|
SYNTHES Y PLT 1X3 H 0.5MM THICK
|
Facility
IP
|
$548.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40205304
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$274.00 |
| Max. Negotiated Rate |
$274.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$274.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$274.00
|
|
|
SYNTHES Y PLT 1X3 H 0.5MM THICK
|
Facility
OP
|
$548.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40205304
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$575.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$301.40
|
| 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 |
$274.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$315.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$575.40
|
| Rate for Payer: Group Health Inc Commercial |
$274.00
|
| Rate for Payer: Group Health Inc Medicare |
$191.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$274.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$274.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$356.20
|
|
|
SYNTHETIC SENTENCE ID TEST
|
Facility
OP
|
$101.25
|
|
|
Service Code
|
HCPCS 92576
|
| Hospital Charge Code |
42004510
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$37.10 |
| Max. Negotiated Rate |
$81.00 |
| 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 |
$44.32
|
| 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 |
$49.25
|
| 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
|
|
|
SYNTH GRAFT- MANDIBLE/FACIAL BONE
|
Facility
OP
|
$4,253.00
|
|
|
Service Code
|
HCPCS D7995
|
| Hospital Charge Code |
42303332
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$136.23 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,339.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$136.23
|
| Rate for Payer: Aetna Government |
$136.23
|
| 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 |
$2,126.50
|
| Rate for Payer: Group Health Inc Medicare |
$1,488.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,126.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,126.50
|
|
|
SYNVIC-ONE (NF) 48MG/6ML-PER 1MG
|
Facility
OP
|
$1,797.00
|
|
|
Service Code
|
HCPCS J7325
|
| Hospital Charge Code |
41647165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.30 |
| Max. Negotiated Rate |
$1,168.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$988.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.12
|
| Rate for Payer: Aetna Government |
$9.12
|
| Rate for Payer: Cash Price |
$9.12
|
| Rate for Payer: Cash Price |
$9.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$898.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,033.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.12
|
| Rate for Payer: EmblemHealth Commercial |
$9.12
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.58
|
| Rate for Payer: Group Health Inc Commercial |
$9.12
|
| Rate for Payer: Group Health Inc Medicare |
$9.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$898.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$898.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.75
|
| Rate for Payer: Healthfirst QHP |
$9.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.12
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$9.41
|
| Rate for Payer: SOMOS Essential |
$9.41
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,168.05
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7.30
|
| Rate for Payer: Wellcare Medicare |
$8.67
|
|
|
SYNVIC-ONE (NF) 48MG/6ML-PER 1MG
|
Facility
IP
|
$1,797.00
|
|
|
Service Code
|
HCPCS J7325
|
| Hospital Charge Code |
41647165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$898.50 |
| Max. Negotiated Rate |
$898.50 |
| Rate for Payer: Cash Price |
$9.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$898.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$898.50
|
|
|
SYNVISC-ONE (NF) 48NG/6ML-PER 1MG
|
Facility
IP
|
$1,797.00
|
|
|
Service Code
|
HCPCS J7325
|
| Hospital Charge Code |
41657165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$898.50 |
| Max. Negotiated Rate |
$898.50 |
| Rate for Payer: Cash Price |
$9.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$898.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$898.50
|
|
|
SYNVISC-ONE (NF) 48NG/6ML-PER 1MG
|
Facility
OP
|
$1,797.00
|
|
|
Service Code
|
HCPCS J7325
|
| Hospital Charge Code |
41657165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.30 |
| Max. Negotiated Rate |
$1,168.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$988.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.12
|
| Rate for Payer: Aetna Government |
$9.12
|
| Rate for Payer: Cash Price |
$9.12
|
| Rate for Payer: Cash Price |
$9.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$898.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,033.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.12
|
| Rate for Payer: EmblemHealth Commercial |
$9.12
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.58
|
| Rate for Payer: Group Health Inc Commercial |
$9.12
|
| Rate for Payer: Group Health Inc Medicare |
$9.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$898.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$898.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.75
|
| Rate for Payer: Healthfirst QHP |
$9.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.12
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$9.41
|
| Rate for Payer: SOMOS Essential |
