|
HALOPERIDOL DECANOATE 50 MG/ML IM SOLN
|
Facility
|
IP
|
$26.68
|
|
|
Service Code
|
HCPCS J1631
|
| Hospital Charge Code |
7006938101
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.34 |
| Max. Negotiated Rate |
$13.34 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$13.34
|
|
|
HALOPERIDOL DECANOATE 50 MG/ML IM SOLN
|
Facility
|
OP
|
$31.07
|
|
|
Service Code
|
HCPCS J1631
|
| Hospital Charge Code |
1014709213
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$24.85 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.57
|
| Rate for Payer: Aetna Government |
$9.57
|
| Rate for Payer: Brighton Health Commercial |
$23.30
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21.13
|
| Rate for Payer: EmblemHealth Commercial |
$15.53
|
| Rate for Payer: Group Health Inc Commercial |
$15.53
|
| Rate for Payer: Group Health Inc Medicare |
$10.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$4.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$20.19
|
|
|
HALOPERIDOL DECANOATE 50 MG/ML IM SOLN
|
Facility
|
OP
|
$26.68
|
|
|
Service Code
|
HCPCS J1631
|
| Hospital Charge Code |
7006938110
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$21.34 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$14.67
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.57
|
| Rate for Payer: Aetna Government |
$9.57
|
| Rate for Payer: Brighton Health Commercial |
$20.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$21.34
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18.14
|
| Rate for Payer: EmblemHealth Commercial |
$13.34
|
| Rate for Payer: Group Health Inc Commercial |
$13.34
|
| Rate for Payer: Group Health Inc Medicare |
$9.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$13.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13.34
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$4.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.34
|
|
|
HALOPERIDOL DECANOATE 50 MG/ML IM SOLN
|
Facility
|
IP
|
$26.68
|
|
|
Service Code
|
HCPCS J1631
|
| Hospital Charge Code |
7006938110
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$13.34 |
| Max. Negotiated Rate |
$13.34 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$13.34
|
|
|
HALOPERIDOL LACTATE 2 MG/ML PO CONC
|
Facility
|
IP
|
$0.88
|
|
|
Service Code
|
NDC 0904711241
|
| Hospital Charge Code |
0904711241
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.44 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.44
|
|
|
HALOPERIDOL LACTATE 2 MG/ML PO CONC
|
Facility
|
IP
|
$0.84
|
|
|
Service Code
|
NDC 0121058105
|
| Hospital Charge Code |
0121058105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$0.42 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.42
|
|
|
HALOPERIDOL LACTATE 2 MG/ML PO CONC
|
Facility
|
IP
|
$0.45
|
|
|
Service Code
|
NDC 0121058104
|
| Hospital Charge Code |
0121058104
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$0.23 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.23
|
|
|
HALOPERIDOL LACTATE 2 MG/ML PO CONC
|
Facility
|
OP
|
$0.88
|
|
|
Service Code
|
NDC 0904711270
|
| Hospital Charge Code |
0904711270
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.44
|
| Rate for Payer: Aetna Government |
$0.44
|
| Rate for Payer: Brighton Health Commercial |
$0.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.71
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.60
|
| Rate for Payer: EmblemHealth Commercial |
$0.44
|
| Rate for Payer: Group Health Inc Commercial |
$0.44
|
| Rate for Payer: Group Health Inc Medicare |
$0.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.57
|
|
|
HALOPERIDOL LACTATE 2 MG/ML PO CONC
|
Facility
|
OP
|
$0.45
|
|
|
Service Code
|
NDC 0121058104
|
| Hospital Charge Code |
0121058104
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$0.36 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.23
|
| Rate for Payer: Aetna Government |
$0.23
|
| Rate for Payer: Brighton Health Commercial |
$0.34
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.36
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.31
|
| Rate for Payer: EmblemHealth Commercial |
$0.23
|
| Rate for Payer: Group Health Inc Commercial |
$0.23
|
| Rate for Payer: Group Health Inc Medicare |
$0.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.23
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.29
|
|
|
HALOPERIDOL LACTATE 2 MG/ML PO CONC
|
Facility
|
OP
|
$0.88
|
|
|
Service Code
|
NDC 0904711241
|
| Hospital Charge Code |
0904711241
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.44
|
| Rate for Payer: Aetna Government |
$0.44
|
| Rate for Payer: Brighton Health Commercial |
$0.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.71
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.60
|
| Rate for Payer: EmblemHealth Commercial |
$0.44
|
| Rate for Payer: Group Health Inc Commercial |
$0.44
|
| Rate for Payer: Group Health Inc Medicare |
$0.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.57
|
|
|
HALOPERIDOL LACTATE 2 MG/ML PO CONC
|
Facility
|
IP
|
$0.88
|
|
|
Service Code
|
NDC 0904711270
|
| Hospital Charge Code |
0904711270
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$0.44 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.44
|
|
|
HALOPERIDOL LACTATE 2 MG/ML PO CONC
|
Facility
|
OP
|
$0.84
|
|
|
Service Code
|
NDC 0121058105
|
| Hospital Charge Code |
0121058105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.29 |
| Max. Negotiated Rate |
$0.67 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.46
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.42
|
| Rate for Payer: Aetna Government |
$0.42
|
| Rate for Payer: Brighton Health Commercial |
$0.63
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.67
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.57
|
| Rate for Payer: EmblemHealth Commercial |
$0.42
|
| Rate for Payer: Group Health Inc Commercial |
$0.42
|
| Rate for Payer: Group Health Inc Medicare |
$0.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.54
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN
|
Facility
|
OP
|
$1.44
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
6745742612
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.46
|
| Rate for Payer: Aetna Government |
$1.46
|
| Rate for Payer: Brighton Health Commercial |
$1.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.98
|
| Rate for Payer: EmblemHealth Commercial |
$0.72
|
| Rate for Payer: Group Health Inc Commercial |
$0.72
|
| Rate for Payer: Group Health Inc Medicare |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.94
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN
|
Facility
|
OP
|
$7.19
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
