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Charge Type Price  
Hospital Charge Code 66528842
Hospital Revenue Code 480
Min. Negotiated Rate $13.26
Max. Negotiated Rate $30.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial $20.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $18.95
Rate for Payer: Aetna Government $18.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $30.32
Rate for Payer: Cigna LocalPlus Benefit Plan $25.77
Rate for Payer: Group Health Inc Commercial $18.95
Rate for Payer: Group Health Inc Medicare $13.26
Rate for Payer: Hamaspik Choice Inc Medicaid $18.95
Rate for Payer: Hamaspik Choice Inc Medicare $18.95
Hospital Charge Code 66528279
Hospital Revenue Code 480
Min. Negotiated Rate $14.70
Max. Negotiated Rate $33.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial $23.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $21.00
Rate for Payer: Aetna Government $21.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $33.60
Rate for Payer: Cigna LocalPlus Benefit Plan $28.56
Rate for Payer: Group Health Inc Commercial $21.00
Rate for Payer: Group Health Inc Medicare $14.70
Rate for Payer: Hamaspik Choice Inc Medicaid $21.00
Rate for Payer: Hamaspik Choice Inc Medicare $21.00
Hospital Charge Code 66528256
Hospital Revenue Code 480
Min. Negotiated Rate $31.50
Max. Negotiated Rate $72.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $45.00
Rate for Payer: Aetna Government $45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $72.00
Rate for Payer: Cigna LocalPlus Benefit Plan $61.20
Rate for Payer: Group Health Inc Commercial $45.00
Rate for Payer: Group Health Inc Medicare $31.50
Rate for Payer: Hamaspik Choice Inc Medicaid $45.00
Rate for Payer: Hamaspik Choice Inc Medicare $45.00
Hospital Charge Code 66528268
Hospital Revenue Code 480
Min. Negotiated Rate $38.36
Max. Negotiated Rate $87.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial $60.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $54.80
Rate for Payer: Aetna Government $54.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $87.68
Rate for Payer: Cigna LocalPlus Benefit Plan $74.53
Rate for Payer: Group Health Inc Commercial $54.80
Rate for Payer: Group Health Inc Medicare $38.36
Rate for Payer: Hamaspik Choice Inc Medicaid $54.80
Rate for Payer: Hamaspik Choice Inc Medicare $54.80
Hospital Charge Code 66528236
Hospital Revenue Code 270
Min. Negotiated Rate $24.99
Max. Negotiated Rate $57.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial $39.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $35.70
Rate for Payer: Aetna Government $35.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $57.12
Rate for Payer: Cigna LocalPlus Benefit Plan $48.55
Rate for Payer: Group Health Inc Commercial $35.70
Rate for Payer: Group Health Inc Medicare $24.99
Rate for Payer: Hamaspik Choice Inc Medicaid $35.70
Rate for Payer: Hamaspik Choice Inc Medicare $35.70
Hospital Charge Code 66528237
Hospital Revenue Code 270
Min. Negotiated Rate $29.99
Max. Negotiated Rate $68.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial $47.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $42.84
Rate for Payer: Aetna Government $42.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $68.54
Rate for Payer: Cigna LocalPlus Benefit Plan $58.26
Rate for Payer: Group Health Inc Commercial $42.84
Rate for Payer: Group Health Inc Medicare $29.99
Rate for Payer: Hamaspik Choice Inc Medicaid $42.84
Rate for Payer: Hamaspik Choice Inc Medicare $42.84
Hospital Charge Code 66526874
Hospital Revenue Code 270
Min. Negotiated Rate $17.50
Max. Negotiated Rate $40.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $27.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $25.00
Rate for Payer: Aetna Government $25.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $40.00
Rate for Payer: Cigna LocalPlus Benefit Plan $34.00
Rate for Payer: Group Health Inc Commercial $25.00
Rate for Payer: Group Health Inc Medicare $17.50
Rate for Payer: Hamaspik Choice Inc Medicaid $25.00
Rate for Payer: Hamaspik Choice Inc Medicare $25.00
Hospital Charge Code 66528238
Hospital Revenue Code 270
Min. Negotiated Rate $26.42
Max. Negotiated Rate $60.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $41.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $37.74
Rate for Payer: Aetna Government $37.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $60.38
Rate for Payer: Cigna LocalPlus Benefit Plan $51.33
Rate for Payer: Group Health Inc Commercial $37.74
Rate for Payer: Group Health Inc Medicare $26.42
Rate for Payer: Hamaspik Choice Inc Medicaid $37.74
Rate for Payer: Hamaspik Choice Inc Medicare $37.74
Service Code HCPCS 33206
Hospital Charge Code 66528627
Hospital Revenue Code 360
Min. Negotiated Rate $516.37
