|
VEEG 2-12 HR CONTIN MONITOR
|
Facility
|
IP
|
$1,470.80
|
|
|
Service Code
|
HCPCS 95713
|
| Hospital Charge Code |
41001007
|
|
Hospital Revenue Code
|
740
|
| Rate for Payer: Cash Price |
$619.82
|
|
|
VEEG 2-12 HR CONTIN MONITOR
|
Facility
|
OP
|
$1,470.80
|
|
|
Service Code
|
HCPCS 95713
|
| Hospital Charge Code |
41001007
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$495.86 |
| Max. Negotiated Rate |
$1,176.64 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$808.94
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$619.82
|
| Rate for Payer: Aetna Government |
$619.82
|
| Rate for Payer: Brighton Health Commercial |
$1,103.10
|
| Rate for Payer: Cash Price |
$619.82
|
| Rate for Payer: Cash Price |
$619.82
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$619.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,176.64
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,000.14
|
| Rate for Payer: Elderplan Medicare Advantage |
$619.82
|
| Rate for Payer: EmblemHealth Commercial |
$619.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$526.85
|
| Rate for Payer: Fidelis Essential Plan QHP |
$551.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$619.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$551.64
|
| Rate for Payer: Group Health Inc Commercial |
$619.82
|
| Rate for Payer: Group Health Inc Medicare |
$619.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$735.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$619.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$526.85
|
| Rate for Payer: Healthfirst QHP |
$619.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$619.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$619.82
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$495.86
|
| Rate for Payer: Wellcare Medicare |
$588.83
|
|
|
VEEG 2-12 HR INTRMIT MONITOR
|
Facility
|
IP
|
$766.58
|
|
|
Service Code
|
HCPCS 95712
|
| Hospital Charge Code |
41001006
|
|
Hospital Revenue Code
|
740
|
| Rate for Payer: Cash Price |
$362.98
|
|
|
VEEG 2-12 HR INTRMIT MONITOR
|
Facility
|
OP
|
$766.58
|
|
|
Service Code
|
HCPCS 95712
|
| Hospital Charge Code |
41001006
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$290.38 |
| Max. Negotiated Rate |
$613.26 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$421.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$362.98
|
| Rate for Payer: Aetna Government |
$362.98
|
| Rate for Payer: Brighton Health Commercial |
$574.94
|
| Rate for Payer: Cash Price |
$362.98
|
| Rate for Payer: Cash Price |
$362.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$362.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$613.26
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$521.27
|
| Rate for Payer: Elderplan Medicare Advantage |
$362.98
|
| Rate for Payer: EmblemHealth Commercial |
$362.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$308.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$323.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$362.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$323.05
|
| Rate for Payer: Group Health Inc Commercial |
$362.98
|
| Rate for Payer: Group Health Inc Medicare |
$362.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$383.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$362.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$308.53
|
| Rate for Payer: Healthfirst QHP |
$362.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$362.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$362.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$290.38
|
| Rate for Payer: Wellcare Medicare |
$344.83
|
|
|
VEEG 2-12 HR UNMONITORED
|
Facility
|
OP
|
$766.58
|
|
|
Service Code
|
HCPCS 95711
|
| Hospital Charge Code |
41001005
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$290.38 |
| Max. Negotiated Rate |
$613.26 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$421.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$362.98
|
| Rate for Payer: Aetna Government |
$362.98
|
| Rate for Payer: Brighton Health Commercial |
$574.94
|
| Rate for Payer: Cash Price |
$362.98
|
| Rate for Payer: Cash Price |
$362.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$362.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$613.26
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$521.27
|
| Rate for Payer: Elderplan Medicare Advantage |
$362.98
|
| Rate for Payer: EmblemHealth Commercial |
$362.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$308.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$323.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$362.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$323.05
|
| Rate for Payer: Group Health Inc Commercial |
$362.98
|
| Rate for Payer: Group Health Inc Medicare |
$362.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$383.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$362.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$308.53
|
| Rate for Payer: Healthfirst QHP |
$362.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$362.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$362.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$290.38
|
| Rate for Payer: Wellcare Medicare |
$344.83
|
|
|
VEEG 2-12 HR UNMONITORED
|
Facility
|
IP
|
$766.58
|
|
|
Service Code
|
HCPCS 95711
|
| Hospital Charge Code |
41001005
|
|
Hospital Revenue Code
|
740
|
| Rate for Payer: Cash Price |
$362.98
|
|
|
VEEG EA 12-26HR CONT MNTR
|
Facility
|
IP
|
$2,831.98
|
|
|
Service Code
|
HCPCS 95716
|
| Hospital Charge Code |
41001014
|
|
Hospital Revenue Code
|
740
|
| Rate for Payer: Cash Price |
$1,209.08
|
|
|
VEEG EA 12-26HR CONT MNTR
|
Facility
|
OP
|
$2,831.98
|
|
|
Service Code
|
HCPCS 95716
|
| Hospital Charge Code |
41001014
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$967.26 |
| Max. Negotiated Rate |
$2,265.58 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,557.59
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,209.08
|
| Rate for Payer: Aetna Government |
$1,209.08
|
| Rate for Payer: Brighton Health Commercial |
$2,123.98
|
| Rate for Payer: Cash Price |
$1,209.08
|
| Rate for Payer: Cash Price |
