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Service Code HCPCS C1769
Hospital Charge Code 41567124
Hospital Revenue Code 278
Min. Negotiated Rate $4.08
Max. Negotiated Rate $143.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial $75.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $4.08
Rate for Payer: Aetna Government $4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $68.40
Rate for Payer: Cigna LocalPlus Benefit Plan $78.65
Rate for Payer: Fidelis Medicare Advantage $143.63
Rate for Payer: Group Health Inc Commercial $68.40
Rate for Payer: Group Health Inc Medicare $47.88
Rate for Payer: Hamaspik Choice Inc Medicaid $68.40
Rate for Payer: Hamaspik Choice Inc Medicare $68.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $88.91
Service Code HCPCS C1769
Hospital Charge Code 41567124
Hospital Revenue Code 278
Min. Negotiated Rate $68.40
Max. Negotiated Rate $68.40
Rate for Payer: Hamaspik Choice Inc Medicaid $68.40
Rate for Payer: Hamaspik Choice Inc Medicare $68.40
Service Code HCPCS C1769
Hospital Charge Code 41567126
Hospital Revenue Code 278
Min. Negotiated Rate $4.08
Max. Negotiated Rate $88.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial $46.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $4.08
Rate for Payer: Aetna Government $4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $42.34
Rate for Payer: Cigna LocalPlus Benefit Plan $48.70
Rate for Payer: Fidelis Medicare Advantage $88.92
Rate for Payer: Group Health Inc Commercial $42.34
Rate for Payer: Group Health Inc Medicare $29.64
Rate for Payer: Hamaspik Choice Inc Medicaid $42.34
Rate for Payer: Hamaspik Choice Inc Medicare $42.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $55.05
Service Code HCPCS C1769
Hospital Charge Code 41567126
Hospital Revenue Code 278
Min. Negotiated Rate $42.34
Max. Negotiated Rate $42.34
Rate for Payer: Hamaspik Choice Inc Medicaid $42.34
Rate for Payer: Hamaspik Choice Inc Medicare $42.34
Service Code HCPCS C1769
Hospital Charge Code 41567125
Hospital Revenue Code 278
Min. Negotiated Rate $4.08
Max. Negotiated Rate $85.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial $44.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $4.08
Rate for Payer: Aetna Government $4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $40.76
Rate for Payer: Cigna LocalPlus Benefit Plan $46.87
Rate for Payer: Fidelis Medicare Advantage $85.59
Rate for Payer: Group Health Inc Commercial $40.76
Rate for Payer: Group Health Inc Medicare $28.53
Rate for Payer: Hamaspik Choice Inc Medicaid $40.76
Rate for Payer: Hamaspik Choice Inc Medicare $40.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $52.98
Service Code HCPCS C1769
Hospital Charge Code 41567125
Hospital Revenue Code 278
Min. Negotiated Rate $40.76
Max. Negotiated Rate $40.76
Rate for Payer: Hamaspik Choice Inc Medicaid $40.76
Rate for Payer: Hamaspik Choice Inc Medicare $40.76
Service Code HCPCS C1769
Hospital Charge Code 41569776
Hospital Revenue Code 278
Min. Negotiated Rate $4.08
Max. Negotiated Rate $74.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial $38.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $4.08
Rate for Payer: Aetna Government $4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $35.44
Rate for Payer: Cigna LocalPlus Benefit Plan $40.76
Rate for Payer: Fidelis Medicare Advantage $74.42
Rate for Payer: Group Health Inc Commercial $35.44
Rate for Payer: Group Health Inc Medicare $24.81
Rate for Payer: Hamaspik Choice Inc Medicaid $35.44
Rate for Payer: Hamaspik Choice Inc Medicare $35.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $46.07
Service Code HCPCS C1769
Hospital Charge Code 41569776
Hospital Revenue Code 278
Min. Negotiated Rate $35.44
Max. Negotiated Rate $35.44
Rate for Payer: Hamaspik Choice Inc Medicaid $35.44
Rate for Payer: Hamaspik Choice Inc Medicare $35.44
Service Code HCPCS C1725
Hospital Charge Code 41569600
Hospital Revenue Code 278
Min. Negotiated Rate $15.78
Max. Negotiated Rate $47.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial $24.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $44.85
Rate for Payer: Aetna Government $44.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $22.54
Rate for Payer: Cigna LocalPlus Benefit Plan $25.92
Rate for Payer: Fidelis Medicare Advantage $47.33
