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Charge Type Price  
Service Code HCPCS C1725
Hospital Charge Code 41569436
Hospital Revenue Code 278
Min. Negotiated Rate $271.10
Max. Negotiated Rate $271.10
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Service Code HCPCS C1725
Hospital Charge Code 41569436
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $569.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial $298.21
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 $271.10
Rate for Payer: Cigna LocalPlus Benefit Plan $311.76
Rate for Payer: Fidelis Medicare Advantage $569.31
Rate for Payer: Group Health Inc Commercial $271.10
Rate for Payer: Group Health Inc Medicare $189.77
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $352.43
Service Code HCPCS C1725
Hospital Charge Code 41569437
Hospital Revenue Code 278
Min. Negotiated Rate $287.04
Max. Negotiated Rate $287.04
Rate for Payer: Hamaspik Choice Inc Medicaid $287.04
Rate for Payer: Hamaspik Choice Inc Medicare $287.04
Service Code HCPCS C1725
Hospital Charge Code 41569437
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $602.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial $315.75
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 $287.04
Rate for Payer: Cigna LocalPlus Benefit Plan $330.10
Rate for Payer: Fidelis Medicare Advantage $602.79
Rate for Payer: Group Health Inc Commercial $287.04
Rate for Payer: Group Health Inc Medicare $200.93
Rate for Payer: Hamaspik Choice Inc Medicaid $287.04
Rate for Payer: Hamaspik Choice Inc Medicare $287.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $373.16
Service Code HCPCS C1725
Hospital Charge Code 41569438
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $569.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial $298.21
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 $271.10
Rate for Payer: Cigna LocalPlus Benefit Plan $311.76
Rate for Payer: Fidelis Medicare Advantage $569.31
Rate for Payer: Group Health Inc Commercial $271.10
Rate for Payer: Group Health Inc Medicare $189.77
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $352.43
Service Code HCPCS C1725
Hospital Charge Code 41569438
Hospital Revenue Code 278
Min. Negotiated Rate $271.10
Max. Negotiated Rate $271.10
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Service Code HCPCS C1725
Hospital Charge Code 41569439
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $602.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial $315.75
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 $287.04
Rate for Payer: Cigna LocalPlus Benefit Plan $330.10
Rate for Payer: Fidelis Medicare Advantage $602.79
Rate for Payer: Group Health Inc Commercial $287.04
Rate for Payer: Group Health Inc Medicare $200.93
Rate for Payer: Hamaspik Choice Inc Medicaid $287.04
Rate for Payer: Hamaspik Choice Inc Medicare $287.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $373.16
Service Code HCPCS C1725
Hospital Charge Code 41569439
Hospital Revenue Code 278
Min. Negotiated Rate $287.04
Max. Negotiated Rate $287.04
Rate for Payer: Hamaspik Choice Inc Medicaid $287.04
Rate for Payer: Hamaspik Choice Inc Medicare $287.04
Service Code HCPCS C1725
Hospital Charge Code 41569440
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $569.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial $298.21
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 $271.10
Rate for Payer: Cigna LocalPlus Benefit Plan $311.76
Rate for Payer: Fidelis Medicare Advantage $569.31
Rate for Payer: Group Health Inc Commercial $271.10
Rate for Payer: Group Health Inc Medicare $189.77
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $352.43
Service Code HCPCS C1725
Hospital Charge Code 41569440
Hospital Revenue Code 278
Min. Negotiated Rate $271.10
Max. Negotiated Rate $271.10
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Service Code HCPCS C1725
Hospital Charge Code 41569441
Hospital Revenue Code 278
Min. Negotiated Rate $287.04
Max. Negotiated Rate $287.04
Rate for Payer: Hamaspik Choice Inc Medicaid $287.04
Rate for Payer: Hamaspik Choice Inc Medicare $287.04
Service Code HCPCS C1725
Hospital Charge Code 41569441
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $602.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial $315.75
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 $287.04
Rate for Payer: Cigna LocalPlus Benefit Plan $330.10
Rate for Payer: Fidelis Medicare Advantage $602.79
Rate for Payer: Group Health Inc Commercial $287.04
Rate for Payer: Group Health Inc Medicare $200.93
Rate for Payer: Hamaspik Choice Inc Medicaid $287.04
Rate for Payer: Hamaspik Choice Inc Medicare $287.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $373.16
Service Code HCPCS C1725
Hospital Charge Code 41569442
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $569.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial $298.21
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 $271.10