$1,209.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,209.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,265.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,925.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,209.08
|
| Rate for Payer: EmblemHealth Commercial |
$1,209.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,027.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,076.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,209.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,076.08
|
| Rate for Payer: Group Health Inc Commercial |
$1,209.08
|
| Rate for Payer: Group Health Inc Medicare |
$1,209.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,415.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,209.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,027.72
|
| Rate for Payer: Healthfirst QHP |
$1,209.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,209.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,209.08
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$967.26
|
| Rate for Payer: Wellcare Medicare |
$1,148.63
|
|
|
VEEG EA 12-26HR INTMT MNTR
|
Facility
|
OP
|
$1,502.55
|
|
|
Service Code
|
HCPCS 95715
|
| Hospital Charge Code |
41001013
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$495.86 |
| Max. Negotiated Rate |
$1,202.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$826.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$619.82
|
| Rate for Payer: Aetna Government |
$619.82
|
| Rate for Payer: Brighton Health Commercial |
$1,126.91
|
| Rate for Payer: Cash Price |
$619.82
|
| Rate for Payer: Cash Price |
$619.82
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$619.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,202.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,021.73
|
| Rate for Payer: Elderplan Medicare Advantage |
$619.82
|
| Rate for Payer: EmblemHealth Commercial |
$619.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$526.85
|
| Rate for Payer: Fidelis Essential Plan QHP |
$551.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$619.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$551.64
|
| Rate for Payer: Group Health Inc Commercial |
$619.82
|
| Rate for Payer: Group Health Inc Medicare |
$619.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$751.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$619.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$526.85
|
| Rate for Payer: Healthfirst QHP |
$619.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$619.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$619.82
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$495.86
|
| Rate for Payer: Wellcare Medicare |
$588.83
|
|
|
VEEG EA 12-26HR INTMT MNTR
|
Facility
|
IP
|
$1,502.55
|
|
|
Service Code
|
HCPCS 95715
|
| Hospital Charge Code |
41001013
|
|
Hospital Revenue Code
|
740
|
| Rate for Payer: Cash Price |
$619.82
|
|
|
VEIN LIGATION AND STRIPPING
|
Facility
|
IP
|
$48,788.38
|
|
|
Service Code
|
MSDRG 263
|
| Min. Negotiated Rate |
$21,625.27 |
| Max. Negotiated Rate |
$48,788.38 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$41,657.57
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$46,505.96
|
| Rate for Payer: Aetna Government |
$46,505.96
|
| Rate for Payer: Brighton Health Commercial |
$40,965.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$47,436.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$48,788.38
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$40,262.26
|
| Rate for Payer: Elderplan Medicare Advantage |
$44,180.66
|
| Rate for Payer: EmblemHealth Commercial |
$24,226.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$46,505.96
|
| Rate for Payer: Group Health Inc Commercial |
$46,505.96
|
| Rate for Payer: Group Health Inc Medicare |
$46,505.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$46,505.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21,625.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$46,505.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$46,505.96
|
| Rate for Payer: Wellcare Medicare |
$44,180.66
|
|
|
VEIN PICK
|
Facility
|
OP
|
$30.00
|
|
| Hospital Charge Code |
66526905
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.00
|
| Rate for Payer: Aetna Government |
$15.00
|
| Rate for Payer: Brighton Health Commercial |
$22.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.40
|
| Rate for Payer: Group Health Inc Commercial |
$15.00
|
| Rate for Payer: Group Health Inc Medicare |
$10.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.00
|
|
|
VEIN SET
|
Facility
|
OP
|
$6.03
|
|
| Hospital Charge Code |
40206620
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$4.82 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.32
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.02
|
| Rate for Payer: Aetna Government |
$3.02
|
| Rate for Payer: Brighton Health Commercial |
$4.52
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4.82
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.10
|
| Rate for Payer: Group Health Inc Commercial |
$3.02
|
| Rate for Payer: Group Health Inc Medicare |
$2.11
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.02
|
|
|
VEIN STRIPPER DISPOSABLE
|
Facility
|
OP
|
$66.67
|
|
| Hospital Charge Code |
64902974
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.33 |
| Max. Negotiated Rate |
$53.34 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$36.67
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$33.34
|
| Rate for Payer: Aetna Government |
$33.34
|
| Rate for Payer: Brighton Health Commercial |
$50.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$53.34
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$45.34
|
| Rate for Payer: Group Health Inc Commercial |
$33.34
|
| Rate for Payer: Group Health Inc Medicare |
$23.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$33.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33.34
|
|
|
VEIN STRIPPERS
|
Facility
|
OP
|
$8.51
|
|
| Hospital Charge Code |
40000430
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$6.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.68
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.26
|
| Rate for Payer: Aetna Government |
$4.26
|
| Rate for Payer: Brighton Health Commercial |
$6.38
