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Service Code HCPCS C1713
Hospital Charge Code 64902297
Hospital Revenue Code 278
Min. Negotiated Rate $143.50
Max. Negotiated Rate $143.50
Rate for Payer: Hamaspik Choice Inc Medicaid $143.50
Rate for Payer: Hamaspik Choice Inc Medicare $143.50
Service Code HCPCS C1713
Hospital Charge Code 64902310
Hospital Revenue Code 278
Min. Negotiated Rate $100.45
Max. Negotiated Rate $301.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial $157.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $172.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $143.50
Rate for Payer: Cigna LocalPlus Benefit Plan $165.02
Rate for Payer: EmblemHealth Commercial $143.50
Rate for Payer: Fidelis Medicare Advantage $301.35
Rate for Payer: Group Health Inc Commercial $143.50
Rate for Payer: Group Health Inc Medicare $100.45
Rate for Payer: Hamaspik Choice Inc Medicaid $143.50
Rate for Payer: Hamaspik Choice Inc Medicare $143.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $186.55
Service Code HCPCS C1713
Hospital Charge Code 64902310
Hospital Revenue Code 278
Min. Negotiated Rate $143.50
Max. Negotiated Rate $143.50
Rate for Payer: Hamaspik Choice Inc Medicaid $143.50
Rate for Payer: Hamaspik Choice Inc Medicare $143.50
Service Code HCPCS C1713
Hospital Charge Code 64906833
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $479.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial $251.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $273.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $228.18
Rate for Payer: Cigna LocalPlus Benefit Plan $262.41
Rate for Payer: EmblemHealth Commercial $228.18
Rate for Payer: Fidelis Medicare Advantage $479.18
Rate for Payer: Group Health Inc Commercial $228.18
Rate for Payer: Group Health Inc Medicare $159.73
Rate for Payer: Hamaspik Choice Inc Medicaid $228.18
Rate for Payer: Hamaspik Choice Inc Medicare $228.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $296.63
Service Code HCPCS C1713
Hospital Charge Code 64906833
Hospital Revenue Code 278
Min. Negotiated Rate $228.18
Max. Negotiated Rate $228.18
Rate for Payer: Hamaspik Choice Inc Medicaid $228.18
Rate for Payer: Hamaspik Choice Inc Medicare $228.18
Service Code HCPCS C1713
Hospital Charge Code 64906531
Hospital Revenue Code 278
Min. Negotiated Rate $204.98
Max. Negotiated Rate $204.98
Rate for Payer: Hamaspik Choice Inc Medicaid $204.98
Rate for Payer: Hamaspik Choice Inc Medicare $204.98
Service Code HCPCS C1713
Hospital Charge Code 64906531
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $430.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial $225.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $245.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $204.98
Rate for Payer: Cigna LocalPlus Benefit Plan $235.73
Rate for Payer: EmblemHealth Commercial $204.98
Rate for Payer: Fidelis Medicare Advantage $430.46
Rate for Payer: Group Health Inc Commercial $204.98
Rate for Payer: Group Health Inc Medicare $143.49
Rate for Payer: Hamaspik Choice Inc Medicaid $204.98
Rate for Payer: Hamaspik Choice Inc Medicare $204.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $266.47
Service Code HCPCS C1713
Hospital Charge Code 64903751
Hospital Revenue Code 278
Min. Negotiated Rate $151.25
Max. Negotiated Rate $151.25
Rate for Payer: Hamaspik Choice Inc Medicaid $151.25
Rate for Payer: Hamaspik Choice Inc Medicare $151.25
Service Code HCPCS C1713
Hospital Charge Code 64903751
Hospital Revenue Code 278
Min. Negotiated Rate $105.88
Max. Negotiated Rate $317.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial $166.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $181.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $151.25
Rate for Payer: Cigna LocalPlus Benefit Plan $173.94
Rate for Payer: EmblemHealth Commercial $151.25
Rate for Payer: Fidelis Medicare Advantage $317.62
Rate for Payer: Group Health Inc Commercial $151.25
