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Charge Type Price  
Service Code HCPCS C1884
Hospital Charge Code 41569055
Hospital Revenue Code 278
Min. Negotiated Rate $71.23
Max. Negotiated Rate $71.23
Rate for Payer: Hamaspik Choice Inc Medicaid $71.23
Rate for Payer: Hamaspik Choice Inc Medicare $71.23
Service Code HCPCS C1884
Hospital Charge Code 41569055
Hospital Revenue Code 278
Min. Negotiated Rate $49.86
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $78.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $71.23
Rate for Payer: Cigna LocalPlus Benefit Plan $81.91
Rate for Payer: Fidelis Medicare Advantage $149.58
Rate for Payer: Group Health Inc Commercial $71.23
Rate for Payer: Group Health Inc Medicare $49.86
Rate for Payer: Hamaspik Choice Inc Medicaid $71.23
Rate for Payer: Hamaspik Choice Inc Medicare $71.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $92.60
Service Code HCPCS C1884
Hospital Charge Code 41569056
Hospital Revenue Code 278
Min. Negotiated Rate $54.86
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $86.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $78.37
Rate for Payer: Cigna LocalPlus Benefit Plan $90.13
Rate for Payer: Fidelis Medicare Advantage $164.58
Rate for Payer: Group Health Inc Commercial $78.37
Rate for Payer: Group Health Inc Medicare $54.86
Rate for Payer: Hamaspik Choice Inc Medicaid $78.37
Rate for Payer: Hamaspik Choice Inc Medicare $78.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $101.88
Service Code HCPCS C1884
Hospital Charge Code 41569056
Hospital Revenue Code 278
Min. Negotiated Rate $78.37
Max. Negotiated Rate $78.37
Rate for Payer: Hamaspik Choice Inc Medicaid $78.37
Rate for Payer: Hamaspik Choice Inc Medicare $78.37
Service Code HCPCS C1884
Hospital Charge Code 41569057
Hospital Revenue Code 278
Min. Negotiated Rate $78.37
Max. Negotiated Rate $78.37
Rate for Payer: Hamaspik Choice Inc Medicaid $78.37
Rate for Payer: Hamaspik Choice Inc Medicare $78.37
Service Code HCPCS C1884
Hospital Charge Code 41569057
Hospital Revenue Code 278
Min. Negotiated Rate $54.86
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $86.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $78.37
Rate for Payer: Cigna LocalPlus Benefit Plan $90.13
Rate for Payer: Fidelis Medicare Advantage $164.58
Rate for Payer: Group Health Inc Commercial $78.37
Rate for Payer: Group Health Inc Medicare $54.86
Rate for Payer: Hamaspik Choice Inc Medicaid $78.37
Rate for Payer: Hamaspik Choice Inc Medicare $78.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $101.88
Service Code HCPCS C1884
Hospital Charge Code 41569059
Hospital Revenue Code 278
Min. Negotiated Rate $54.86
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $86.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $78.37
Rate for Payer: Cigna LocalPlus Benefit Plan $90.13
Rate for Payer: Fidelis Medicare Advantage $164.58
Rate for Payer: Group Health Inc Commercial $78.37
Rate for Payer: Group Health Inc Medicare $54.86
Rate for Payer: Hamaspik Choice Inc Medicaid $78.37
Rate for Payer: Hamaspik Choice Inc Medicare $78.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $101.88
Service Code HCPCS C1884
Hospital Charge Code 41569059
Hospital Revenue Code 278
Min. Negotiated Rate $78.37
Max. Negotiated Rate $78.37
Rate for Payer: Hamaspik Choice Inc Medicaid $78.37
Rate for Payer: Hamaspik Choice Inc Medicare $78.37
Service Code HCPCS C1884
Hospital Charge Code 41569058
Hospital Revenue Code 278
Min. Negotiated Rate $54.86
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $86.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $78.37
