|
HC ASSAY OF ALDOSTERONE - ALDOSTERONE
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 82088
|
| Hospital Charge Code |
3018208802
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.52 |
| Max. Negotiated Rate |
$91.69 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$55.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$40.75
|
| Rate for Payer: Aetna Government |
$40.75
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$28.52
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$28.52
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$28.52
|
| Rate for Payer: Brighton Health Commercial |
$75.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$40.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$69.28
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.31
|
| Rate for Payer: Elderplan Medicare Advantage |
$40.75
|
| Rate for Payer: EmblemHealth Commercial |
$40.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$34.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$36.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$40.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$36.27
|
| Rate for Payer: Group Health Inc Commercial |
$40.75
|
| Rate for Payer: Group Health Inc Medicare |
$40.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40.75
|
| Rate for Payer: Healthfirst Essential Plan |
$91.69
|
| Rate for Payer: Healthfirst Medicare Advantage |
$40.75
|
| Rate for Payer: Healthfirst QHP |
$40.75
|
| Rate for Payer: Humana Medicare |
$41.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40.75
|
| Rate for Payer: United Healthcare Commercial |
$51.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40.75
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$40.75
|
| Rate for Payer: Wellcare Medicare |
$36.67
|
|
|
HC ASSAY OF ALDOSTERONE - ALDOSTERONE,24HR URINE
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 82088
|
| Hospital Charge Code |
3018208801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.52 |
| Max. Negotiated Rate |
$91.69 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$55.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$40.75
|
| Rate for Payer: Aetna Government |
$40.75
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$28.52
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$28.52
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$28.52
|
| Rate for Payer: Brighton Health Commercial |
$75.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$40.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$69.28
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.31
|
| Rate for Payer: Elderplan Medicare Advantage |
$40.75
|
| Rate for Payer: EmblemHealth Commercial |
$40.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$34.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$36.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$40.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$36.27
|
| Rate for Payer: Group Health Inc Commercial |
$40.75
|
| Rate for Payer: Group Health Inc Medicare |
$40.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40.75
|
| Rate for Payer: Healthfirst Essential Plan |
$91.69
|
| Rate for Payer: Healthfirst Medicare Advantage |
$40.75
|
| Rate for Payer: Healthfirst QHP |
$40.75
|
| Rate for Payer: Humana Medicare |
$41.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40.75
|
| Rate for Payer: United Healthcare Commercial |
$51.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40.75
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$40.75
|
| Rate for Payer: Wellcare Medicare |
$36.67
|
|
|
HC ASSAY OF ALDOSTERONE - ALDOSTERONE,24HR URINE
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 82088
|
| Hospital Charge Code |
3018208801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.50 |
| Max. Negotiated Rate |
$50.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.50
|
|
|
HC ASSAY OF ALUMINUM - ALUMINUM LEVEL
|
Facility
|
OP
|
$63.00
|
|
|
Service Code
|
CPT 82108
|
| Hospital Charge Code |
3018210801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.84 |
| Max. Negotiated Rate |
$57.33 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$34.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$25.48
|
| Rate for Payer: Aetna Government |
$25.48
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$17.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$17.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$17.84
|
| Rate for Payer: Brighton Health Commercial |
$47.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25.48
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$43.30
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$36.45
|
| Rate for Payer: Elderplan Medicare Advantage |
$25.48
|
| Rate for Payer: EmblemHealth Commercial |
$25.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.68
|
| Rate for Payer: Group Health Inc Commercial |
$25.48
|
| Rate for Payer: Group Health Inc Medicare |
$25.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25.48
|
| Rate for Payer: Healthfirst Essential Plan |
$57.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25.48
|
| Rate for Payer: Healthfirst QHP |
$25.48
|
| Rate for Payer: Humana Medicare |
$25.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.48
|
| Rate for Payer: United Healthcare Commercial |
$32.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.48
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$25.48
|
| Rate for Payer: Wellcare Medicare |
$22.93
|
|
|
HC ASSAY OF ALUMINUM - ALUMINUM LEVEL
|
Facility
|
IP
|
$63.00
|
|
|
Service Code
|
CPT 82108
|
| Hospital Charge Code |
3018210801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.50 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$31.50
|
|
|
HC ASSAY OF AMIKACIN - AMIKACIN PEAK
|
Facility
|
IP
|
$37.00
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
3018015002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.50 |
| Max. Negotiated Rate |
$18.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.50
|
|
|
HC ASSAY OF AMIKACIN - AMIKACIN PEAK
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
3018015002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.08
|
| Rate for Payer: Aetna Government |
$15.08
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.56
|
| Rate for Payer: Brighton Health Commercial |
$27.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$25.63
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21.57
|
| Rate for Payer: Elderplan Medicare Advantage |
$15.08
|
| Rate for Payer: EmblemHealth Commercial |
$15.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$13.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13.42
|
| Rate for Payer: Group Health Inc Commercial |
$15.08
|
| Rate for Payer: Group Health Inc Medicare |
$15.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$10.61
|
| Rate for Payer: Healthfirst Essential Plan |
$23.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.08
|
| Rate for Payer: Healthfirst QHP |
$15.08
|
| Rate for Payer: Humana Medicare |
$15.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.08
|
| Rate for Payer: United Healthcare Commercial |