Rate for Payer: Group Health Inc Medicare $105.88
Rate for Payer: Hamaspik Choice Inc Medicaid $151.25
Rate for Payer: Hamaspik Choice Inc Medicare $151.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $196.62
Service Code HCPCS C1713
Hospital Charge Code 64903269
Hospital Revenue Code 278
Min. Negotiated Rate $381.25
Max. Negotiated Rate $381.25
Rate for Payer: Hamaspik Choice Inc Medicaid $381.25
Rate for Payer: Hamaspik Choice Inc Medicare $381.25
Service Code HCPCS C1713
Hospital Charge Code 64903269
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $800.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial $419.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $457.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $381.25
Rate for Payer: Cigna LocalPlus Benefit Plan $438.44
Rate for Payer: EmblemHealth Commercial $381.25
Rate for Payer: Fidelis Medicare Advantage $800.62
Rate for Payer: Group Health Inc Commercial $381.25
Rate for Payer: Group Health Inc Medicare $266.88
Rate for Payer: Hamaspik Choice Inc Medicaid $381.25
Rate for Payer: Hamaspik Choice Inc Medicare $381.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $495.62
Service Code HCPCS C1713
Hospital Charge Code 40200746
Hospital Revenue Code 278
Min. Negotiated Rate $35.00
Max. Negotiated Rate $134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial $55.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $60.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $50.00
Rate for Payer: Cigna LocalPlus Benefit Plan $57.50
Rate for Payer: EmblemHealth Commercial $50.00
Rate for Payer: Fidelis Medicare Advantage $105.00
Rate for Payer: Group Health Inc Commercial $50.00
Rate for Payer: Group Health Inc Medicare $35.00
Rate for Payer: Hamaspik Choice Inc Medicaid $50.00
Rate for Payer: Hamaspik Choice Inc Medicare $50.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $65.00
Service Code HCPCS C1713
Hospital Charge Code 40200746
Hospital Revenue Code 278
Min. Negotiated Rate $50.00
Max. Negotiated Rate $50.00
Rate for Payer: Hamaspik Choice Inc Medicaid $50.00
Rate for Payer: Hamaspik Choice Inc Medicare $50.00
Service Code HCPCS C1713
Hospital Charge Code 64906651
Hospital Revenue Code 278
Min. Negotiated Rate $80.50
Max. Negotiated Rate $241.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $126.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $138.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $115.00
Rate for Payer: Cigna LocalPlus Benefit Plan $132.25
Rate for Payer: EmblemHealth Commercial $115.00
Rate for Payer: Fidelis Medicare Advantage $241.50
Rate for Payer: Group Health Inc Commercial $115.00
Rate for Payer: Group Health Inc Medicare $80.50
Rate for Payer: Hamaspik Choice Inc Medicaid $115.00
Rate for Payer: Hamaspik Choice Inc Medicare $115.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $149.50
Service Code HCPCS C1713
Hospital Charge Code 64906651
Hospital Revenue Code 278
Min. Negotiated Rate $115.00
Max. Negotiated Rate $115.00
Rate for Payer: Hamaspik Choice Inc Medicaid $115.00
Rate for Payer: Hamaspik Choice Inc Medicare $115.00
Service Code HCPCS C1713
Hospital Charge Code 64906553
Hospital Revenue Code 278
Min. Negotiated Rate $79.80
Max. Negotiated Rate $239.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial $125.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $136.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $114.00
Rate for Payer: Cigna LocalPlus Benefit Plan $131.10
Rate for Payer: EmblemHealth Commercial $114.00
Rate for Payer: Fidelis Medicare Advantage $239.40
Rate for Payer: Group Health Inc Commercial $114.00
Rate for Payer: Group Health Inc Medicare $79.80
Rate for Payer: Hamaspik Choice Inc Medicaid $114.00
Rate for Payer: Hamaspik Choice Inc Medicare $114.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $148.20
Service Code HCPCS C1713
Hospital Charge Code 64906553
Hospital Revenue Code 278
