|
HC ALLERGEN SPEC IGE - ALLERGEN TURKEY IGE
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003O5
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.22
|
| Rate for Payer: Aetna Government |
$5.22
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.65
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.65
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.65
|
| Rate for Payer: Brighton Health Commercial |
$9.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.22
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.22
|
| Rate for Payer: EmblemHealth Commercial |
$5.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.65
|
| Rate for Payer: Group Health Inc Commercial |
$5.22
|
| Rate for Payer: Group Health Inc Medicare |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Healthfirst Essential Plan |
$8.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.22
|
| Rate for Payer: Healthfirst QHP |
$5.22
|
| Rate for Payer: Humana Medicare |
$5.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare Commercial |
$6.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.22
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Wellcare Medicare |
$4.70
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN TURKEY IGE
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003O5
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.50
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WALNUT IGE
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003S5
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.22
|
| Rate for Payer: Aetna Government |
$5.22
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.65
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.65
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.65
|
| Rate for Payer: Brighton Health Commercial |
$9.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.22
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.22
|
| Rate for Payer: EmblemHealth Commercial |
$5.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.65
|
| Rate for Payer: Group Health Inc Commercial |
$5.22
|
| Rate for Payer: Group Health Inc Medicare |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Healthfirst Essential Plan |
$8.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.22
|
| Rate for Payer: Healthfirst QHP |
$5.22
|
| Rate for Payer: Humana Medicare |
$5.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare Commercial |
$6.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.22
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Wellcare Medicare |
$4.70
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WALNUT IGE
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003S5
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.50
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WASP, PAPER IGE
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003T5
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.50
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WASP, PAPER IGE
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003T5
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.22
|
| Rate for Payer: Aetna Government |
$5.22
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.65
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.65
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.65
|
| Rate for Payer: Brighton Health Commercial |
$9.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.22
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.22
|
| Rate for Payer: EmblemHealth Commercial |
$5.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.65
|
| Rate for Payer: Group Health Inc Commercial |
$5.22
|
| Rate for Payer: Group Health Inc Medicare |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Healthfirst Essential Plan |
$8.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.22
|
| Rate for Payer: Healthfirst QHP |
$5.22
|
| Rate for Payer: Humana Medicare |
$5.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare Commercial |
$6.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.22
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Wellcare Medicare |
$4.70
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WEED: DANDELION IGE
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
3028600377
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.22
|
| Rate for Payer: Aetna Government |
$5.22
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.65
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.65
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.65
|
| Rate for Payer: Brighton Health Commercial |
$9.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.22
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.22
|
| Rate for Payer: EmblemHealth Commercial |
$5.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.65
|
| Rate for Payer: Group Health Inc Commercial |
$5.22
|
| Rate for Payer: Group Health Inc Medicare |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Healthfirst Essential Plan |
$8.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.22
|
| Rate for Payer: Healthfirst QHP |
$5.22
|
| Rate for Payer: Humana Medicare |
$5.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare Commercial |
$6.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.22
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Wellcare Medicare |
$4.70
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WEED: DANDELION IGE
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
3028600377
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.50
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WEEDS
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
302860033O6
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.50
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WEEDS
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
302860033O6
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.22
|
| Rate for Payer: Aetna Government |
$5.22
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.65
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.65
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.65
|
| Rate for Payer: Brighton Health Commercial |
$9.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.22
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.22
|
| Rate for Payer: EmblemHealth Commercial |
$5.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.65
|
| Rate for Payer: Group Health Inc Commercial |
$5.22
|
| Rate for Payer: Group Health Inc Medicare |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Healthfirst Essential Plan |
$8.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.22
|
| Rate for Payer: Healthfirst QHP |
$5.22
|
| Rate for Payer: Humana Medicare |
$5.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare Commercial |