$19.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.08
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.61
|
| Rate for Payer: Wellcare Medicare |
$13.57
|
|
|
HC ASSAY OF AMIKACIN - AMIKACIN RANDOM
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
3018015001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.08
|
| Rate for Payer: Aetna Government |
$15.08
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.56
|
| Rate for Payer: Brighton Health Commercial |
$27.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$25.63
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21.57
|
| Rate for Payer: Elderplan Medicare Advantage |
$15.08
|
| Rate for Payer: EmblemHealth Commercial |
$15.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$13.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13.42
|
| Rate for Payer: Group Health Inc Commercial |
$15.08
|
| Rate for Payer: Group Health Inc Medicare |
$15.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$10.61
|
| Rate for Payer: Healthfirst Essential Plan |
$23.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.08
|
| Rate for Payer: Healthfirst QHP |
$15.08
|
| Rate for Payer: Humana Medicare |
$15.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.08
|
| Rate for Payer: United Healthcare Commercial |
$19.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.08
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.61
|
| Rate for Payer: Wellcare Medicare |
$13.57
|
|
|
HC ASSAY OF AMIKACIN - AMIKACIN RANDOM
|
Facility
|
IP
|
$37.00
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
3018015001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.50 |
| Max. Negotiated Rate |
$18.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.50
|
|
|
HC ASSAY OF AMIKACIN - AMIKACIN TROUGH
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
3018015003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.08
|
| Rate for Payer: Aetna Government |
$15.08
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.56
|
| Rate for Payer: Brighton Health Commercial |
$27.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$25.63
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21.57
|
| Rate for Payer: Elderplan Medicare Advantage |
$15.08
|
| Rate for Payer: EmblemHealth Commercial |
$15.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$13.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13.42
|
| Rate for Payer: Group Health Inc Commercial |
$15.08
|
| Rate for Payer: Group Health Inc Medicare |
$15.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$10.61
|
| Rate for Payer: Healthfirst Essential Plan |
$23.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.08
|
| Rate for Payer: Healthfirst QHP |
$15.08
|
| Rate for Payer: Humana Medicare |
$15.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.08
|
| Rate for Payer: United Healthcare Commercial |
$19.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.08
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.61
|
| Rate for Payer: Wellcare Medicare |
$13.57
|
|
|
HC ASSAY OF AMIKACIN - AMIKACIN TROUGH
|
Facility
|
IP
|
$37.00
|
|
|
Service Code
|
CPT 80150
|
| Hospital Charge Code |
3018015003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.50 |
| Max. Negotiated Rate |
$18.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.50
|
|
|
HC ASSAY OF AMMONIA - AMMONIA
|
Facility
|
IP
|
$36.00
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
3018214001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.00
|
|
|
HC ASSAY OF AMMONIA - AMMONIA
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
3018214001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$32.78 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.57
|
| Rate for Payer: Aetna Government |
$14.57
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.20
|
| Rate for Payer: Brighton Health Commercial |
$27.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$14.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.77
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.85
|
| Rate for Payer: Elderplan Medicare Advantage |
$14.57
|
| Rate for Payer: EmblemHealth Commercial |
$14.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$13.11
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$12.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$12.97
|
| Rate for Payer: Group Health Inc Commercial |
$14.57
|
| Rate for Payer: Group Health Inc Medicare |
$14.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.57
|
| Rate for Payer: Healthfirst Essential Plan |
$32.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.57
|
| Rate for Payer: Healthfirst QHP |
$14.57
|
| Rate for Payer: Humana Medicare |
$14.86
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.57
|
| Rate for Payer: United Healthcare Commercial |
$18.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$14.57
|
| Rate for Payer: Wellcare Medicare |
$13.11
|
|
|
HC ASSAY OF AMYLASE - AMYLASE
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3018215005
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.00
|
|
|
HC ASSAY OF AMYLASE - AMYLASE
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3018215005
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.54 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.48
|
| Rate for Payer: Aetna Government |
$6.48
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4.54
|
| Rate for Payer: Brighton Health Commercial |
$12.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.48
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.48
|
| Rate for Payer: EmblemHealth Commercial |
$6.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5.83
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.51
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.77
|
| Rate for Payer: Group Health Inc Commercial |
$6.48
|
| Rate for Payer: Group Health Inc Medicare |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Healthfirst Essential Plan |
$11.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.48
|
| Rate for Payer: Healthfirst QHP |
$6.48
|
| Rate for Payer: Humana Medicare |
$6.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.48
|
| Rate for Payer: United Healthcare Commercial |
$8.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.48
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Wellcare Medicare |
$5.83
|
|
|
HC ASSAY OF AMYLASE - AMYLASE,24 HOUR URINE
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3018215003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.54 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.48
|
| Rate for Payer: Aetna Government |
$6.48
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4.54
|
| Rate for Payer: Brighton Health Commercial |
$12.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.48
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.48
|
| Rate for Payer: EmblemHealth Commercial |
$6.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5.83
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.51
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.77
|
| Rate for Payer: Group Health Inc Commercial |
$6.48
|
