hospital Revenue Code 720
Min. Negotiated Rate $37.66
Max. Negotiated Rate $2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $276.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $251.46
Rate for Payer: Aetna Government $251.46
Rate for Payer: Cash Price $230.44
Rate for Payer: Cash Price $230.44
Rate for Payer: Cash Price $230.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan $2,477.75
Rate for Payer: Fidelis CHP/HARP/Medicaid $37.66
Rate for Payer: Group Health Inc Commercial $251.46
Rate for Payer: Group Health Inc Medicare $176.03
Rate for Payer: Hamaspik Choice Inc Medicaid $251.46
Rate for Payer: Hamaspik Choice Inc Medicare $251.46
Rate for Payer: Healthfirst CHP/FHP/Medicaid $41.85
Service Code HCPCS C1713
Hospital Charge Code 40204452
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $614.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial $321.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $292.50
Rate for Payer: Cigna LocalPlus Benefit Plan $336.38
Rate for Payer: Fidelis Medicare Advantage $614.25
Rate for Payer: Group Health Inc Commercial $292.50
Rate for Payer: Group Health Inc Medicare $204.75
Rate for Payer: Hamaspik Choice Inc Medicaid $292.50
Rate for Payer: Hamaspik Choice Inc Medicare $292.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $380.25
Service Code HCPCS C1713
Hospital Charge Code 40204452
Hospital Revenue Code 278
Min. Negotiated Rate $292.50
Max. Negotiated Rate $292.50
Rate for Payer: Hamaspik Choice Inc Medicaid $292.50
Rate for Payer: Hamaspik Choice Inc Medicare $292.50
Service Code HCPCS C1713
Hospital Charge Code 40204441
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $693.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $363.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $330.00
Rate for Payer: Cigna LocalPlus Benefit Plan $379.50
Rate for Payer: Fidelis Medicare Advantage $693.00
Rate for Payer: Group Health Inc Commercial $330.00
Rate for Payer: Group Health Inc Medicare $231.00
Rate for Payer: Hamaspik Choice Inc Medicaid $330.00
Rate for Payer: Hamaspik Choice Inc Medicare $330.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $429.00
Service Code HCPCS C1713
Hospital Charge Code 40204441
Hospital Revenue Code 278
Min. Negotiated Rate $330.00
Max. Negotiated Rate $330.00
Rate for Payer: Hamaspik Choice Inc Medicaid $330.00
Rate for Payer: Hamaspik Choice Inc Medicare $330.00
Hospital Charge Code 64901485
Hospital Revenue Code 270
Min. Negotiated Rate $0.75
Max. Negotiated Rate $1.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.06
Rate for Payer: Aetna Government $1.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.70
Rate for Payer: Cigna LocalPlus Benefit Plan $1.45
Rate for Payer: Group Health Inc Commercial $1.06
Rate for Payer: Group Health Inc Medicare $0.75
Rate for Payer: Hamaspik Choice Inc Medicaid $1.06
Rate for Payer: Hamaspik Choice Inc Medicare $1.06
Hospital Charge Code 64905241
Hospital Revenue Code 270
Min. Negotiated Rate $0.07
Max. Negotiated Rate $0.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.11
Rate for Payer: Aetna Government $0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.17
Rate for Payer: Cigna LocalPlus Benefit Plan $0.14
Rate for Payer: Group Health Inc Commercial $0.11
Rate for Payer: Group Health Inc Medicare $0.07
Rate for Payer: Hamaspik Choice Inc Medicaid $0.11
Rate for Payer: Hamaspik Choice Inc Medicare $0.11
Hospital Charge Code 64902219
Hospital Revenue Code 270
Min. Negotiated Rate $5.95
Max. Negotiated Rate $13.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial $9.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $8.50
Rate for Payer: Aetna Government $8.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $13.60
Rate for Payer: Cigna LocalPlus Benefit Plan $11.56
Rate for Payer: Group Health Inc Commercial $8.50
Rate for Payer: Group Health Inc Medicare $5.95
Rate for Payer: Hamaspik Choice Inc Medicaid $8.50
Rate for Payer: Hamaspik Choice Inc Medicare $8.50
Hospital Charge Code 64901870
Hospital Revenue Code 270
Min. Negotiated Rate $0.28
Max. Negotiated Rate $0.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.40
Rate for Payer: Aetna Government $0.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.63
Rate for Payer: Cigna LocalPlus Benefit Plan $0.54
Rate for Payer: Group Health Inc Commercial $0.40
Rate for Payer: Group Health Inc Medicare $0.28
Rate for Payer: Hamaspik Choice Inc Medicaid $0.40
Rate for Payer: Hamaspik Choice Inc Medicare $0.40
Hospital Charge Code 64902799
Hospital Revenue Code 270
Min. Negotiated Rate $35.92
Max. Negotiated Rate $82.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial $56.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $51.32
Rate for Payer: Aetna Government $51.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $82.10
Rate for Payer: Cigna LocalPlus Benefit Plan $69.79
Rate for Payer: Group Health Inc Commercial $51.32
Rate for Payer: Group Health Inc Medicare $35.92