$6.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.22
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Wellcare Medicare |
$4.70
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WHEAT IGE
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003V5
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.22
|
| Rate for Payer: Aetna Government |
$5.22
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.65
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.65
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.65
|
| Rate for Payer: Brighton Health Commercial |
$9.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.22
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.22
|
| Rate for Payer: EmblemHealth Commercial |
$5.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.65
|
| Rate for Payer: Group Health Inc Commercial |
$5.22
|
| Rate for Payer: Group Health Inc Medicare |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Healthfirst Essential Plan |
$8.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.22
|
| Rate for Payer: Healthfirst QHP |
$5.22
|
| Rate for Payer: Humana Medicare |
$5.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare Commercial |
$6.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.22
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Wellcare Medicare |
$4.70
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WHEAT IGE
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003V5
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.50
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WHITE BEAN IGE
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003Y5
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.22
|
| Rate for Payer: Aetna Government |
$5.22
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.65
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.65
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.65
|
| Rate for Payer: Brighton Health Commercial |
$9.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.22
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.22
|
| Rate for Payer: EmblemHealth Commercial |
$5.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.65
|
| Rate for Payer: Group Health Inc Commercial |
$5.22
|
| Rate for Payer: Group Health Inc Medicare |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Healthfirst Essential Plan |
$8.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.22
|
| Rate for Payer: Healthfirst QHP |
$5.22
|
| Rate for Payer: Humana Medicare |
$5.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare Commercial |
$6.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.22
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Wellcare Medicare |
$4.70
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN WHITE BEAN IGE
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003Y5
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.50
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN YELLOW JACKET IGE
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003F6
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.22
|
| Rate for Payer: Aetna Government |
$5.22
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.65
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.65
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.65
|
| Rate for Payer: Brighton Health Commercial |
$9.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.22
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.22
|
| Rate for Payer: EmblemHealth Commercial |
$5.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.65
|
| Rate for Payer: Group Health Inc Commercial |
$5.22
|
| Rate for Payer: Group Health Inc Medicare |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Healthfirst Essential Plan |
$8.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.22
|
| Rate for Payer: Healthfirst QHP |
$5.22
|
| Rate for Payer: Humana Medicare |
$5.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.22
|
| Rate for Payer: United Healthcare Commercial |
$6.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.22
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.69
|
| Rate for Payer: Wellcare Medicare |
$4.70
|
|
|
HC ALLERGEN SPEC IGE - ALLERGEN YELLOW JACKET IGE
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30286003F6
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.50
|
|
|
HC ALLERGEN SPEC IGE -MULTIALLERGEN SCREEN - ANIMAL MIX
|
Facility
|
IP
|
$19.00
|
|
|
Service Code
|
CPT 86005
|
| Hospital Charge Code |
3028600501
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$9.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.50
|
|
|
HC ALLERGEN SPEC IGE -MULTIALLERGEN SCREEN - ANIMAL MIX
|
Facility
|
OP
|
$19.00
|
|
|
Service Code
|
CPT 86005
|
| Hospital Charge Code |
3028600501
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.58 |
| Max. Negotiated Rate |
$14.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$10.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7.97
|
| Rate for Payer: Aetna Government |
$7.97
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5.58
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5.58
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5.58
|
| Rate for Payer: Brighton Health Commercial |
$14.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$7.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.55
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.41
|
| Rate for Payer: Elderplan Medicare Advantage |
$7.97
|
| Rate for Payer: EmblemHealth Commercial |
$7.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.17
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6.77
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.09
|
| Rate for Payer: Fidelis Medicare Advantage |
$7.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.09
|
| Rate for Payer: Group Health Inc Commercial |
$7.97
|
| Rate for Payer: Group Health Inc Medicare |
$7.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.97
|
| Rate for Payer: Healthfirst QHP |
$7.97
|
| Rate for Payer: Humana Medicare |
$8.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$7.97
|
| Rate for Payer: United Healthcare Commercial |
$10.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7.97
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7.57
|
| Rate for Payer: Wellcare Medicare |
$7.17
|
|
|
HC ALLERGEN SPEC IGG QUANT,EACH - ALLERGENS, FOOD, IGG PANEL 18
|
Facility
|
OP
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
3028600135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.47 |
| Max. Negotiated Rate |
$14.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$10.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7.82
|
| Rate for Payer: Aetna Government |
$7.82
