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Hospital Charge Code 64901620
Hospital Revenue Code 270
Min. Negotiated Rate $0.20
Max. Negotiated Rate $0.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.29
Rate for Payer: Aetna Government $0.29
Rate for Payer: Brighton Health Commercial $0.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.46
Rate for Payer: Cigna LocalPlus Benefit Plan $0.39
Rate for Payer: Group Health Inc Commercial $0.29
Rate for Payer: Group Health Inc Medicare $0.20
Rate for Payer: Hamaspik Choice Inc Medicaid $0.29
Rate for Payer: Hamaspik Choice Inc Medicare $0.29
Hospital Charge Code 64901632
Hospital Revenue Code 270
Min. Negotiated Rate $0.30
Max. Negotiated Rate $0.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.43
Rate for Payer: Aetna Government $0.43
Rate for Payer: Brighton Health Commercial $0.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.68
Rate for Payer: Cigna LocalPlus Benefit Plan $0.58
Rate for Payer: Group Health Inc Commercial $0.43
Rate for Payer: Group Health Inc Medicare $0.30
Rate for Payer: Hamaspik Choice Inc Medicaid $0.43
Rate for Payer: Hamaspik Choice Inc Medicare $0.43
Hospital Charge Code 64901488
Hospital Revenue Code 270
Min. Negotiated Rate $0.75
Max. Negotiated Rate $1.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.06
Rate for Payer: Aetna Government $1.06
Rate for Payer: Brighton Health Commercial $1.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.70
Rate for Payer: Cigna LocalPlus Benefit Plan $1.45
Rate for Payer: Group Health Inc Commercial $1.06
Rate for Payer: Group Health Inc Medicare $0.75
Rate for Payer: Hamaspik Choice Inc Medicaid $1.06
Rate for Payer: Hamaspik Choice Inc Medicare $1.06
Hospital Charge Code 64901490
Hospital Revenue Code 270
Min. Negotiated Rate $1.31
Max. Negotiated Rate $3.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.88
Rate for Payer: Aetna Government $1.88
Rate for Payer: Brighton Health Commercial $2.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $3.00
Rate for Payer: Cigna LocalPlus Benefit Plan $2.55
Rate for Payer: Group Health Inc Commercial $1.88
Rate for Payer: Group Health Inc Medicare $1.31
Rate for Payer: Hamaspik Choice Inc Medicaid $1.88
Rate for Payer: Hamaspik Choice Inc Medicare $1.88
Hospital Charge Code 64902565
Hospital Revenue Code 270
Min. Negotiated Rate $5.51
Max. Negotiated Rate $12.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial $8.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $7.88
Rate for Payer: Aetna Government $7.88
Rate for Payer: Brighton Health Commercial $11.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $12.60
Rate for Payer: Cigna LocalPlus Benefit Plan $10.71
Rate for Payer: Group Health Inc Commercial $7.88
Rate for Payer: Group Health Inc Medicare $5.51
Rate for Payer: Hamaspik Choice Inc Medicaid $7.88
Rate for Payer: Hamaspik Choice Inc Medicare $7.88
Hospital Charge Code 64902749
Hospital Revenue Code 270
Min. Negotiated Rate $1.22
Max. Negotiated Rate $2.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.74
Rate for Payer: Aetna Government $1.74
Rate for Payer: Brighton Health Commercial $2.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2.79
Rate for Payer: Cigna LocalPlus Benefit Plan $2.37
Rate for Payer: Group Health Inc Commercial $1.74
Rate for Payer: Group Health Inc Medicare $1.22
Rate for Payer: Hamaspik Choice Inc Medicaid $1.74
Rate for Payer: Hamaspik Choice Inc Medicare $1.74
Hospital Charge Code 64901051
Hospital Revenue Code 270
Min. Negotiated Rate $0.43
Max. Negotiated Rate $0.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.61
Rate for Payer: Aetna Government $0.61
Rate for Payer: Brighton Health Commercial $0.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.98
Rate for Payer: Cigna LocalPlus Benefit Plan $0.83
Rate for Payer: Group Health Inc Commercial $0.61
Rate for Payer: Group Health Inc Medicare $0.43
Rate for Payer: Hamaspik Choice Inc Medicaid $0.61
Rate for Payer: Hamaspik Choice Inc Medicare $0.61
Hospital Charge Code 64903006
Hospital Revenue Code 270
Min. Negotiated Rate $5.83
Max. Negotiated Rate $13.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial $9.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $8.34
Rate for Payer: Aetna Government $8.34
Rate for Payer: Brighton Health Commercial $12.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $13.34
Rate for Payer: Cigna LocalPlus Benefit Plan $11.34
Rate for Payer: Group Health Inc Commercial $8.34
Rate for Payer: Group Health Inc Medicare $5.83
Rate for Payer: Hamaspik Choice Inc Medicaid $8.34
Rate for Payer: Hamaspik Choice Inc Medicare $8.34
Hospital Charge Code 64901039
Hospital Revenue Code 270
Min. Negotiated Rate $36.38