Rate for Payer: Hamaspik Choice Inc Medicaid $51.32
Rate for Payer: Hamaspik Choice Inc Medicare $51.32
Hospital Charge Code 64906098
Hospital Revenue Code 270
Min. Negotiated Rate $4,681.25
Max. Negotiated Rate $10,700.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $7,356.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $6,687.50
Rate for Payer: Aetna Government $6,687.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $10,700.00
Rate for Payer: Cigna LocalPlus Benefit Plan $9,095.00
Rate for Payer: Group Health Inc Commercial $6,687.50
Rate for Payer: Group Health Inc Medicare $4,681.25
Rate for Payer: Hamaspik Choice Inc Medicaid $6,687.50
Rate for Payer: Hamaspik Choice Inc Medicare $6,687.50
Hospital Charge Code 40005127
Hospital Revenue Code 272
Min. Negotiated Rate $3,745.00
Max. Negotiated Rate $8,560.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $5,885.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $5,350.00
Rate for Payer: Aetna Government $5,350.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $8,560.00
Rate for Payer: Cigna LocalPlus Benefit Plan $7,276.00
Rate for Payer: Group Health Inc Commercial $5,350.00
Rate for Payer: Group Health Inc Medicare $3,745.00
Rate for Payer: Hamaspik Choice Inc Medicaid $5,350.00
Rate for Payer: Hamaspik Choice Inc Medicare $5,350.00
Hospital Charge Code 64901620
Hospital Revenue Code 270
Min. Negotiated Rate $0.20
Max. Negotiated Rate $0.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.29
Rate for Payer: Aetna Government $0.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.46
Rate for Payer: Cigna LocalPlus Benefit Plan $0.39
Rate for Payer: Group Health Inc Commercial $0.29
Rate for Payer: Group Health Inc Medicare $0.20
Rate for Payer: Hamaspik Choice Inc Medicaid $0.29
Rate for Payer: Hamaspik Choice Inc Medicare $0.29
Hospital Charge Code 64901632
Hospital Revenue Code 270
Min. Negotiated Rate $0.30
Max. Negotiated Rate $0.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.43
Rate for Payer: Aetna Government $0.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.68
Rate for Payer: Cigna LocalPlus Benefit Plan $0.58
Rate for Payer: Group Health Inc Commercial $0.43
Rate for Payer: Group Health Inc Medicare $0.30
Rate for Payer: Hamaspik Choice Inc Medicaid $0.43
Rate for Payer: Hamaspik Choice Inc Medicare $0.43
Hospital Charge Code 64901488
Hospital Revenue Code 270
Min. Negotiated Rate $0.75
Max. Negotiated Rate $1.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.06
Rate for Payer: Aetna Government $1.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.70
Rate for Payer: Cigna LocalPlus Benefit Plan $1.45
Rate for Payer: Group Health Inc Commercial $1.06
Rate for Payer: Group Health Inc Medicare $0.75
Rate for Payer: Hamaspik Choice Inc Medicaid $1.06
Rate for Payer: Hamaspik Choice Inc Medicare $1.06
Hospital Charge Code 64901490
Hospital Revenue Code 270
Min. Negotiated Rate $1.31
Max. Negotiated Rate $3.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.88
Rate for Payer: Aetna Government $1.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $3.00
Rate for Payer: Cigna LocalPlus Benefit Plan $2.55
Rate for Payer: Group Health Inc Commercial $1.88
Rate for Payer: Group Health Inc Medicare $1.31
Rate for Payer: Hamaspik Choice Inc Medicaid $1.88
Rate for Payer: Hamaspik Choice Inc Medicare $1.88
Hospital Charge Code 64902565
Hospital Revenue Code 270
Min. Negotiated Rate $5.51
Max. Negotiated Rate $12.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial $8.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $7.88
Rate for Payer: Aetna Government $7.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $12.60
Rate for Payer: Cigna LocalPlus Benefit Plan $10.71
Rate for Payer: Group Health Inc Commercial $7.88
Rate for Payer: Group Health Inc Medicare $5.51
Rate for Payer: Hamaspik Choice Inc Medicaid $7.88
Rate for Payer: Hamaspik Choice Inc Medicare $7.88
Hospital Charge Code 64902749
Hospital Revenue Code 270
Min. Negotiated Rate $1.22
Max. Negotiated Rate $2.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.74
Rate for Payer: Aetna Government $1.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2.79
Rate for Payer: Cigna LocalPlus Benefit Plan $2.37
Rate for Payer: Group Health Inc Commercial $1.74
Rate for Payer: Group Health Inc Medicare $1.22
Rate for Payer: Hamaspik Choice Inc Medicaid $1.74
Rate for Payer: Hamaspik Choice Inc Medicare $1.74
Hospital Charge Code 64901051
Hospital Revenue Code 270
Min. Negotiated Rate $0.43
Max. Negotiated Rate $0.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.61
Rate for Payer: Aetna Government $0.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.98
Rate for Payer: Cigna LocalPlus Benefit Plan $0.83
Rate for Payer: Group Health Inc Commercial $0.61
Rate for Payer: Group Health Inc Medicare $0.43
Rate for Payer: Hamaspik Choice Inc Medicaid $0.61
Rate for Payer: Hamaspik Choice Inc Medicare $0.61