Rate for Payer: Cigna LocalPlus Benefit Plan $90.13
Rate for Payer: Fidelis Medicare Advantage $164.58
Rate for Payer: Group Health Inc Commercial $78.37
Rate for Payer: Group Health Inc Medicare $54.86
Rate for Payer: Hamaspik Choice Inc Medicaid $78.37
Rate for Payer: Hamaspik Choice Inc Medicare $78.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $101.88
Service Code HCPCS C1884
Hospital Charge Code 41569058
Hospital Revenue Code 278
Min. Negotiated Rate $78.37
Max. Negotiated Rate $78.37
Rate for Payer: Hamaspik Choice Inc Medicaid $78.37
Rate for Payer: Hamaspik Choice Inc Medicare $78.37
Service Code HCPCS C1884
Hospital Charge Code 41569060
Hospital Revenue Code 278
Min. Negotiated Rate $32.49
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $51.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $46.41
Rate for Payer: Cigna LocalPlus Benefit Plan $53.37
Rate for Payer: Fidelis Medicare Advantage $97.46
Rate for Payer: Group Health Inc Commercial $46.41
Rate for Payer: Group Health Inc Medicare $32.49
Rate for Payer: Hamaspik Choice Inc Medicaid $46.41
Rate for Payer: Hamaspik Choice Inc Medicare $46.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $60.33
Service Code HCPCS C1884
Hospital Charge Code 41569060
Hospital Revenue Code 278
Min. Negotiated Rate $46.41
Max. Negotiated Rate $46.41
Rate for Payer: Hamaspik Choice Inc Medicaid $46.41
Rate for Payer: Hamaspik Choice Inc Medicare $46.41
Service Code HCPCS C1884
Hospital Charge Code 41569061
Hospital Revenue Code 278
Min. Negotiated Rate $46.41
Max. Negotiated Rate $46.41
Rate for Payer: Hamaspik Choice Inc Medicaid $46.41
Rate for Payer: Hamaspik Choice Inc Medicare $46.41
Service Code HCPCS C1884
Hospital Charge Code 41569061
Hospital Revenue Code 278
Min. Negotiated Rate $32.49
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $51.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $46.41
Rate for Payer: Cigna LocalPlus Benefit Plan $53.37
Rate for Payer: Fidelis Medicare Advantage $97.46
Rate for Payer: Group Health Inc Commercial $46.41
Rate for Payer: Group Health Inc Medicare $32.49
Rate for Payer: Hamaspik Choice Inc Medicaid $46.41
Rate for Payer: Hamaspik Choice Inc Medicare $46.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $60.33
Service Code HCPCS C1884
Hospital Charge Code 41569062
Hospital Revenue Code 278
Min. Negotiated Rate $46.41
Max. Negotiated Rate $46.41
Rate for Payer: Hamaspik Choice Inc Medicaid $46.41
Rate for Payer: Hamaspik Choice Inc Medicare $46.41
Service Code HCPCS C1884
Hospital Charge Code 41569062
Hospital Revenue Code 278
Min. Negotiated Rate $32.49
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $51.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $46.41
Rate for Payer: Cigna LocalPlus Benefit Plan $53.37
Rate for Payer: Fidelis Medicare Advantage $97.46
Rate for Payer: Group Health Inc Commercial $46.41
Rate for Payer: Group Health Inc Medicare $32.49
Rate for Payer: Hamaspik Choice Inc Medicaid $46.41
Rate for Payer: Hamaspik Choice Inc Medicare $46.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $60.33
Service Code HCPCS C1884
Hospital Charge Code 41569063
Hospital Revenue Code 278
Min. Negotiated Rate $32.49
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $51.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $46.41
Rate for Payer: Cigna LocalPlus Benefit Plan $53.37
Rate for Payer: Fidelis Medicare Advantage $97.46
Rate for Payer: Group Health Inc Commercial $46.41
Rate for Payer: Group Health Inc Medicare $32.49