Rate for Payer: Cigna LocalPlus Benefit Plan $311.76
Rate for Payer: Fidelis Medicare Advantage $569.31
Rate for Payer: Group Health Inc Commercial $271.10
Rate for Payer: Group Health Inc Medicare $189.77
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $352.43
Service Code HCPCS C1725
Hospital Charge Code 41569442
Hospital Revenue Code 278
Min. Negotiated Rate $271.10
Max. Negotiated Rate $271.10
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Service Code HCPCS C1725
Hospital Charge Code 41569443
Hospital Revenue Code 278
Min. Negotiated Rate $271.10
Max. Negotiated Rate $271.10
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Service Code HCPCS C1725
Hospital Charge Code 41569443
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $569.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial $298.21
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 $271.10
Rate for Payer: Cigna LocalPlus Benefit Plan $311.76
Rate for Payer: Fidelis Medicare Advantage $569.31
Rate for Payer: Group Health Inc Commercial $271.10
Rate for Payer: Group Health Inc Medicare $189.77
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $352.43
Service Code HCPCS C1725
Hospital Charge Code 41569444
Hospital Revenue Code 278
Min. Negotiated Rate $287.04
Max. Negotiated Rate $287.04
Rate for Payer: Hamaspik Choice Inc Medicaid $287.04
Rate for Payer: Hamaspik Choice Inc Medicare $287.04
Service Code HCPCS C1725
Hospital Charge Code 41569444
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $602.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial $315.75
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 $287.04
Rate for Payer: Cigna LocalPlus Benefit Plan $330.10
Rate for Payer: Fidelis Medicare Advantage $602.79
Rate for Payer: Group Health Inc Commercial $287.04
Rate for Payer: Group Health Inc Medicare $200.93
Rate for Payer: Hamaspik Choice Inc Medicaid $287.04
Rate for Payer: Hamaspik Choice Inc Medicare $287.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $373.16
Service Code HCPCS C1725
Hospital Charge Code 41569445
Hospital Revenue Code 278
Min. Negotiated Rate $271.10
Max. Negotiated Rate $271.10
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Service Code HCPCS C1725
Hospital Charge Code 41569445
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $569.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial $298.21
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 $271.10
Rate for Payer: Cigna LocalPlus Benefit Plan $311.76
Rate for Payer: Fidelis Medicare Advantage $569.31
Rate for Payer: Group Health Inc Commercial $271.10
Rate for Payer: Group Health Inc Medicare $189.77
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $352.43
Service Code HCPCS C1725
Hospital Charge Code 41569446
Hospital Revenue Code 278
Min. Negotiated Rate $271.10
Max. Negotiated Rate $271.10
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Service Code HCPCS C1725
Hospital Charge Code 41569446
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $569.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial $298.21
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 $271.10
Rate for Payer: Cigna LocalPlus Benefit Plan $311.76
Rate for Payer: Fidelis Medicare Advantage $569.31
Rate for Payer: Group Health Inc Commercial $271.10
Rate for Payer: Group Health Inc Medicare $189.77
Rate for Payer: Hamaspik Choice Inc Medicaid $271.10
Rate for Payer: Hamaspik Choice Inc Medicare $271.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $352.43
Service Code HCPCS C1725
Hospital Charge Code 41569447
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $602.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial $315.75
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 $287.04
Rate for Payer: Cigna LocalPlus Benefit Plan $330.10
Rate for Payer: Fidelis Medicare Advantage $602.79
Rate for Payer: Group Health Inc Commercial $287.04
Rate for Payer: Group Health Inc Medicare $200.93
Rate for Payer: Hamaspik Choice Inc Medicaid $287.04
Rate for Payer: Hamaspik Choice Inc Medicare $287.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $373.16
Service Code HCPCS C1725
Hospital Charge Code 41569447
Hospital Revenue Code 278
Min. Negotiated Rate $287.04
Max. Negotiated Rate $287.04
Rate for Payer: Hamaspik Choice Inc Medicaid $287.04
Rate for Payer: Hamaspik Choice Inc Medicare $287.04
Service Code HCPCS C1725
Hospital Charge Code 41569448
Hospital Revenue Code 278
Min. Negotiated Rate $44.85
Max. Negotiated Rate $689.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial $361.36
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 $328.51
Rate for Payer: Cigna LocalPlus Benefit Plan $377.79
Rate for Payer: Fidelis Medicare Advantage $689.87
Rate for Payer: Group Health Inc Commercial $328.51
Rate for Payer: Group Health Inc Medicare $229.96
Rate for Payer: Hamaspik Choice Inc Medicaid $328.51
Rate for Payer: Hamaspik Choice Inc Medicare $328.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $427.06