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Service Code HCPCS C1713
Hospital Charge Code 40204450
Hospital Revenue Code 278
Min. Negotiated Rate $78.19
Max. Negotiated Rate $78.19
Rate for Payer: Hamaspik Choice Inc Medicaid $78.19
Rate for Payer: Hamaspik Choice Inc Medicare $78.19
Service Code HCPCS C1713
Hospital Charge Code 40204456
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
Service Code HCPCS C1713
Hospital Charge Code 40204456
Hospital Revenue Code 278
Min. Negotiated Rate $78.19
Max. Negotiated Rate $78.19
Rate for Payer: Hamaspik Choice Inc Medicaid $78.19
Rate for Payer: Hamaspik Choice Inc Medicare $78.19
Service Code HCPCS C1713
Hospital Charge Code 40204457
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 40204457
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 40204451
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 40204451
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 40204663
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $3,993.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2,092.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $2,282.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1,901.90
Rate for Payer: Cigna LocalPlus Benefit Plan $2,187.18
Rate for Payer: EmblemHealth Commercial $1,901.90
Rate for Payer: Fidelis Medicare Advantage $3,993.99
Rate for Payer: Group Health Inc Commercial $1,901.90
Rate for Payer: Group Health Inc Medicare $1,331.33
Rate for Payer: Hamaspik Choice Inc Medicaid $1,901.90
Rate for Payer: Hamaspik Choice Inc Medicare $1,901.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2,472.47
Service Code HCPCS C1713
Hospital Charge Code 40204663
Hospital Revenue Code 278
Min. Negotiated Rate $1,901.90
Max. Negotiated Rate $1,901.90
Rate for Payer: Hamaspik Choice Inc Medicaid $1,901.90
Rate for Payer: Hamaspik Choice Inc Medicare $1,901.90
Service Code HCPCS C1713
Hospital Charge Code 64901935
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $3,516.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,842.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $2,009.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1,674.75
Rate for Payer: Cigna LocalPlus Benefit Plan $1,925.96
Rate for Payer: EmblemHealth Commercial $1,674.75
Rate for Payer: Fidelis Medicare Advantage $3,516.98
Rate for Payer: Group Health Inc Commercial $1,674.75
Rate for Payer: Group Health Inc Medicare $1,172.32
Rate for Payer: Hamaspik Choice Inc Medicaid $1,674.75
Rate for Payer: Hamaspik Choice Inc Medicare $1,674.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2,177.18
Service Code HCPCS C1713
Hospital Charge Code 64901935
Hospital Revenue Code 278
Min. Negotiated Rate $1,674.75
Max. Negotiated Rate $1,674.75
Rate for Payer: Hamaspik Choice Inc Medicaid $1,674.75
Rate for Payer: Hamaspik Choice Inc Medicare $1,674.75
Service Code HCPCS C1713
Hospital Charge Code 64901936
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $3,516.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,842.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $2,009.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1,674.75
Rate for Payer: Cigna LocalPlus Benefit Plan $1,925.96
Rate for Payer: EmblemHealth Commercial $1,674.75
Rate for Payer: Fidelis Medicare Advantage $3,516.98
Rate for Payer: Group Health Inc Commercial $1,674.75
Rate for Payer: Group Health Inc Medicare $1,172.32
Rate for Payer: Hamaspik Choice Inc Medicaid $1,674.75
Rate for Payer: Hamaspik Choice Inc Medicare $1,674.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2,177.18
Service Code HCPCS C1713
Hospital Charge Code 64901936
Hospital Revenue Code 278
Min. Negotiated Rate $1,674.75
Max. Negotiated Rate $1,674.75
Rate for Payer: Hamaspik Choice Inc Medicaid $1,674.75
Rate for Payer: Hamaspik Choice Inc Medicare $1,674.75
Service Code HCPCS C1776
Hospital Charge Code 64906330
Hospital Revenue Code 278
Min. Negotiated Rate $339.17
Max. Negotiated Rate $1,226.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial $642.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $339.17
Rate for Payer: Aetna Government $339.17
Rate for Payer: Brighton Health Commercial $700.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $584.00
Rate for Payer: Cigna LocalPlus Benefit Plan $671.60
Rate for Payer: EmblemHealth Commercial $584.00
Rate for Payer: Fidelis Medicare Advantage $1,226.40
Rate for Payer: Group Health Inc Commercial $584.00
Rate for Payer: Group Health Inc Medicare $408.80
Rate for Payer: Hamaspik Choice Inc Medicaid $584.00
Rate for Payer: Hamaspik Choice Inc Medicare $584.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $759.20
Service Code HCPCS C1776
Hospital Charge Code 64906330
Hospital Revenue Code 278
Min. Negotiated Rate $584.00
Max. Negotiated Rate $584.00
Rate for Payer: Hamaspik Choice Inc Medicaid $584.00
