STRIPS, CUROS
|
Facility
|
OP
|
$0.58
|
|
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
|
|
STRIPS GLUCOSE INFORM II
|
Facility
|
OP
|
$0.85
|
|
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
|
|
STRIP SKIN CLOSURE 1/4X4
|
Facility
|
OP
|
$2.13
|
|
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
|
|
STRIP SKIN CLOSURE 1 X 5 STERI
|
Facility
|
OP
|
$3.75
|
|
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
|
|
STRIPS,TEST,AIR, DART
|
Facility
|
OP
|
$15.75
|
|
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
|
|
STRIP SURGICAL 1/4 X 6
|
Facility
|
OP
|
$3.49
|
|
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
|
|
STRIP TEST BLD GLUC COMFORT CURVE
|
Facility
|
OP
|
$1.22
|
|
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
|
|
STRIP TEST COAGUCHEK XS 48/KT
|
Facility
|
OP
|
$16.67
|
|
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
|
|
STRIP,TEST,SOLUTION CIDEX OPA
|
Facility
|
OP
|
$103.94
|
|
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
|
|
STRIP, VELOCITY CHEM
|
Facility
|
OP
|
$101.23
|
|
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
|
|
STRK MNTB TRIAX STER WR KT 15X200
|
Facility
|
OP
|
$2,879.50
|
|
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
|
|
STR LK 4.0X26MM SCREW
|
Facility
|
IP
|
$448.00
|
|
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
|
|
STR LK 4.0X26MM SCREW
|
Facility
|
OP
|
$448.00
|
|
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
|
|
STRL WATER BLADR IRRG.-3000CC
|
Facility
|
OP
|
$16.65
|
|
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
|
|
STR NONLK 3.5X50MM SCREW
|
Facility
|
OP
|
$502.00
|
|
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
|
|
STR NONLK 3.5X50MM SCREW
|
Facility
|
IP
|
$502.00
|
|
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
|
|
STRONGYLOIDES IGG ANTIBODY
|
Facility
|
IP
|
$32.53
|
|
Service Code
|
HCPCS 86682
|
Hospital Charge Code |
40729366
|
Hospital Revenue Code
|
300
|
Rate for Payer: Cash Price |
$13.01
|
|
STRONGYLOIDES IGG ANTIBODY
|
Facility
|
OP
|
$32.53
|
|
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
|
|
STR PLT/4-HOLE PREBENT -RT
|
Facility
|
OP
|
$180.18
|
|
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
|
|
STR PLT/4-HOLE PREBENT -RT
|
Facility
|
IP
|
$180.18
|
|
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
|
|
STR PLT/4-HOLE PREB -RT
|
Facility
|
OP
|
$586.92
|
|
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
|
|
STR PLT/4-HOLE PREB -RT
|
Facility
|
IP
|
$586.92
|
|
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
|
|
STR PLT/FRACT 4 HOLE W.BA
|
Facility
|
OP
|
$156.44
|
|
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
|
|
STR PLT/FRACT 4 HOLE W.BA
|
Facility
|
IP
|
$156.44
|
|
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
|
|
STR SCR/2.0X8MM LCK CROSS PIN
|
Facility
|
OP
|
$156.38
|
|
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
|
|