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Service Code HCPCS C1713
Hospital Charge Code 64905465
Hospital Revenue Code 278
Min. Negotiated Rate $157.50
Max. Negotiated Rate $157.50
Rate for Payer: Hamaspik Choice Inc Medicaid $157.50
Rate for Payer: Hamaspik Choice Inc Medicare $157.50
Service Code HCPCS C1713
Hospital Charge Code 64905465
Hospital Revenue Code 278
Min. Negotiated Rate $110.25
Max. Negotiated Rate $330.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial $173.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $189.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $157.50
Rate for Payer: Cigna LocalPlus Benefit Plan $181.12
Rate for Payer: EmblemHealth Commercial $157.50
Rate for Payer: Fidelis Medicare Advantage $330.75
Rate for Payer: Group Health Inc Commercial $157.50
Rate for Payer: Group Health Inc Medicare $110.25
Rate for Payer: Hamaspik Choice Inc Medicaid $157.50
Rate for Payer: Hamaspik Choice Inc Medicare $157.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $204.75
Service Code HCPCS C1713
Hospital Charge Code 64901373
Hospital Revenue Code 278
Min. Negotiated Rate $88.71
Max. Negotiated Rate $266.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial $139.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $152.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $126.72
Rate for Payer: Cigna LocalPlus Benefit Plan $145.73
Rate for Payer: EmblemHealth Commercial $126.72
Rate for Payer: Fidelis Medicare Advantage $266.12
Rate for Payer: Group Health Inc Commercial $126.72
Rate for Payer: Group Health Inc Medicare $88.71
Rate for Payer: Hamaspik Choice Inc Medicaid $126.72
Rate for Payer: Hamaspik Choice Inc Medicare $126.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $164.74
Service Code HCPCS C1713
Hospital Charge Code 64901373
Hospital Revenue Code 278
Min. Negotiated Rate $126.72
Max. Negotiated Rate $126.72
Rate for Payer: Hamaspik Choice Inc Medicaid $126.72
Rate for Payer: Hamaspik Choice Inc Medicare $126.72
Service Code HCPCS C1713
Hospital Charge Code 64901371
Hospital Revenue Code 278
Min. Negotiated Rate $126.50
Max. Negotiated Rate $126.50
Rate for Payer: Hamaspik Choice Inc Medicaid $126.50
Rate for Payer: Hamaspik Choice Inc Medicare $126.50
Service Code HCPCS C1713
Hospital Charge Code 64901371
Hospital Revenue Code 278
Min. Negotiated Rate $88.55
Max. Negotiated Rate $265.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial $139.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $151.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $126.50
Rate for Payer: Cigna LocalPlus Benefit Plan $145.48
Rate for Payer: EmblemHealth Commercial $126.50
Rate for Payer: Fidelis Medicare Advantage $265.65
Rate for Payer: Group Health Inc Commercial $126.50
Rate for Payer: Group Health Inc Medicare $88.55
Rate for Payer: Hamaspik Choice Inc Medicaid $126.50
Rate for Payer: Hamaspik Choice Inc Medicare $126.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $164.45
Service Code HCPCS C1713
Hospital Charge Code 40200392
Hospital Revenue Code 278
Min. Negotiated Rate $56.00
Max. Negotiated Rate $168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $88.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $96.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $80.00
Rate for Payer: Cigna LocalPlus Benefit Plan $92.00
Rate for Payer: EmblemHealth Commercial $80.00
Rate for Payer: Fidelis Medicare Advantage $168.00
Rate for Payer: Group Health Inc Commercial $80.00
Rate for Payer: Group Health Inc Medicare $56.00
Rate for Payer: Hamaspik Choice Inc Medicaid $80.00
Rate for Payer: Hamaspik Choice Inc Medicare $80.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $104.00
Service Code HCPCS C1713
Hospital Charge Code 40200392
Hospital Revenue Code 278
Min. Negotiated Rate $80.00
Max. Negotiated Rate $80.00
Rate for Payer: Hamaspik Choice Inc Medicaid $80.00
Rate for Payer: Hamaspik Choice Inc Medicare $80.00
Service Code HCPCS C1713
Hospital Charge Code 64901624
Hospital Revenue Code 278
Min. Negotiated Rate $243.75
Max. Negotiated Rate $243.75