Rate for Payer: Hamaspik Choice Inc Medicaid $46.41
Rate for Payer: Hamaspik Choice Inc Medicare $46.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $60.33
Service Code HCPCS C1884
Hospital Charge Code 41569063
Hospital Revenue Code 278
Min. Negotiated Rate $46.41
Max. Negotiated Rate $46.41
Rate for Payer: Hamaspik Choice Inc Medicaid $46.41
Rate for Payer: Hamaspik Choice Inc Medicare $46.41
Service Code HCPCS C1884
Hospital Charge Code 41569065
Hospital Revenue Code 278
Min. Negotiated Rate $32.49
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $51.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $46.41
Rate for Payer: Cigna LocalPlus Benefit Plan $53.37
Rate for Payer: Fidelis Medicare Advantage $97.46
Rate for Payer: Group Health Inc Commercial $46.41
Rate for Payer: Group Health Inc Medicare $32.49
Rate for Payer: Hamaspik Choice Inc Medicaid $46.41
Rate for Payer: Hamaspik Choice Inc Medicare $46.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $60.33
Service Code HCPCS C1884
Hospital Charge Code 41569065
Hospital Revenue Code 278
Min. Negotiated Rate $46.41
Max. Negotiated Rate $46.41
Rate for Payer: Hamaspik Choice Inc Medicaid $46.41
Rate for Payer: Hamaspik Choice Inc Medicare $46.41
Service Code HCPCS C1884
Hospital Charge Code 41560053
Hospital Revenue Code 278
Min. Negotiated Rate $54.15
Max. Negotiated Rate $54.15
Rate for Payer: Hamaspik Choice Inc Medicaid $54.15
Rate for Payer: Hamaspik Choice Inc Medicare $54.15
Service Code HCPCS C1884
Hospital Charge Code 41560053
Hospital Revenue Code 278
Min. Negotiated Rate $37.90
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $59.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $54.15
Rate for Payer: Cigna LocalPlus Benefit Plan $62.27
Rate for Payer: Fidelis Medicare Advantage $113.72
Rate for Payer: Group Health Inc Commercial $54.15
Rate for Payer: Group Health Inc Medicare $37.90
Rate for Payer: Hamaspik Choice Inc Medicaid $54.15
Rate for Payer: Hamaspik Choice Inc Medicare $54.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $70.40
Service Code HCPCS C1884
Hospital Charge Code 41569066
Hospital Revenue Code 278
Min. Negotiated Rate $54.15
Max. Negotiated Rate $54.15
Rate for Payer: Hamaspik Choice Inc Medicaid $54.15
Rate for Payer: Hamaspik Choice Inc Medicare $54.15
Service Code HCPCS C1884
Hospital Charge Code 41569066
Hospital Revenue Code 278
Min. Negotiated Rate $37.90
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $59.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $54.15
Rate for Payer: Cigna LocalPlus Benefit Plan $62.27
Rate for Payer: Fidelis Medicare Advantage $113.72
Rate for Payer: Group Health Inc Commercial $54.15
Rate for Payer: Group Health Inc Medicare $37.90
Rate for Payer: Hamaspik Choice Inc Medicaid $54.15
Rate for Payer: Hamaspik Choice Inc Medicare $54.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $70.40
Service Code HCPCS C1884
Hospital Charge Code 41569067
Hospital Revenue Code 278
Min. Negotiated Rate $37.90
Max. Negotiated Rate $180.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $59.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $180.07
Rate for Payer: Aetna Government $180.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $54.15
Rate for Payer: Cigna LocalPlus Benefit Plan $62.27
Rate for Payer: Fidelis Medicare Advantage $113.72
Rate for Payer: Group Health Inc Commercial $54.15
Rate for Payer: Group Health Inc Medicare $37.90
Rate for Payer: Hamaspik Choice Inc Medicaid $54.15
Rate for Payer: Hamaspik Choice Inc Medicare $54.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $70.40