$9.41
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,168.05
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7.30
|
| Rate for Payer: Wellcare Medicare |
$8.67
|
|
|
SYPHILIS (T.PALLIDUM)SCREEN W/REF
|
Facility
OP
|
$33.10
|
|
|
Service Code
|
HCPCS 86780
|
| Hospital Charge Code |
40721420
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.59 |
| Max. Negotiated Rate |
$21.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$18.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13.24
|
| Rate for Payer: Aetna Government |
$13.24
|
| Rate for Payer: Cash Price |
$13.24
|
| Rate for Payer: Cash Price |
$13.24
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$13.24
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$21.05
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.81
|
| Rate for Payer: Elderplan Medicare Advantage |
$13.24
|
| Rate for Payer: EmblemHealth Commercial |
$13.24
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.25
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.78
|
| Rate for Payer: Fidelis Medicare Advantage |
$13.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.78
|
| Rate for Payer: Group Health Inc Commercial |
$13.24
|
| Rate for Payer: Group Health Inc Medicare |
$13.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.24
|
| Rate for Payer: Healthfirst QHP |
$13.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$13.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.24
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.59
|
| Rate for Payer: Wellcare Medicare |
$11.92
|
|
|
SYRINGE 10ML W/LUERLOCK TIP
|
Facility
OP
|
$0.16
|
|
| Hospital Charge Code |
64902016
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.13 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.09
|
| 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 |
$0.13
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.11
|
| Rate for Payer: Group Health Inc Commercial |
$0.08
|
| Rate for Payer: Group Health Inc Medicare |
$0.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.08
|
|
|
SYRINGE 1ML 30GX1/2 HYPO ECLIPSE
|
Facility
OP
|
$0.77
|
|
| Hospital Charge Code |
64903256
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$0.62 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.42
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.39
|
| Rate for Payer: Aetna Government |
$0.39
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.62
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.52
|
| Rate for Payer: Group Health Inc Commercial |
$0.39
|
| Rate for Payer: Group Health Inc Medicare |
$0.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.39
|
|
|
SYRINGE,30ML,LUER-LOK TIP,DISP
|
Facility
OP
|
$0.50
|
|
| Hospital Charge Code |
64901917
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.28
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.25
|
| Rate for Payer: Aetna Government |
$0.25
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.34
|
| Rate for Payer: Group Health Inc Commercial |
$0.25
|
| Rate for Payer: Group Health Inc Medicare |
$0.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.25
|
|
|
SYRINGE,30ML,W/ENFIT CONNECTOR
|
Facility
OP
|
$91.25
|
|
| Hospital Charge Code |
64903716
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.94 |
| Max. Negotiated Rate |
$73.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$50.19
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$45.62
|
| Rate for Payer: Aetna Government |
$45.62
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$73.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$62.05
|
| Rate for Payer: Group Health Inc Commercial |
$45.62
|
| Rate for Payer: Group Health Inc Medicare |
$31.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$45.62
|
|
|
SYRINGE,3ML,LUER-LOK TIP,SCALE
|
Facility
OP
|
$0.09
|
|
| Hospital Charge Code |
64902033
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.07 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.05
|
| Rate for Payer: Aetna Government |
$0.05
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.07
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.06
|
| Rate for Payer: Group Health Inc Commercial |
$0.05
|
| Rate for Payer: Group Health Inc Medicare |
$0.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.05
|
|
|
SYRINGE 50CC FEEDING TRAY
|
Facility
OP
|
$17.01
|
|
| Hospital Charge Code |
40205960
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$13.61 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9.36
|
| 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 |
$13.61
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.57
|
| 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
|
|
|
SYRINGE,5ML,WITH ENFIT CONNECTOR
|
Facility
OP
|
$112.50
|
|
| Hospital Charge Code |
64903711
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.38 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$61.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$56.25
|
| Rate for Payer: Aetna Government |
$56.25
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$90.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$76.50
|
| Rate for Payer: Group Health Inc Commercial |
$56.25
|
| Rate for Payer: Group Health Inc Medicare |
$39.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$56.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$56.25
|
|
|
SYRINGE,60ML,ENFIT CONNECTOR
|
Facility
OP