Rate for Payer: Hamaspik Choice Inc Medicaid $243.75
Rate for Payer: Hamaspik Choice Inc Medicare $243.75
Service Code HCPCS C1713
Hospital Charge Code 64901624
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $511.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial $268.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $292.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $243.75
Rate for Payer: Cigna LocalPlus Benefit Plan $280.31
Rate for Payer: EmblemHealth Commercial $243.75
Rate for Payer: Fidelis Medicare Advantage $511.88
Rate for Payer: Group Health Inc Commercial $243.75
Rate for Payer: Group Health Inc Medicare $170.62
Rate for Payer: Hamaspik Choice Inc Medicaid $243.75
Rate for Payer: Hamaspik Choice Inc Medicare $243.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $316.88
Service Code HCPCS C1713
Hospital Charge Code 64901158
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $501.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $262.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $286.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $238.75
Rate for Payer: Cigna LocalPlus Benefit Plan $274.56
Rate for Payer: EmblemHealth Commercial $238.75
Rate for Payer: Fidelis Medicare Advantage $501.38
Rate for Payer: Group Health Inc Commercial $238.75
Rate for Payer: Group Health Inc Medicare $167.12
Rate for Payer: Hamaspik Choice Inc Medicaid $238.75
Rate for Payer: Hamaspik Choice Inc Medicare $238.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $310.38
Service Code HCPCS C1713
Hospital Charge Code 64901158
Hospital Revenue Code 278
Min. Negotiated Rate $238.75
Max. Negotiated Rate $238.75
Rate for Payer: Hamaspik Choice Inc Medicaid $238.75
Rate for Payer: Hamaspik Choice Inc Medicare $238.75
Service Code HCPCS C1713
Hospital Charge Code 64901739
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $1,346.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial $705.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $769.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $641.06
Rate for Payer: Cigna LocalPlus Benefit Plan $737.22
Rate for Payer: EmblemHealth Commercial $641.06
Rate for Payer: Fidelis Medicare Advantage $1,346.24
Rate for Payer: Group Health Inc Commercial $641.06
Rate for Payer: Group Health Inc Medicare $448.75
Rate for Payer: Hamaspik Choice Inc Medicaid $641.06
Rate for Payer: Hamaspik Choice Inc Medicare $641.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $833.38
Service Code HCPCS C1713
Hospital Charge Code 64901739
Hospital Revenue Code 278
Min. Negotiated Rate $641.06
Max. Negotiated Rate $641.06
Rate for Payer: Hamaspik Choice Inc Medicaid $641.06
Rate for Payer: Hamaspik Choice Inc Medicare $641.06
Service Code HCPCS C1713
Hospital Charge Code 64901773
Hospital Revenue Code 278
Min. Negotiated Rate $738.50
Max. Negotiated Rate $738.50
Rate for Payer: Hamaspik Choice Inc Medicaid $738.50
Rate for Payer: Hamaspik Choice Inc Medicare $738.50
Service Code HCPCS C1713
Hospital Charge Code 64901773
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $1,550.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial $812.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $886.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $738.50
Rate for Payer: Cigna LocalPlus Benefit Plan $849.28
Rate for Payer: EmblemHealth Commercial $738.50
Rate for Payer: Fidelis Medicare Advantage $1,550.85
Rate for Payer: Group Health Inc Commercial $738.50
Rate for Payer: Group Health Inc Medicare $516.95
Rate for Payer: Hamaspik Choice Inc Medicaid $738.50
Rate for Payer: Hamaspik Choice Inc Medicare $738.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $960.05
Service Code HCPCS C1713
Hospital Charge Code 64901650
Hospital Revenue Code 278
Min. Negotiated Rate $641.06
Max. Negotiated Rate $641.06
Rate for Payer: Hamaspik Choice Inc Medicaid $641.06
Rate for Payer: Hamaspik Choice Inc Medicare $641.06
Service Code HCPCS C1713
Hospital Charge Code 64901650
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $1,346.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial $705.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $769.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $641.06