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.79
|
| Rate for Payer: Group Health Inc Commercial |
$4.26
|
| Rate for Payer: Group Health Inc Medicare |
$2.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.26
|
|
|
VENIPUNCTURE
|
Facility
|
IP
|
$9.71
|
|
|
Service Code
|
HCPCS 36415
|
| Hospital Charge Code |
40500009
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$8.83
|
|
|
VENIPUNCTURE
|
Facility
|
OP
|
$9.71
|
|
|
Service Code
|
HCPCS 36415
|
| Hospital Charge Code |
40500009
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.87 |
| Max. Negotiated Rate |
$926.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.34
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.57
|
| Rate for Payer: Aetna Government |
$8.57
|
| Rate for Payer: Amida Care Medicaid |
$9.26
|
| Rate for Payer: Brighton Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$8.83
|
| Rate for Payer: Cash Price |
$8.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.39
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2.87
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.57
|
| Rate for Payer: EmblemHealth Commercial |
$8.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$926.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.72
|
| Rate for Payer: Group Health Inc Commercial |
$8.57
|
| Rate for Payer: Group Health Inc Medicare |
$8.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.26
|
| Rate for Payer: Healthfirst Essential Plan |
$20.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.28
|
| Rate for Payer: Healthfirst QHP |
$9.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.57
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$9.26
|
| Rate for Payer: SOMOS Essential |
$20.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6.86
|
| Rate for Payer: Wellcare Medicare |
$7.71
|
|
|
VENIPUNCTURE < 3 YEARS
|
Facility
|
OP
|
$37.52
|
|
|
Service Code
|
HCPCS 36406
|
| Hospital Charge Code |
40034383
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13.13 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.59
|
| Rate for Payer: Aetna Government |
$17.59
|
| Rate for Payer: Brighton Health Commercial |
$28.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Group Health Inc Commercial |
$18.76
|
| Rate for Payer: Group Health Inc Medicare |
$13.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.76
|
|
|
VENIPUNCTURE <3YEARS
|
Facility
|
OP
|
$37.52
|
|
|
Service Code
|
HCPCS 36406
|
| Hospital Charge Code |
30304068
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.59 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.59
|
| Rate for Payer: Aetna Government |
$17.59
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$204.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$173.89
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.76
|
|
|
VENIPUNCTURE, 3YRS OLD OR OLDER
|
Facility
|
OP
|
$28.86
|
|
|
Service Code
|
HCPCS 36410
|
| Hospital Charge Code |
30103224
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$14.43 |
| Max. Negotiated Rate |
$874.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.97
|
| Rate for Payer: Aetna Government |
$17.97
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$747.30
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$635.21
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
|
|
VENIPUNCTURE BLOOD DRAW >3YRS OLD
|
Facility
|
OP
|
$58.23
|
|
|
Service Code
|
HCPCS 36400
|
| Hospital Charge Code |
30103223
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$21.61 |
| Max. Negotiated Rate |
$874.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21.61
|
| Rate for Payer: Aetna Government |
$21.61
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$747.30
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$635.21
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
|
|
VENIPUNCTURE BLOOD DRAWING
|
Facility
|
OP
|
$58.23
|
|
|
Service Code
|
HCPCS 36400
|
| Hospital Charge Code |
30300033
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.61 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21.61
|
| Rate for Payer: Aetna Government |
$21.61
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$204.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$173.89
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29.12
|
|
|
VENIPUNCTURE, PHYSICAN SKILL
|
Facility
|
OP
|
$28.86
|
|
|
Service Code
|
HCPCS 36410
|
| Hospital Charge Code |
30304066
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.43 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.97
|
| Rate for Payer: Aetna Government |
$17.97
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$204.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$173.89
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.43
|
|
|
VENLAFAXINE HCL ER 150 MG PO CP24 [27859]
|
Facility
|
OP
|
$5.08
|
|
|
Service Code
|
NDC 65862069705
|
| Hospital Charge Code |
65862069705
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.78 |
| Max. Negotiated Rate |
$4.07 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.54
|
| Rate for Payer: Aetna Government |
$2.54
|
| Rate for Payer: Brighton Health Commercial |
$3.81
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4.07
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.46
|
| Rate for Payer: Group Health Inc Commercial |
$2.54
|
| Rate for Payer: Group Health Inc Medicare |
$1.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.54
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.30
|
|
|
VENLAFAXINE HCL ER 150 MG PO CP24 [27859]
|
Facility
|
OP
|
$5.08
|
|
|
Service Code
|
NDC 00093738698
|
| Hospital Charge Code |
00093738698
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.78 |
| Max. Negotiated Rate |
$4.07 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.54
|
| Rate for Payer: Aetna Government |
$2.54
|
| Rate for Payer: Brighton Health Commercial |
$3.81
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4.07
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.46
|
| Rate for Payer: Group Health Inc Commercial |
$2.54
|
| Rate for Payer: Group Health Inc Medicare |
$1.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.54
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.30
|
|