| Rate for Payer: Group Health Inc Medicare |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Healthfirst Essential Plan |
$11.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.48
|
| Rate for Payer: Healthfirst QHP |
$6.48
|
| Rate for Payer: Humana Medicare |
$6.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.48
|
| Rate for Payer: United Healthcare Commercial |
$8.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.48
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Wellcare Medicare |
$5.83
|
|
|
HC ASSAY OF AMYLASE - AMYLASE,24 HOUR URINE
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3018215003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.00
|
|
|
HC ASSAY OF AMYLASE - AMYLASE BODY FLUID
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3018215001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.54 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.48
|
| Rate for Payer: Aetna Government |
$6.48
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4.54
|
| Rate for Payer: Brighton Health Commercial |
$12.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.48
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.48
|
| Rate for Payer: EmblemHealth Commercial |
$6.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5.83
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.51
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.77
|
| Rate for Payer: Group Health Inc Commercial |
$6.48
|
| Rate for Payer: Group Health Inc Medicare |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Healthfirst Essential Plan |
$11.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.48
|
| Rate for Payer: Healthfirst QHP |
$6.48
|
| Rate for Payer: Humana Medicare |
$6.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.48
|
| Rate for Payer: United Healthcare Commercial |
$8.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.48
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Wellcare Medicare |
$5.83
|
|
|
HC ASSAY OF AMYLASE - AMYLASE BODY FLUID
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3018215001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.00
|
|
|
HC ASSAY OF AMYLASE - AMYLASE,RANDOM
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3018215002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.54 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.48
|
| Rate for Payer: Aetna Government |
$6.48
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4.54
|
| Rate for Payer: Brighton Health Commercial |
$12.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.48
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.48
|
| Rate for Payer: EmblemHealth Commercial |
$6.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5.83
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.51
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.77
|
| Rate for Payer: Group Health Inc Commercial |
$6.48
|
| Rate for Payer: Group Health Inc Medicare |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Healthfirst Essential Plan |
$11.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.48
|
| Rate for Payer: Healthfirst QHP |
$6.48
|
| Rate for Payer: Humana Medicare |
$6.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.48
|
| Rate for Payer: United Healthcare Commercial |
$8.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.48
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Wellcare Medicare |
$5.83
|
|
|
HC ASSAY OF AMYLASE - AMYLASE,RANDOM
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3018215002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.00
|
|
|
HC ASSAY OF AMYLASE - CSF
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3018215004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.54 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.48
|
| Rate for Payer: Aetna Government |
$6.48
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4.54
|
| Rate for Payer: Brighton Health Commercial |
$12.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.48
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.48
|
| Rate for Payer: EmblemHealth Commercial |
$6.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5.83
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.51
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.77
|
| Rate for Payer: Group Health Inc Commercial |
$6.48
|
| Rate for Payer: Group Health Inc Medicare |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Healthfirst Essential Plan |
$11.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.48
|
| Rate for Payer: Healthfirst QHP |
$6.48
|
| Rate for Payer: Humana Medicare |
$6.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.48
|
| Rate for Payer: United Healthcare Commercial |
$8.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.48
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Wellcare Medicare |
$5.83
|
|
|
HC ASSAY OF AMYLASE - CSF
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
3018215004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$8.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.00
|
|
|
HC ASSAY OF ANDROSTENEDIONE - ANDROSTENEDIONE
|
Facility
|
IP
|
$73.00
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
3018215701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.50 |
| Max. Negotiated Rate |
$36.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36.50
|
|
|
HC ASSAY OF ANDROSTENEDIONE - ANDROSTENEDIONE
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
CPT 82157
|
| Hospital Charge Code |
3018215701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.50 |
| Max. Negotiated Rate |
$65.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$40.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$29.28
|
| Rate for Payer: Aetna Government |
$29.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$20.50
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$20.50
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$20.50
|
| Rate for Payer: Brighton Health Commercial |
$54.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$29.28
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$49.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$41.89
|
| Rate for Payer: Elderplan Medicare Advantage |
$29.28
|
| Rate for Payer: EmblemHealth Commercial |
$29.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26.35
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$24.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$26.06
|
| Rate for Payer: Fidelis Medicare Advantage |
$29.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$26.06
|
| Rate for Payer: Group Health Inc Commercial |
$29.28
|
| Rate for Payer: Group Health Inc Medicare |
$29.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.28
|
| Rate for Payer: Healthfirst Essential Plan |
$65.88
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29.28
|
| Rate for Payer: Healthfirst QHP |
$29.28
|
| Rate for Payer: Humana Medicare |
$29.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$29.28
|
| Rate for Payer: United Healthcare Commercial |
$37.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$29.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$29.28
|
| Rate for Payer: Wellcare Medicare |
$26.35
|
|
