|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE 24 HOUR URINE
|
Facility
|
OP
|
$9.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3018294503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$8.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.93
|
| Rate for Payer: Aetna Government |
$3.93
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2.75
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2.75
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2.75
|
| Rate for Payer: Brighton Health Commercial |
$6.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.67
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.62
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.93
|
| Rate for Payer: EmblemHealth Commercial |
$3.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.50
|
| Rate for Payer: Group Health Inc Commercial |
$3.93
|
| Rate for Payer: Group Health Inc Medicare |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.93
|
| Rate for Payer: Healthfirst Essential Plan |
$8.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.93
|
| Rate for Payer: Healthfirst QHP |
$3.93
|
| Rate for Payer: Humana Medicare |
$4.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare Commercial |
$4.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.93
|
| Rate for Payer: Wellcare Medicare |
$3.54
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE 24 HOUR URINE
|
Facility
|
IP
|
$9.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3018294503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.50
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE BODY FLUID
|
Facility
|
OP
|
$9.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3018294502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$8.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.93
|
| Rate for Payer: Aetna Government |
$3.93
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2.75
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2.75
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2.75
|
| Rate for Payer: Brighton Health Commercial |
$6.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.67
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.62
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.93
|
| Rate for Payer: EmblemHealth Commercial |
$3.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.50
|
| Rate for Payer: Group Health Inc Commercial |
$3.93
|
| Rate for Payer: Group Health Inc Medicare |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.93
|
| Rate for Payer: Healthfirst Essential Plan |
$8.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.93
|
| Rate for Payer: Healthfirst QHP |
$3.93
|
| Rate for Payer: Humana Medicare |
$4.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare Commercial |
$4.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.93
|
| Rate for Payer: Wellcare Medicare |
$3.54
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE BODY FLUID
|
Facility
|
IP
|
$9.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3018294502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.50
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE CSF
|
Facility
|
IP
|
$9.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3018294501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.50
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE CSF
|
Facility
|
OP
|
$9.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3018294501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$8.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.93
|
| Rate for Payer: Aetna Government |
$3.93
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2.75
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2.75
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2.75
|
| Rate for Payer: Brighton Health Commercial |
$6.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.67
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.62
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.93
|
| Rate for Payer: EmblemHealth Commercial |
$3.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.50
|
| Rate for Payer: Group Health Inc Commercial |
$3.93
|
| Rate for Payer: Group Health Inc Medicare |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.93
|
| Rate for Payer: Healthfirst Essential Plan |
$8.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.93
|
| Rate for Payer: Healthfirst QHP |
$3.93
|
| Rate for Payer: Humana Medicare |
$4.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare Commercial |
$4.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.93
|
| Rate for Payer: Wellcare Medicare |
$3.54
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE URINE RANDOM
|
Facility
|
OP
|
$9.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3018294504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$8.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.93
|
| Rate for Payer: Aetna Government |
$3.93
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2.75
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2.75
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2.75
|
| Rate for Payer: Brighton Health Commercial |
$6.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.67
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.62
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.93
|
| Rate for Payer: EmblemHealth Commercial |
$3.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.50
|
| Rate for Payer: Group Health Inc Commercial |
$3.93
|
| Rate for Payer: Group Health Inc Medicare |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.93
|
| Rate for Payer: Healthfirst Essential Plan |
$8.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.93
|
| Rate for Payer: Healthfirst QHP |
$3.93
|
| Rate for Payer: Humana Medicare |
$4.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare Commercial |
$4.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.93
|
| Rate for Payer: Wellcare Medicare |
$3.54
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - GLUCOSE URINE RANDOM
|
Facility
|
IP
|
$9.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3018294504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.50
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - REDUCING SUBSTANCES STOOL
|
Facility
|
IP
|
$9.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3018294505
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.50
|
|
|
HC ASSAY GLUCOSE, BODY FLUID - REDUCING SUBSTANCES STOOL
|
Facility
|
OP
|
$9.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
3018294505
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$8.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.93
|
| Rate for Payer: Aetna Government |
$3.93
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2.75
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2.75
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2.75
|
| Rate for Payer: Brighton Health Commercial |
$6.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.67
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.62
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.93
|
| Rate for Payer: EmblemHealth Commercial |