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5.47
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5.47
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5.47
|
| Rate for Payer: Brighton Health Commercial |
$14.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$7.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$7.82
|
| Rate for Payer: EmblemHealth Commercial |
$7.82
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$7.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6.96
|
| Rate for Payer: Group Health Inc Commercial |
$7.82
|
| Rate for Payer: Group Health Inc Medicare |
$7.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7.82
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.82
|
| Rate for Payer: Healthfirst QHP |
$7.82
|
| Rate for Payer: Humana Medicare |
$7.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$7.82
|
| Rate for Payer: United Healthcare Commercial |
$6.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7.82
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7.43
|
| Rate for Payer: Wellcare Medicare |
$7.04
|
|
|
HC ALLERGEN SPEC IGG QUANT,EACH - ALLERGENS, FOOD, IGG PANEL 18
|
Facility
|
IP
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
3028600135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$9.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.50
|
|
|
HC ALLERGEN SPEC IGG QUANT,EACH - ASPERGILLUS NIGER IGG
|
Facility
|
IP
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
3028600101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$9.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.50
|
|
|
HC ALLERGEN SPEC IGG QUANT,EACH - ASPERGILLUS NIGER IGG
|
Facility
|
OP
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
3028600101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.47 |
| Max. Negotiated Rate |
$14.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$10.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7.82
|
| Rate for Payer: Aetna Government |
$7.82
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5.47
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5.47
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5.47
|
| Rate for Payer: Brighton Health Commercial |
$14.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$7.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$7.82
|
| Rate for Payer: EmblemHealth Commercial |
$7.82
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$7.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6.96
|
| Rate for Payer: Group Health Inc Commercial |
$7.82
|
| Rate for Payer: Group Health Inc Medicare |
$7.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7.82
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.82
|
| Rate for Payer: Healthfirst QHP |
$7.82
|
| Rate for Payer: Humana Medicare |
$7.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$7.82
|
| Rate for Payer: United Healthcare Commercial |
$6.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7.82
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7.43
|
| Rate for Payer: Wellcare Medicare |
$7.04
|
|
|
HC ALLERGEN SPEC IGG QUANT,EACH - IGG FOOD PANEL III
|
Facility
|
IP
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
3028600136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$9.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.50
|
|
|
HC ALLERGEN SPEC IGG QUANT,EACH - IGG FOOD PANEL III
|
Facility
|
OP
|
$19.00
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
3028600136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.47 |
| Max. Negotiated Rate |
$14.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$10.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7.82
|
| Rate for Payer: Aetna Government |
$7.82
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5.47
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5.47
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5.47
|
| Rate for Payer: Brighton Health Commercial |
$14.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$7.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$7.82
|
| Rate for Payer: EmblemHealth Commercial |
$7.82
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$7.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6.96
|
| Rate for Payer: Group Health Inc Commercial |
$7.82
|
| Rate for Payer: Group Health Inc Medicare |
$7.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7.82
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.82
|
| Rate for Payer: Healthfirst QHP |
$7.82
|
| Rate for Payer: Humana Medicare |
$7.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$7.82
|
| Rate for Payer: United Healthcare Commercial |
$6.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7.82
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7.43
|
| Rate for Payer: Wellcare Medicare |
$7.04
|
|
|
HC ALLERGY PATCH TESTS
|
Facility
|
OP
|
$2,752.00
|
|
|
Service Code
|
CPT 95044
|
| Hospital Charge Code |
9249504401
|
|
Hospital Revenue Code
|
924
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$2,201.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,513.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,243.07
|
| Rate for Payer: Aetna Government |
$1,243.07
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$870.15
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$870.15
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$870.15
|
| Rate for Payer: Brighton Health Commercial |
$2,064.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,243.07
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,201.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,871.36
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,243.07
|
| Rate for Payer: EmblemHealth Commercial |
$1,243.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,118.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,056.61
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,106.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,243.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,106.33
|
| Rate for Payer: Group Health Inc Commercial |
$1,243.07
|
| Rate for Payer: Group Health Inc Medicare |
$1,243.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,243.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,243.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$6.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,056.61
|
| Rate for Payer: Healthfirst QHP |
$1,243.07
|
| Rate for Payer: Humana Medicare |
$1,267.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,243.07
|
| Rate for Payer: United Healthcare Commercial |
$1,376.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,243.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,243.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,180.92
|
| Rate for Payer: Wellcare Medicare |
$1,180.92
|
|