Min. Negotiated Rate $114.00
Max. Negotiated Rate $114.00
Rate for Payer: Hamaspik Choice Inc Medicaid $114.00
Rate for Payer: Hamaspik Choice Inc Medicare $114.00
Service Code HCPCS C1713
Hospital Charge Code 64902839
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $748.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial $391.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $427.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $356.25
Rate for Payer: Cigna LocalPlus Benefit Plan $409.69
Rate for Payer: EmblemHealth Commercial $356.25
Rate for Payer: Fidelis Medicare Advantage $748.12
Rate for Payer: Group Health Inc Commercial $356.25
Rate for Payer: Group Health Inc Medicare $249.38
Rate for Payer: Hamaspik Choice Inc Medicaid $356.25
Rate for Payer: Hamaspik Choice Inc Medicare $356.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $463.12
Service Code HCPCS C1713
Hospital Charge Code 64902839
Hospital Revenue Code 278
Min. Negotiated Rate $356.25
Max. Negotiated Rate $356.25
Rate for Payer: Hamaspik Choice Inc Medicaid $356.25
Rate for Payer: Hamaspik Choice Inc Medicare $356.25
Service Code HCPCS C1713
Hospital Charge Code 64903705
Hospital Revenue Code 278
Min. Negotiated Rate $158.75
Max. Negotiated Rate $158.75
Rate for Payer: Hamaspik Choice Inc Medicaid $158.75
Rate for Payer: Hamaspik Choice Inc Medicare $158.75
Service Code HCPCS C1713
Hospital Charge Code 64903705
Hospital Revenue Code 278
Min. Negotiated Rate $111.12
Max. Negotiated Rate $333.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $174.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $190.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $158.75
Rate for Payer: Cigna LocalPlus Benefit Plan $182.56
Rate for Payer: EmblemHealth Commercial $158.75
Rate for Payer: Fidelis Medicare Advantage $333.38
Rate for Payer: Group Health Inc Commercial $158.75
Rate for Payer: Group Health Inc Medicare $111.12
Rate for Payer: Hamaspik Choice Inc Medicaid $158.75
Rate for Payer: Hamaspik Choice Inc Medicare $158.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $206.38
Service Code HCPCS C1713
Hospital Charge Code 64902247
Hospital Revenue Code 278
Min. Negotiated Rate $116.60
Max. Negotiated Rate $349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial $183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $166.56
Rate for Payer: Cigna LocalPlus Benefit Plan $191.55
Rate for Payer: EmblemHealth Commercial $166.56
Rate for Payer: Fidelis Medicare Advantage $349.79
Rate for Payer: Group Health Inc Commercial $166.56
Rate for Payer: Group Health Inc Medicare $116.60
Rate for Payer: Hamaspik Choice Inc Medicaid $166.56
Rate for Payer: Hamaspik Choice Inc Medicare $166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $216.53
Service Code HCPCS C1713
Hospital Charge Code 64902247
Hospital Revenue Code 278
Min. Negotiated Rate $166.56
Max. Negotiated Rate $166.56
Rate for Payer: Hamaspik Choice Inc Medicaid $166.56
Rate for Payer: Hamaspik Choice Inc Medicare $166.56
Service Code HCPCS C1713
Hospital Charge Code 64902249
Hospital Revenue Code 278
Min. Negotiated Rate $166.56
Max. Negotiated Rate $166.56
Rate for Payer: Hamaspik Choice Inc Medicaid $166.56
Rate for Payer: Hamaspik Choice Inc Medicare $166.56
Service Code HCPCS C1713
Hospital Charge Code 64902249
Hospital Revenue Code 278
Min. Negotiated Rate $116.60
Max. Negotiated Rate $349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial $183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $166.56
Rate for Payer: Cigna LocalPlus Benefit Plan $191.55
Rate for Payer: EmblemHealth Commercial $166.56
Rate for Payer: Fidelis Medicare Advantage $349.79
Rate for Payer: Group Health Inc Commercial $166.56
Rate for Payer: Group Health Inc Medicare $116.60
Rate for Payer: Hamaspik Choice Inc Medicaid $166.56
Rate for Payer: Hamaspik Choice Inc Medicare $166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $216.53