Rate for Payer: Hamaspik Choice Inc Medicare $584.00
Hospital Charge Code 64907390
Hospital Revenue Code 270
Min. Negotiated Rate $1,810.38
Max. Negotiated Rate $4,138.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2,844.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $2,586.25
Rate for Payer: Aetna Government $2,586.25
Rate for Payer: Brighton Health Commercial $3,879.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $4,138.00
Rate for Payer: Cigna LocalPlus Benefit Plan $3,517.30
Rate for Payer: Group Health Inc Commercial $2,586.25
Rate for Payer: Group Health Inc Medicare $1,810.38
Rate for Payer: Hamaspik Choice Inc Medicaid $2,586.25
Rate for Payer: Hamaspik Choice Inc Medicare $2,586.25
Service Code HCPCS C1713
Hospital Charge Code 64907404
Hospital Revenue Code 278
Min. Negotiated Rate $4,833.75
Max. Negotiated Rate $4,833.75
Rate for Payer: Hamaspik Choice Inc Medicaid $4,833.75
Rate for Payer: Hamaspik Choice Inc Medicare $4,833.75
Service Code HCPCS C1713
Hospital Charge Code 64907404
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $10,150.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial $5,317.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $5,800.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $4,833.75
Rate for Payer: Cigna LocalPlus Benefit Plan $5,558.81
Rate for Payer: EmblemHealth Commercial $4,833.75
Rate for Payer: Fidelis Medicare Advantage $10,150.88
Rate for Payer: Group Health Inc Commercial $4,833.75
Rate for Payer: Group Health Inc Medicare $3,383.62
Rate for Payer: Hamaspik Choice Inc Medicaid $4,833.75
Rate for Payer: Hamaspik Choice Inc Medicare $4,833.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $6,283.88
Service Code HCPCS C1713
Hospital Charge Code 64907401
Hospital Revenue Code 278
Min. Negotiated Rate $49.17
Max. Negotiated Rate $147.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $77.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $84.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $70.24
Rate for Payer: Cigna LocalPlus Benefit Plan $80.78
Rate for Payer: EmblemHealth Commercial $70.24
Rate for Payer: Fidelis Medicare Advantage $147.50
Rate for Payer: Group Health Inc Commercial $70.24
Rate for Payer: Group Health Inc Medicare $49.17
Rate for Payer: Hamaspik Choice Inc Medicaid $70.24
Rate for Payer: Hamaspik Choice Inc Medicare $70.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $91.31
Service Code HCPCS C1713
Hospital Charge Code 64907401
Hospital Revenue Code 278
Min. Negotiated Rate $70.24
Max. Negotiated Rate $70.24
Rate for Payer: Hamaspik Choice Inc Medicaid $70.24
Rate for Payer: Hamaspik Choice Inc Medicare $70.24
Service Code HCPCS C1713
Hospital Charge Code 40001659
Hospital Revenue Code 278
Min. Negotiated Rate $110.95
Max. Negotiated Rate $332.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial $174.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $190.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $158.50
Rate for Payer: Cigna LocalPlus Benefit Plan $182.28
Rate for Payer: EmblemHealth Commercial $158.50
Rate for Payer: Fidelis Medicare Advantage $332.85
Rate for Payer: Group Health Inc Commercial $158.50
Rate for Payer: Group Health Inc Medicare $110.95
Rate for Payer: Hamaspik Choice Inc Medicaid $158.50
Rate for Payer: Hamaspik Choice Inc Medicare $158.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $206.05
Service Code HCPCS C1713
Hospital Charge Code 40001659
Hospital Revenue Code 278
Min. Negotiated Rate $158.50
Max. Negotiated Rate $158.50
Rate for Payer: Hamaspik Choice Inc Medicaid $158.50
Rate for Payer: Hamaspik Choice Inc Medicare $158.50
Service Code HCPCS C1713
Hospital Charge Code 40203415
Hospital Revenue Code 278
Min. Negotiated Rate $214.08
Max. Negotiated Rate $214.08
Rate for Payer: Hamaspik Choice Inc Medicaid $214.08
Rate for Payer: Hamaspik Choice Inc Medicare $214.08
Service Code HCPCS C1713
Hospital Charge Code 40203415
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $449.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial $235.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Brighton Health Commercial $256.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $214.08
Rate for Payer: Cigna LocalPlus Benefit Plan $246.19
Rate for Payer: EmblemHealth Commercial $214.08
Rate for Payer: Fidelis Medicare Advantage $449.57
Rate for Payer: Group Health Inc Commercial $214.08
Rate for Payer: Group Health Inc Medicare $149.86
Rate for Payer: Hamaspik Choice Inc Medicaid $214.08
Rate for Payer: Hamaspik Choice Inc Medicare $214.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $278.30
Service Code HCPCS C1713
Hospital Charge Code 40004609
Hospital Revenue Code 278
Min. Negotiated Rate $451.75
Max. Negotiated Rate $451.75
Rate for Payer: Hamaspik Choice Inc Medicaid $451.75
Rate for Payer: Hamaspik Choice Inc Medicare $451.75