Max. Negotiated Rate $16,751.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $16,751.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $12,348.58
Rate for Payer: Aetna Government $12,348.58
Rate for Payer: Cash Price $12,348.58
Rate for Payer: Cash Price $12,348.58
Rate for Payer: Cash Price $12,348.58
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $12,348.58
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: Elderplan Medicare Advantage $12,348.58
Rate for Payer: EmblemHealth Commercial $1,505.00
Rate for Payer: Fidelis CHP/HARP/Medicaid $516.37
Rate for Payer: Fidelis Essential Plan Aliesa $10,496.29
Rate for Payer: Fidelis Essential Plan QHP $10,990.24
Rate for Payer: Fidelis Medicare Advantage $12,348.58
Rate for Payer: Fidelis Qualified Health Plan $10,990.24
Rate for Payer: Group Health Inc Commercial $12,348.58
Rate for Payer: Group Health Inc Medicare $12,348.58
Rate for Payer: Hamaspik Choice Inc Medicaid $15,525.29
Rate for Payer: Hamaspik Choice Inc Medicare $12,348.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid $573.74
Rate for Payer: Healthfirst Medicare Advantage $10,496.29
Rate for Payer: Healthfirst QHP $12,348.58
Rate for Payer: Senior Whole Health Medicare Advantage $12,348.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $12,348.58
Rate for Payer: Wellcare CHP/FHP/Medicaid $9,878.86
Rate for Payer: Wellcare Medicare $11,731.15
Service Code HCPCS C1769
Hospital Charge Code 66528983
Hospital Revenue Code 278
Min. Negotiated Rate $4.08
Max. Negotiated Rate $388.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $203.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $4.08
Rate for Payer: Aetna Government $4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $185.00
Rate for Payer: Cigna LocalPlus Benefit Plan $212.75
Rate for Payer: Fidelis Medicare Advantage $388.50
Rate for Payer: Group Health Inc Commercial $185.00
Rate for Payer: Group Health Inc Medicare $129.50
Rate for Payer: Hamaspik Choice Inc Medicaid $185.00
Rate for Payer: Hamaspik Choice Inc Medicare $185.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $240.50
Service Code HCPCS C1769
Hospital Charge Code 66528983
Hospital Revenue Code 278
Min. Negotiated Rate $185.00
Max. Negotiated Rate $185.00
Rate for Payer: Hamaspik Choice Inc Medicaid $185.00
Rate for Payer: Hamaspik Choice Inc Medicare $185.00
Hospital Charge Code 66528405
Hospital Revenue Code 270
Min. Negotiated Rate $26.42
Max. Negotiated Rate $60.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $41.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $37.74
Rate for Payer: Aetna Government $37.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $60.38
Rate for Payer: Cigna LocalPlus Benefit Plan $51.33
Rate for Payer: Group Health Inc Commercial $37.74
Rate for Payer: Group Health Inc Medicare $26.42
Rate for Payer: Hamaspik Choice Inc Medicaid $37.74
Rate for Payer: Hamaspik Choice Inc Medicare $37.74
Hospital Charge Code 66522015
Hospital Revenue Code 270
Min. Negotiated Rate $34.30
Max. Negotiated Rate $78.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial $53.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $49.00
Rate for Payer: Aetna Government $49.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $78.40
Rate for Payer: Cigna LocalPlus Benefit Plan $66.64
Rate for Payer: Group Health Inc Commercial $49.00
Rate for Payer: Group Health Inc Medicare $34.30
Rate for Payer: Hamaspik Choice Inc Medicaid $49.00
Rate for Payer: Hamaspik Choice Inc Medicare $49.00
Service Code HCPCS C1769
Hospital Charge Code 66522113
Hospital Revenue Code 278
Min. Negotiated Rate $4.08
Max. Negotiated Rate $577.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $302.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $4.08
Rate for Payer: Aetna Government $4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $275.00
Rate for Payer: Cigna LocalPlus Benefit Plan $316.25
Rate for Payer: Fidelis Medicare Advantage $577.50
Rate for Payer: Group Health Inc Commercial $275.00
Rate for Payer: Group Health Inc Medicare $192.50
Rate for Payer: Hamaspik Choice Inc Medicaid $275.00
Rate for Payer: Hamaspik Choice Inc Medicare $275.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $357.50
Service Code HCPCS C1769
Hospital Charge Code 66522113
Hospital Revenue Code 278
Min. Negotiated Rate $275.00
Max. Negotiated Rate $275.00
Rate for Payer: Hamaspik Choice Inc Medicaid $275.00
Rate for Payer: Hamaspik Choice Inc Medicare $275.00
Hospital Charge Code 66528401
Hospital Revenue Code 480
Min. Negotiated Rate $20.26
Max. Negotiated Rate $46.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial $31.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $28.94
Rate for Payer: Aetna Government $28.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $46.30