Max. Negotiated Rate $83.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial $57.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $51.97
Rate for Payer: Aetna Government $51.97
Rate for Payer: Brighton Health Commercial $77.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $83.15
Rate for Payer: Cigna LocalPlus Benefit Plan $70.68
Rate for Payer: Group Health Inc Commercial $51.97
Rate for Payer: Group Health Inc Medicare $36.38
Rate for Payer: Hamaspik Choice Inc Medicaid $51.97
Rate for Payer: Hamaspik Choice Inc Medicare $51.97
Hospital Charge Code 64903562
Hospital Revenue Code 270
Min. Negotiated Rate $35.43
Max. Negotiated Rate $80.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial $55.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $50.62
Rate for Payer: Aetna Government $50.62
Rate for Payer: Brighton Health Commercial $75.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $80.98
Rate for Payer: Cigna LocalPlus Benefit Plan $68.84
Rate for Payer: Group Health Inc Commercial $50.62
Rate for Payer: Group Health Inc Medicare $35.43
Rate for Payer: Hamaspik Choice Inc Medicaid $50.62
Rate for Payer: Hamaspik Choice Inc Medicare $50.62
Hospital Charge Code 40204495
Hospital Revenue Code 272
Min. Negotiated Rate $1,007.82
Max. Negotiated Rate $2,303.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,583.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1,439.75
Rate for Payer: Aetna Government $1,439.75
Rate for Payer: Brighton Health Commercial $2,159.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2,303.60
Rate for Payer: Cigna LocalPlus Benefit Plan $1,958.06
Rate for Payer: Group Health Inc Commercial $1,439.75
Rate for Payer: Group Health Inc Medicare $1,007.82
Rate for Payer: Hamaspik Choice Inc Medicaid $1,439.75
Rate for Payer: Hamaspik Choice Inc Medicare $1,439.75
Service Code HCPCS C1713
Hospital Charge Code 40008252
Hospital Revenue Code 278
Min. Negotiated Rate $224.00
Max. Negotiated Rate $224.00
Rate for Payer: Hamaspik Choice Inc Medicaid $224.00
Rate for Payer: Hamaspik Choice Inc Medicare $224.00
Service Code HCPCS C1713
Hospital Charge Code 40008252
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $470.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial $246.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $268.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $224.00
Rate for Payer: Cigna LocalPlus Benefit Plan $257.60
Rate for Payer: EmblemHealth Commercial $224.00
Rate for Payer: Fidelis Medicare Advantage $470.40
Rate for Payer: Group Health Inc Commercial $224.00
Rate for Payer: Group Health Inc Medicare $156.80
Rate for Payer: Hamaspik Choice Inc Medicaid $224.00
Rate for Payer: Hamaspik Choice Inc Medicare $224.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $291.20
Hospital Charge Code 40197117
Hospital Revenue Code 710
Min. Negotiated Rate $5.83
Max. Negotiated Rate $13.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial $9.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $8.32
Rate for Payer: Aetna Government $8.32
Rate for Payer: Brighton Health Commercial $12.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $13.32
Rate for Payer: Cigna LocalPlus Benefit Plan $11.32
Rate for Payer: Group Health Inc Commercial $8.32
Rate for Payer: Group Health Inc Medicare $5.83
Rate for Payer: Hamaspik Choice Inc Medicaid $8.32
Rate for Payer: Hamaspik Choice Inc Medicare $8.32
Service Code HCPCS C1713
Hospital Charge Code 40008253
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $527.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial $276.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $301.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $251.00
Rate for Payer: Cigna LocalPlus Benefit Plan $288.65
Rate for Payer: EmblemHealth Commercial $251.00
Rate for Payer: Fidelis Medicare Advantage $527.10
Rate for Payer: Group Health Inc Commercial $251.00
Rate for Payer: Group Health Inc Medicare $175.70
Rate for Payer: Hamaspik Choice Inc Medicaid $251.00
Rate for Payer: Hamaspik Choice Inc Medicare $251.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $326.30
Service Code HCPCS C1713
Hospital Charge Code 40008253
Hospital Revenue Code 278
Min. Negotiated Rate $251.00
Max. Negotiated Rate $251.00
Rate for Payer: Hamaspik Choice Inc Medicaid $251.00
Rate for Payer: Hamaspik Choice Inc Medicare $251.00
Service Code HCPCS 86682
Hospital Charge Code 40729366
Hospital Revenue Code 300
Rate for Payer: Cash Price $13.01
Service Code HCPCS 86682
Hospital Charge Code 40729366
Hospital Revenue Code 300
Min. Negotiated Rate $10.41
Max. Negotiated Rate $24.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial $17.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $13.01