Rate for Payer: Group Health Inc Commercial $22.54
Rate for Payer: Group Health Inc Medicare $15.78
Rate for Payer: Hamaspik Choice Inc Medicaid $22.54
Rate for Payer: Hamaspik Choice Inc Medicare $22.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $29.30
Service Code HCPCS C1725
Hospital Charge Code 41569600
Hospital Revenue Code 278
Min. Negotiated Rate $22.54
Max. Negotiated Rate $22.54
Rate for Payer: Hamaspik Choice Inc Medicaid $22.54
Rate for Payer: Hamaspik Choice Inc Medicare $22.54
Service Code HCPCS C1725
Hospital Charge Code 41569601
Hospital Revenue Code 278
Min. Negotiated Rate $17.72
Max. Negotiated Rate $17.72
Rate for Payer: Hamaspik Choice Inc Medicaid $17.72
Rate for Payer: Hamaspik Choice Inc Medicare $17.72
Service Code HCPCS C1725
Hospital Charge Code 41569601
Hospital Revenue Code 278
Min. Negotiated Rate $12.40
Max. Negotiated Rate $44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial $19.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $44.85
Rate for Payer: Aetna Government $44.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $17.72
Rate for Payer: Cigna LocalPlus Benefit Plan $20.38
Rate for Payer: Fidelis Medicare Advantage $37.21
Rate for Payer: Group Health Inc Commercial $17.72
Rate for Payer: Group Health Inc Medicare $12.40
Rate for Payer: Hamaspik Choice Inc Medicaid $17.72
Rate for Payer: Hamaspik Choice Inc Medicare $17.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $23.04
Hospital Charge Code 41567000
Hospital Revenue Code 270
Min. Negotiated Rate $31.38
Max. Negotiated Rate $71.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial $49.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $44.83
Rate for Payer: Aetna Government $44.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $71.73
Rate for Payer: Cigna LocalPlus Benefit Plan $60.97
Rate for Payer: Group Health Inc Commercial $44.83
Rate for Payer: Group Health Inc Medicare $31.38
Rate for Payer: Hamaspik Choice Inc Medicaid $44.83
Rate for Payer: Hamaspik Choice Inc Medicare $44.83
Service Code HCPCS C1760
Hospital Charge Code 41561951
Hospital Revenue Code 278
Min. Negotiated Rate $290.00
Max. Negotiated Rate $290.00
Rate for Payer: Hamaspik Choice Inc Medicaid $290.00
Rate for Payer: Hamaspik Choice Inc Medicare $290.00
Service Code HCPCS C1760
Hospital Charge Code 41561951
Hospital Revenue Code 278
Min. Negotiated Rate $73.50
Max. Negotiated Rate $609.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $319.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $73.50
Rate for Payer: Aetna Government $73.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $290.00
Rate for Payer: Cigna LocalPlus Benefit Plan $333.50
Rate for Payer: Fidelis Medicare Advantage $609.00
Rate for Payer: Group Health Inc Commercial $290.00
Rate for Payer: Group Health Inc Medicare $203.00
Rate for Payer: Hamaspik Choice Inc Medicaid $290.00
Rate for Payer: Hamaspik Choice Inc Medicare $290.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $377.00
Hospital Charge Code 41564610
Hospital Revenue Code 272
Min. Negotiated Rate $9.10
Max. Negotiated Rate $20.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $14.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $13.00
Rate for Payer: Aetna Government $13.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $20.80
Rate for Payer: Cigna LocalPlus Benefit Plan $17.68
Rate for Payer: Group Health Inc Commercial $13.00
Rate for Payer: Group Health Inc Medicare $9.10
Rate for Payer: Hamaspik Choice Inc Medicaid $13.00
Rate for Payer: Hamaspik Choice Inc Medicare $13.00
Hospital Charge Code 41567311
Hospital Revenue Code 270
Min. Negotiated Rate $120.68
Max. Negotiated Rate $275.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial $189.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $172.40
Rate for Payer: Aetna Government $172.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $275.85
Rate for Payer: Cigna LocalPlus Benefit Plan $234.47
Rate for Payer: Group Health Inc Commercial $172.40
Rate for Payer: Group Health Inc Medicare $120.68
Rate for Payer: Hamaspik Choice Inc Medicaid $172.40
Rate for Payer: Hamaspik Choice Inc Medicare $172.40
Hospital Charge Code 41569639
Hospital Revenue Code 270
Min. Negotiated Rate $74.47
Max. Negotiated Rate $170.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial $117.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $106.38