Rate for Payer: Cigna LocalPlus Benefit Plan $39.36
Rate for Payer: Group Health Inc Commercial $28.94
Rate for Payer: Group Health Inc Medicare $20.26
Rate for Payer: Hamaspik Choice Inc Medicaid $28.94
Rate for Payer: Hamaspik Choice Inc Medicare $28.94
Service Code HCPCS C1876
Hospital Charge Code 66528915
Hospital Revenue Code 278
Min. Negotiated Rate $975.00
Max. Negotiated Rate $975.00
Rate for Payer: Hamaspik Choice Inc Medicaid $975.00
Rate for Payer: Hamaspik Choice Inc Medicare $975.00
Service Code HCPCS C1876
Hospital Charge Code 66528915
Hospital Revenue Code 278
Min. Negotiated Rate $398.18
Max. Negotiated Rate $2,047.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,072.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $398.18
Rate for Payer: Aetna Government $398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $975.00
Rate for Payer: Cigna LocalPlus Benefit Plan $1,121.25
Rate for Payer: Fidelis Medicare Advantage $2,047.50
Rate for Payer: Group Health Inc Commercial $975.00
Rate for Payer: Group Health Inc Medicare $682.50
Rate for Payer: Hamaspik Choice Inc Medicaid $975.00
Rate for Payer: Hamaspik Choice Inc Medicare $975.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1,267.50
Service Code HCPCS C1876
Hospital Charge Code 66528929
Hospital Revenue Code 278
Min. Negotiated Rate $398.18
Max. Negotiated Rate $2,047.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,072.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $398.18
Rate for Payer: Aetna Government $398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $975.00
Rate for Payer: Cigna LocalPlus Benefit Plan $1,121.25
Rate for Payer: Fidelis Medicare Advantage $2,047.50
Rate for Payer: Group Health Inc Commercial $975.00
Rate for Payer: Group Health Inc Medicare $682.50
Rate for Payer: Hamaspik Choice Inc Medicaid $975.00
Rate for Payer: Hamaspik Choice Inc Medicare $975.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1,267.50
Service Code HCPCS C1876
Hospital Charge Code 66528929
Hospital Revenue Code 278
Min. Negotiated Rate $975.00
Max. Negotiated Rate $975.00
Rate for Payer: Hamaspik Choice Inc Medicaid $975.00
Rate for Payer: Hamaspik Choice Inc Medicare $975.00
Service Code HCPCS C1876
Hospital Charge Code 66528939
Hospital Revenue Code 278
Min. Negotiated Rate $398.18
Max. Negotiated Rate $2,047.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,072.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $398.18
Rate for Payer: Aetna Government $398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $975.00
Rate for Payer: Cigna LocalPlus Benefit Plan $1,121.25
Rate for Payer: Fidelis Medicare Advantage $2,047.50
Rate for Payer: Group Health Inc Commercial $975.00
Rate for Payer: Group Health Inc Medicare $682.50
Rate for Payer: Hamaspik Choice Inc Medicaid $975.00
Rate for Payer: Hamaspik Choice Inc Medicare $975.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1,267.50
Service Code HCPCS C1876
Hospital Charge Code 66528939
Hospital Revenue Code 278
Min. Negotiated Rate $975.00
Max. Negotiated Rate $975.00
Rate for Payer: Hamaspik Choice Inc Medicaid $975.00
Rate for Payer: Hamaspik Choice Inc Medicare $975.00
Service Code HCPCS C1876
Hospital Charge Code 66528940
Hospital Revenue Code 278
Min. Negotiated Rate $398.18
Max. Negotiated Rate $2,047.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,072.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $398.18
Rate for Payer: Aetna Government $398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $975.00
Rate for Payer: Cigna LocalPlus Benefit Plan $1,121.25
Rate for Payer: Fidelis Medicare Advantage $2,047.50
Rate for Payer: Group Health Inc Commercial $975.00
Rate for Payer: Group Health Inc Medicare $682.50
Rate for Payer: Hamaspik Choice Inc Medicaid $975.00
Rate for Payer: Hamaspik Choice Inc Medicare $975.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1,267.50
Service Code HCPCS C1876
Hospital Charge Code 66528940
Hospital Revenue Code 278
Min. Negotiated Rate $975.00
Max. Negotiated Rate $975.00
Rate for Payer: Hamaspik Choice Inc Medicaid $975.00
Rate for Payer: Hamaspik Choice Inc Medicare $975.00
Hospital Charge Code 66526890
Hospital Revenue Code 270
Min. Negotiated Rate $94.50
Max. Negotiated Rate $216.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $148.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $135.00
Rate for Payer: Aetna Government $135.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $216.00
Rate for Payer: Cigna LocalPlus Benefit Plan $183.60
Rate for Payer: Group Health Inc Commercial $135.00
Rate for Payer: Group Health Inc Medicare $94.50
Rate for Payer: Hamaspik Choice Inc Medicaid $135.00
Rate for Payer: Hamaspik Choice Inc Medicare $135.00