Rate for Payer: Aetna Government $13.01
Rate for Payer: Brighton Health Commercial $24.40
Rate for Payer: Cash Price $13.01
Rate for Payer: Cash Price $13.01
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $13.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $20.68
Rate for Payer: Cigna LocalPlus Benefit Plan $17.50
Rate for Payer: Elderplan Medicare Advantage $13.01
Rate for Payer: EmblemHealth Commercial $13.01
Rate for Payer: Fidelis Essential Plan Aliesa $11.06
Rate for Payer: Fidelis Essential Plan QHP $11.58
Rate for Payer: Fidelis Medicare Advantage $13.01
Rate for Payer: Fidelis Qualified Health Plan $11.58
Rate for Payer: Group Health Inc Commercial $13.01
Rate for Payer: Group Health Inc Medicare $13.01
Rate for Payer: Hamaspik Choice Inc Medicaid $16.26
Rate for Payer: Hamaspik Choice Inc Medicare $13.01
Rate for Payer: Healthfirst Medicare Advantage $13.01
Rate for Payer: Healthfirst QHP $13.01
Rate for Payer: Senior Whole Health Medicare Advantage $13.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $13.01
Rate for Payer: Wellcare CHP/FHP/Medicaid $10.41
Rate for Payer: Wellcare Medicare $11.71
Service Code HCPCS C1713
Hospital Charge Code 40204449
Hospital Revenue Code 278
Min. Negotiated Rate $63.06
Max. Negotiated Rate $189.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial $99.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $108.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $90.09
Rate for Payer: Cigna LocalPlus Benefit Plan $103.60
Rate for Payer: EmblemHealth Commercial $90.09
Rate for Payer: Fidelis Medicare Advantage $189.19
Rate for Payer: Group Health Inc Commercial $90.09
Rate for Payer: Group Health Inc Medicare $63.06
Rate for Payer: Hamaspik Choice Inc Medicaid $90.09
Rate for Payer: Hamaspik Choice Inc Medicare $90.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $117.12
Service Code HCPCS C1713
Hospital Charge Code 40204449
Hospital Revenue Code 278
Min. Negotiated Rate $90.09
Max. Negotiated Rate $90.09
Rate for Payer: Hamaspik Choice Inc Medicaid $90.09
Rate for Payer: Hamaspik Choice Inc Medicare $90.09
Service Code HCPCS C1713
Hospital Charge Code 40204453
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $616.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial $322.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $352.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $293.46
Rate for Payer: Cigna LocalPlus Benefit Plan $337.48
Rate for Payer: EmblemHealth Commercial $293.46
Rate for Payer: Fidelis Medicare Advantage $616.27
Rate for Payer: Group Health Inc Commercial $293.46
Rate for Payer: Group Health Inc Medicare $205.42
Rate for Payer: Hamaspik Choice Inc Medicaid $293.46
Rate for Payer: Hamaspik Choice Inc Medicare $293.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $381.50
Service Code HCPCS C1713
Hospital Charge Code 40204453
Hospital Revenue Code 278
Min. Negotiated Rate $293.46
Max. Negotiated Rate $293.46
Rate for Payer: Hamaspik Choice Inc Medicaid $293.46
Rate for Payer: Hamaspik Choice Inc Medicare $293.46
Service Code HCPCS C1713
Hospital Charge Code 40204447
Hospital Revenue Code 278
Min. Negotiated Rate $54.75
Max. Negotiated Rate $164.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial $86.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $93.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $78.22
Rate for Payer: Cigna LocalPlus Benefit Plan $89.95
Rate for Payer: EmblemHealth Commercial $78.22
Rate for Payer: Fidelis Medicare Advantage $164.26
Rate for Payer: Group Health Inc Commercial $78.22
Rate for Payer: Group Health Inc Medicare $54.75
Rate for Payer: Hamaspik Choice Inc Medicaid $78.22
Rate for Payer: Hamaspik Choice Inc Medicare $78.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $101.69
Service Code HCPCS C1713
Hospital Charge Code 40204447
Hospital Revenue Code 278
Min. Negotiated Rate $78.22
Max. Negotiated Rate $78.22
Rate for Payer: Hamaspik Choice Inc Medicaid $78.22
Rate for Payer: Hamaspik Choice Inc Medicare $78.22
Service Code HCPCS C1713
Hospital Charge Code 40204450
Hospital Revenue Code 278
Min. Negotiated Rate $54.73
Max. Negotiated Rate $164.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial $86.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $93.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $78.19
Rate for Payer: Cigna LocalPlus Benefit Plan $89.92
Rate for Payer: EmblemHealth Commercial $78.19
Rate for Payer: Fidelis Medicare Advantage $164.20
Rate for Payer: Group Health Inc Commercial $78.19
Rate for Payer: Group Health Inc Medicare $54.73
Rate for Payer: Hamaspik Choice Inc Medicaid $78.19
Rate for Payer: Hamaspik Choice Inc Medicare $78.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $101.65