Rate for Payer: Aetna Government $106.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $170.22
Rate for Payer: Cigna LocalPlus Benefit Plan $144.68
Rate for Payer: Group Health Inc Commercial $106.38
Rate for Payer: Group Health Inc Medicare $74.47
Rate for Payer: Hamaspik Choice Inc Medicaid $106.38
Rate for Payer: Hamaspik Choice Inc Medicare $106.38
Hospital Charge Code 41563507
Hospital Revenue Code 272
Min. Negotiated Rate $175.00
Max. Negotiated Rate $400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $275.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $250.00
Rate for Payer: Aetna Government $250.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $400.00
Rate for Payer: Cigna LocalPlus Benefit Plan $340.00
Rate for Payer: Group Health Inc Commercial $250.00
Rate for Payer: Group Health Inc Medicare $175.00
Rate for Payer: Hamaspik Choice Inc Medicaid $250.00
Rate for Payer: Hamaspik Choice Inc Medicare $250.00
Hospital Charge Code 41540610
Hospital Revenue Code 272
Min. Negotiated Rate $5.43
Max. Negotiated Rate $12.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial $8.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $7.76
Rate for Payer: Aetna Government $7.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $12.42
Rate for Payer: Cigna LocalPlus Benefit Plan $10.55
Rate for Payer: Group Health Inc Commercial $7.76
Rate for Payer: Group Health Inc Medicare $5.43
Rate for Payer: Hamaspik Choice Inc Medicaid $7.76
Rate for Payer: Hamaspik Choice Inc Medicare $7.76
Hospital Charge Code 41540609
Hospital Revenue Code 272
Min. Negotiated Rate $16.45
Max. Negotiated Rate $37.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial $25.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $23.50
Rate for Payer: Aetna Government $23.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $37.60
Rate for Payer: Cigna LocalPlus Benefit Plan $31.96
Rate for Payer: Group Health Inc Commercial $23.50
Rate for Payer: Group Health Inc Medicare $16.45
Rate for Payer: Hamaspik Choice Inc Medicaid $23.50
Rate for Payer: Hamaspik Choice Inc Medicare $23.50
Hospital Charge Code 41563212
Hospital Revenue Code 272
Min. Negotiated Rate $28.00
Max. Negotiated Rate $64.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $44.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $40.00
Rate for Payer: Aetna Government $40.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $64.00
Rate for Payer: Cigna LocalPlus Benefit Plan $54.40
Rate for Payer: Group Health Inc Commercial $40.00
Rate for Payer: Group Health Inc Medicare $28.00
Rate for Payer: Hamaspik Choice Inc Medicaid $40.00
Rate for Payer: Hamaspik Choice Inc Medicare $40.00
Service Code HCPCS C1880
Hospital Charge Code 66520352
Hospital Revenue Code 278
Min. Negotiated Rate $57.08
Max. Negotiated Rate $2,520.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,320.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $57.08
Rate for Payer: Aetna Government $57.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1,200.00
Rate for Payer: Cigna LocalPlus Benefit Plan $1,380.00
Rate for Payer: Fidelis Medicare Advantage $2,520.00
Rate for Payer: Group Health Inc Commercial $1,200.00
Rate for Payer: Group Health Inc Medicare $840.00
Rate for Payer: Hamaspik Choice Inc Medicaid $1,200.00
Rate for Payer: Hamaspik Choice Inc Medicare $1,200.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1,560.00
Service Code HCPCS C1880
Hospital Charge Code 66520352
Hospital Revenue Code 278
Min. Negotiated Rate $1,200.00
Max. Negotiated Rate $1,200.00
Rate for Payer: Hamaspik Choice Inc Medicaid $1,200.00
Rate for Payer: Hamaspik Choice Inc Medicare $1,200.00
Hospital Charge Code 41568615
Hospital Revenue Code 279
Min. Negotiated Rate $420.00
Max. Negotiated Rate $960.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $660.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $600.00
Rate for Payer: Aetna Government $600.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $960.00
Rate for Payer: Cigna LocalPlus Benefit Plan $816.00
Rate for Payer: Group Health Inc Commercial $600.00
Rate for Payer: Group Health Inc Medicare $420.00
Rate for Payer: Hamaspik Choice Inc Medicaid $600.00
Rate for Payer: Hamaspik Choice Inc Medicare $600.00