|
$121.25
|
|
| Hospital Charge Code |
64903719
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$42.44 |
| Max. Negotiated Rate |
$97.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$66.69
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$60.62
|
| Rate for Payer: Aetna Government |
$60.62
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$97.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$82.45
|
| Rate for Payer: Group Health Inc Commercial |
$60.62
|
| Rate for Payer: Group Health Inc Medicare |
$42.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$60.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$60.62
|
|
|
SYRINGE ABG W/HEPARIN&VACUUM 1ML
|
Facility
OP
|
$0.62
|
|
| Hospital Charge Code |
64903255
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.34
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.31
|
| Rate for Payer: Aetna Government |
$0.31
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.42
|
| Rate for Payer: Group Health Inc Commercial |
$0.31
|
| Rate for Payer: Group Health Inc Medicare |
$0.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.31
|
|
|
SYRINGE ARTERIAL BL SUB
|
Facility
OP
|
$2.52
|
|
| Hospital Charge Code |
64901799
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$2.02 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.39
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.26
|
| Rate for Payer: Aetna Government |
$1.26
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.71
|
| Rate for Payer: Group Health Inc Commercial |
$1.26
|
| Rate for Payer: Group Health Inc Medicare |
$0.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.26
|
|
|
SYRINGE ASSEMBLY 100 UL SAMPLE
|
Facility
OP
|
$795.00
|
|
| Hospital Charge Code |
64902659
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$278.25 |
| Max. Negotiated Rate |
$636.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$437.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$397.50
|
| Rate for Payer: Aetna Government |
$397.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$636.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$540.60
|
| Rate for Payer: Group Health Inc Commercial |
$397.50
|
| Rate for Payer: Group Health Inc Medicare |
$278.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$397.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$397.50
|
|
|
SYRINGE BULB IRRIGATION 60ML
|
Facility
OP
|
$1.48
|
|
| Hospital Charge Code |
64901451
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$1.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.81
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.74
|
| Rate for Payer: Aetna Government |
$0.74
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.18
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.01
|
| Rate for Payer: Group Health Inc Commercial |
$0.74
|
| Rate for Payer: Group Health Inc Medicare |
$0.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.74
|
|
|
SYRINGE,CATHETER TIP,2 0Z
|
Facility
OP
|
$0.75
|
|
| Hospital Charge Code |
64901426
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.38
|
| Rate for Payer: Aetna Government |
$0.38
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.51
|
| Rate for Payer: Group Health Inc Commercial |
$0.38
|
| Rate for Payer: Group Health Inc Medicare |
$0.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.38
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.38
|
|
|
SYRINGE EAR & ULCER 2OZ
|
Facility
OP
|
$1.35
|
|
| Hospital Charge Code |
64901816
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$1.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.74
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.68
|
| Rate for Payer: Aetna Government |
$0.68
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.08
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.92
|
| Rate for Payer: Group Health Inc Commercial |
$0.68
|
| Rate for Payer: Group Health Inc Medicare |
$0.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.68
|
|
|
SYRINGE - IMBIBE 10 CC
|
Facility
OP
|
$394.33
|
|
| Hospital Charge Code |
64906028
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$138.02 |
| Max. Negotiated Rate |
$315.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$216.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$197.16
|
| Rate for Payer: Aetna Government |
$197.16
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$315.46
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$268.14
|
| Rate for Payer: Group Health Inc Commercial |
$197.16
|
| Rate for Payer: Group Health Inc Medicare |
$138.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$197.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$197.16
|
|
|
SYRINGE INFLATION ALLI 60ML
|
Facility
OP
|
$1,472.41
|
|
| Hospital Charge Code |
64904007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$515.34 |
| Max. Negotiated Rate |
$1,177.93 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$809.83
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$736.20
|
| Rate for Payer: Aetna Government |
$736.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,177.93
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,001.24
|
| Rate for Payer: Group Health Inc Commercial |
$736.20
|
| Rate for Payer: Group Health Inc Medicare |
$515.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$736.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$736.20
|
|