Rate for Payer: Cigna LocalPlus Benefit Plan $737.22
Rate for Payer: EmblemHealth Commercial $641.06
Rate for Payer: Fidelis Medicare Advantage $1,346.24
Rate for Payer: Group Health Inc Commercial $641.06
Rate for Payer: Group Health Inc Medicare $448.75
Rate for Payer: Hamaspik Choice Inc Medicaid $641.06
Rate for Payer: Hamaspik Choice Inc Medicare $641.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $833.38
Service Code HCPCS C1713
Hospital Charge Code 64901999
Hospital Revenue Code 278
Min. Negotiated Rate $641.06
Max. Negotiated Rate $641.06
Rate for Payer: Hamaspik Choice Inc Medicaid $641.06
Rate for Payer: Hamaspik Choice Inc Medicare $641.06
Service Code HCPCS C1713
Hospital Charge Code 64901999
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $1,346.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial $705.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $769.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $641.06
Rate for Payer: Cigna LocalPlus Benefit Plan $737.22
Rate for Payer: EmblemHealth Commercial $641.06
Rate for Payer: Fidelis Medicare Advantage $1,346.24
Rate for Payer: Group Health Inc Commercial $641.06
Rate for Payer: Group Health Inc Medicare $448.75
Rate for Payer: Hamaspik Choice Inc Medicaid $641.06
Rate for Payer: Hamaspik Choice Inc Medicare $641.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $833.38
Service Code HCPCS C1713
Hospital Charge Code 64901854
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $1,346.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial $705.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $769.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $641.06
Rate for Payer: Cigna LocalPlus Benefit Plan $737.22
Rate for Payer: EmblemHealth Commercial $641.06
Rate for Payer: Fidelis Medicare Advantage $1,346.24
Rate for Payer: Group Health Inc Commercial $641.06
Rate for Payer: Group Health Inc Medicare $448.75
Rate for Payer: Hamaspik Choice Inc Medicaid $641.06
Rate for Payer: Hamaspik Choice Inc Medicare $641.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $833.38
Service Code HCPCS C1713
Hospital Charge Code 64901854
Hospital Revenue Code 278
Min. Negotiated Rate $641.06
Max. Negotiated Rate $641.06
Rate for Payer: Hamaspik Choice Inc Medicaid $641.06
Rate for Payer: Hamaspik Choice Inc Medicare $641.06
Service Code HCPCS C1713
Hospital Charge Code 40205081
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $954.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial $499.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $545.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $454.30
Rate for Payer: Cigna LocalPlus Benefit Plan $522.44
Rate for Payer: EmblemHealth Commercial $454.30
Rate for Payer: Fidelis Medicare Advantage $954.03
Rate for Payer: Group Health Inc Commercial $454.30
Rate for Payer: Group Health Inc Medicare $318.01
Rate for Payer: Hamaspik Choice Inc Medicaid $454.30
Rate for Payer: Hamaspik Choice Inc Medicare $454.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $590.59
Service Code HCPCS C1713
Hospital Charge Code 64901446
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $1,346.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial $705.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $769.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $641.06
Rate for Payer: Cigna LocalPlus Benefit Plan $737.22
Rate for Payer: EmblemHealth Commercial $641.06
Rate for Payer: Fidelis Medicare Advantage $1,346.24
Rate for Payer: Group Health Inc Commercial $641.06
Rate for Payer: Group Health Inc Medicare $448.75
Rate for Payer: Hamaspik Choice Inc Medicaid $641.06
Rate for Payer: Hamaspik Choice Inc Medicare $641.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $833.38
Service Code HCPCS C1713
Hospital Charge Code 64901446
Hospital Revenue Code 278
Min. Negotiated Rate $641.06
Max. Negotiated Rate $641.06
Rate for Payer: Hamaspik Choice Inc Medicaid $641.06
Rate for Payer: Hamaspik Choice Inc Medicare $641.06