6332347401
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$5.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.46
|
| Rate for Payer: Aetna Government |
$1.46
|
| Rate for Payer: Brighton Health Commercial |
$5.39
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.75
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.89
|
| Rate for Payer: EmblemHealth Commercial |
$3.59
|
| Rate for Payer: Group Health Inc Commercial |
$3.59
|
| Rate for Payer: Group Health Inc Medicare |
$2.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.67
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN
|
Facility
|
IP
|
$6.00
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
2502180601
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.00
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN
|
Facility
|
OP
|
$6.90
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
6332347410
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$5.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.46
|
| Rate for Payer: Aetna Government |
$1.46
|
| Rate for Payer: Brighton Health Commercial |
$5.17
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.69
|
| Rate for Payer: EmblemHealth Commercial |
$3.45
|
| Rate for Payer: Group Health Inc Commercial |
$3.45
|
| Rate for Payer: Group Health Inc Medicare |
$2.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.45
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.45
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.49
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN
|
Facility
|
IP
|
$7.19
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
6332347401
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.59 |
| Max. Negotiated Rate |
$3.59 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.59
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN
|
Facility
|
IP
|
$1.44
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
6745742600
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$0.72 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.72
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN
|
Facility
|
IP
|
$6.90
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
6332347410
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.45 |
| Max. Negotiated Rate |
$3.45 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.45
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN
|
Facility
|
IP
|
$1.44
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
6745742612
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$0.72 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.72
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN
|
Facility
|
OP
|
$1.44
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
6745742600
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.46
|
| Rate for Payer: Aetna Government |
$1.46
|
| Rate for Payer: Brighton Health Commercial |
$1.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.98
|
| Rate for Payer: EmblemHealth Commercial |
$0.72
|
| Rate for Payer: Group Health Inc Commercial |
$0.72
|
| Rate for Payer: Group Health Inc Medicare |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.94
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN
|
Facility
|
OP
|
$6.00
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
2502180601
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$4.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.46
|
| Rate for Payer: Aetna Government |
$1.46
|
| Rate for Payer: Brighton Health Commercial |
$4.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.08
|
| Rate for Payer: EmblemHealth Commercial |
$3.00
|
| Rate for Payer: Group Health Inc Commercial |
$3.00
|
| Rate for Payer: Group Health Inc Medicare |
$2.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.90
|
|
|
HAND AND FOOT TENOTOMY
|
Facility
|
OP
|
$1,199.32
|
|
|
Service Code
|
EAPG 00048
|
| Min. Negotiated Rate |
$870.18 |
| Max. Negotiated Rate |
$1,199.32 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$870.18
|
| Rate for Payer: Healthfirst Commercial |
$1,199.32
|
|
|
Hand & wrist procedures
|
Facility
|
IP
|
$52,780.43
|
|
|
Service Code
|
APR-DRG 3162
|
| Min. Negotiated Rate |
$11,299.00 |
| Max. Negotiated Rate |
$52,780.43 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$52,780.43
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$52,780.43
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,457.97
|
| Rate for Payer: Amida Care Medicaid |
$23,457.97
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$52,780.43
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,457.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,457.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28,149.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,457.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,457.97
|
| Rate for Payer: Healthfirst Commercial |
$20,998.00
|
| Rate for Payer: Healthfirst Essential Plan |
$52,780.43
|
| Rate for Payer: Healthfirst QHP |
$11,299.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,457.97
|
| Rate for Payer: SOMOS Essential |
$52,780.43
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$52,780.43
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$52,780.43
|
| Rate for Payer: United Healthcare Medicaid |
$23,457.97
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,457.97
|
|
|
Hand & wrist procedures
|
Facility
|
IP
|
$69,532.49
|
|
|
Service Code
|
APR-DRG 3163
|
| Min. Negotiated Rate |
$20,327.00 |
| Max. Negotiated Rate |
$69,532.49 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$69,532.49
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$69,532.49
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$30,903.33
|
| Rate for Payer: Amida Care Medicaid |
$30,903.33
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$69,532.49
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$30,903.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30,903.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$37,084.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30,903.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30,903.33
|
| Rate for Payer: Healthfirst Commercial |
$36,156.00
|
| Rate for Payer: Healthfirst Essential Plan |
$69,532.49
|
| Rate for Payer: Healthfirst QHP |
$20,327.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$30,903.33
|
| Rate for Payer: SOMOS Essential |
$69,532.49
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$69,532.49
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$69,532.49
|
| Rate for Payer: United Healthcare Medicaid |
$30,903.33
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$30,903.33
|
|