$3.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.50
|
| Rate for Payer: Group Health Inc Commercial |
$3.93
|
| Rate for Payer: Group Health Inc Medicare |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.93
|
| Rate for Payer: Healthfirst Essential Plan |
$8.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.93
|
| Rate for Payer: Healthfirst QHP |
$3.93
|
| Rate for Payer: Humana Medicare |
$4.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.93
|
| Rate for Payer: United Healthcare Commercial |
$4.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.93
|
| Rate for Payer: Wellcare Medicare |
$3.54
|
|
|
HC ASSAY GROWTH HORMONE (HGH) - GROWTH HORMONE
|
Facility
|
IP
|
$41.00
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
3018300301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.50 |
| Max. Negotiated Rate |
$20.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20.50
|
|
|
HC ASSAY GROWTH HORMONE (HGH) - GROWTH HORMONE
|
Facility
|
OP
|
$41.00
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
3018300301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$37.51 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$22.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.67
|
| Rate for Payer: Aetna Government |
$16.67
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$11.67
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$11.67
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$11.67
|
| Rate for Payer: Brighton Health Commercial |
$30.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.67
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28.36
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$23.87
|
| Rate for Payer: Elderplan Medicare Advantage |
$16.67
|
| Rate for Payer: EmblemHealth Commercial |
$16.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$15.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$14.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$14.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$16.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$14.84
|
| Rate for Payer: Group Health Inc Commercial |
$16.67
|
| Rate for Payer: Group Health Inc Medicare |
$16.67
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.67
|
| Rate for Payer: Healthfirst Essential Plan |
$37.51
|
| Rate for Payer: Healthfirst Medicare Advantage |
$16.67
|
| Rate for Payer: Healthfirst QHP |
$16.67
|
| Rate for Payer: Humana Medicare |
$17.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16.67
|
| Rate for Payer: United Healthcare Commercial |
$21.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.67
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$16.67
|
| Rate for Payer: Wellcare Medicare |
$15.00
|
|
|
HC ASSAY, NON-ENDOCRINE RECEPTOR - ACETYLCHOLINE RECEPTOR, BINDING
|
Facility
|
IP
|
$91.00
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
3018423801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.50 |
| Max. Negotiated Rate |
$45.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.50
|
|
|
HC ASSAY, NON-ENDOCRINE RECEPTOR - ACETYLCHOLINE RECEPTOR, BINDING
|
Facility
|
OP
|
$91.00
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
3018423801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$68.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$50.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$36.57
|
| Rate for Payer: Aetna Government |
$36.57
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$25.60
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$25.60
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$25.60
|
| Rate for Payer: Brighton Health Commercial |
$68.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$36.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$62.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$52.31
|
| Rate for Payer: Elderplan Medicare Advantage |
$36.57
|
| Rate for Payer: EmblemHealth Commercial |
$36.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$31.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$32.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$36.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$32.55
|
| Rate for Payer: Group Health Inc Commercial |
$36.57
|
| Rate for Payer: Group Health Inc Medicare |
$36.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$36.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$36.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$36.57
|
| Rate for Payer: Healthfirst QHP |
$36.57
|
| Rate for Payer: Humana Medicare |
$37.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$36.57
|
| Rate for Payer: United Healthcare Commercial |
$46.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$36.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$34.74
|
| Rate for Payer: Wellcare Medicare |
$32.91
|
|
|
HC ASSAY OF 17-HYDROXYPREGNENOLONE - 17-HYDROXYPREGNENOLONE
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
3018414301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.50 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28.50
|
|
|
HC ASSAY OF 17-HYDROXYPREGNENOLONE - 17-HYDROXYPREGNENOLONE
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
CPT 84143
|
| Hospital Charge Code |
3018414301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.97 |
| Max. Negotiated Rate |
$51.32 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$31.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$22.81
|
| Rate for Payer: Aetna Government |
$22.81
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$15.97
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$15.97
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$15.97
|
| Rate for Payer: Brighton Health Commercial |
$42.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22.81
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$38.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$32.67
|
| Rate for Payer: Elderplan Medicare Advantage |
$22.81
|
| Rate for Payer: EmblemHealth Commercial |
$22.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$19.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$20.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$22.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$20.30
|
| Rate for Payer: Group Health Inc Commercial |
$22.81
|
| Rate for Payer: Group Health Inc Medicare |
$22.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$22.81
|
| Rate for Payer: Healthfirst Essential Plan |
$51.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22.81
|
| Rate for Payer: Healthfirst QHP |
$22.81
|
| Rate for Payer: Humana Medicare |
$23.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22.81
|
| Rate for Payer: United Healthcare Commercial |
$28.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22.81
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$22.81
|
| Rate for Payer: Wellcare Medicare |
$20.53
|
|
|
HC ASSAY OF 5-HIAA - 5 HIAA QUANT,24HR URINE
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
3018349701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.90
|
| Rate for Payer: Aetna Government |
$12.90
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.03
|
| Rate for Payer: Brighton Health Commercial |
$24.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.90
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$21.91
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18.44
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.90
|
| Rate for Payer: EmblemHealth Commercial |
$12.90
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.61
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.90
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.48
|
| Rate for Payer: Group Health Inc Commercial |
$12.90
|
| Rate for Payer: Group Health Inc Medicare |
$12.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.90
|
| Rate for Payer: Healthfirst Essential Plan |
$29.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.90
|
| Rate for Payer: Healthfirst QHP |
$12.90
|
| Rate for Payer: Humana Medicare |
$13.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.90
|
| Rate for Payer: United Healthcare Commercial |
$16.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.90
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.90
|
| Rate for Payer: Wellcare Medicare |
$11.61
|
|
|
HC ASSAY OF 5-HIAA - 5 HIAA QUANT,24HR URINE
|
Facility
|
IP
|
$32.00
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
3018349701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$16.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.00
|
|
|
HC ASSAY OF 5-HIAA - 5 HIAA QUANT,RANDOM URINE
|
Facility
|
IP
|
$32.00
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
3018349702
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$16.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.00
|
|
|
HC ASSAY OF 5-HIAA - 5 HIAA QUANT,RANDOM URINE
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
3018349702
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.90
|
| Rate for Payer: Aetna Government |
$12.90
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.03
|
| Rate for Payer: Brighton Health Commercial |
$24.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.90
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$21.91
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18.44
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.90
|
| Rate for Payer: EmblemHealth Commercial |
$12.90
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.61
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.90
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.48
|
| Rate for Payer: Group Health Inc Commercial |
$12.90
|
| Rate for Payer: Group Health Inc Medicare |
$12.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.90
|
| Rate for Payer: Healthfirst Essential Plan |
$29.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.90
|
| Rate for Payer: Healthfirst QHP |
$12.90
|
| Rate for Payer: Humana Medicare |
$13.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.90
|
| Rate for Payer: United Healthcare Commercial |
$16.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.90
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.90
|
| Rate for Payer: Wellcare Medicare |
$11.61
|
|
|
HC ASSAY OF ACTH - ACTH
|
Facility
|
OP
|
$96.00
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
3018202401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.03 |
| Max. Negotiated Rate |
$86.89 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$52.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$38.62
|
| Rate for Payer: Aetna Government |
$38.62
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$27.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$27.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$27.03
|
| Rate for Payer: Brighton Health Commercial |
$72.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$38.62
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$65.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$55.26
|
| Rate for Payer: Elderplan Medicare Advantage |
$38.62
|
| Rate for Payer: EmblemHealth Commercial |
$38.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$32.83
|
| Rate for Payer: Fidelis Essential Plan QHP |
$34.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$38.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34.37
|
| Rate for Payer: Group Health Inc Commercial |
$38.62
|
| Rate for Payer: Group Health Inc Medicare |
$38.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$38.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$38.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$38.62
|
| Rate for Payer: Healthfirst Essential Plan |
$86.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.62
|
| Rate for Payer: Healthfirst QHP |
$38.62
|
| Rate for Payer: Humana Medicare |
$39.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$38.62
|
| Rate for Payer: United Healthcare Commercial |
$48.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$38.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$38.62
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$38.62
|
| Rate for Payer: Wellcare Medicare |
$34.76
|
|
|
HC ASSAY OF ACTH - ACTH
|
Facility
|
IP
|
$96.00
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
3018202401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$48.00
|
|
|
HC ASSAY OF ALDOLASE - ALDOLASE
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 82085
|
| Hospital Charge Code |
3018208501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.71
|
| Rate for Payer: Aetna Government |
$9.71
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.80
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.80
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.80
|
| Rate for Payer: Brighton Health Commercial |
$18.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.71
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$16.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$13.89
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.71
|
| Rate for Payer: EmblemHealth Commercial |
$9.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.74
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.25
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.64
|
| Rate for Payer: Group Health Inc Commercial |
$9.71
|
| Rate for Payer: Group Health Inc Medicare |
$9.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.71
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.71
|
| Rate for Payer: Healthfirst QHP |
$9.71
|
| Rate for Payer: Humana Medicare |
$9.90
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.71
|
| Rate for Payer: United Healthcare Commercial |
$12.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.71
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.22
|
| Rate for Payer: Wellcare Medicare |
$8.74
|
|
|
HC ASSAY OF ALDOLASE - ALDOLASE
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 82085
|
| Hospital Charge Code |
3018208501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.00
|
|
|
HC ASSAY OF ALDOSTERONE - ALDOSTERONE
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 82088
|
| Hospital Charge Code |
3018208802
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.50 |
| Max. Negotiated Rate |
$50.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.50
|
|
