|
HC ASSAY OF APOLIPOPROTEIN
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
3018217203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.76 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$28.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21.09
|
| Rate for Payer: Aetna Government |
$21.09
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$14.76
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$14.76
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$14.76
|
| Rate for Payer: Brighton Health Commercial |
$39.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21.09
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$26.35
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$22.18
|
| Rate for Payer: Elderplan Medicare Advantage |
$21.09
|
| Rate for Payer: EmblemHealth Commercial |
$21.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$21.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18.77
|
| Rate for Payer: Group Health Inc Commercial |
$21.09
|
| Rate for Payer: Group Health Inc Medicare |
$21.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.09
|
| Rate for Payer: Healthfirst Essential Plan |
$36.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21.09
|
| Rate for Payer: Healthfirst QHP |
$21.09
|
| Rate for Payer: Humana Medicare |
$21.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21.09
|
| Rate for Payer: United Healthcare Commercial |
$19.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21.09
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$16.09
|
| Rate for Payer: Wellcare Medicare |
$18.98
|
|
|
HC ASSAY OF APOLIPOPROTEIN
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
3018217203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.00
|
|
|
HC ASSAY OF APOLIPOPROTEIN - LIPOPROTEIN A-1
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
3018217201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.00
|
|
|
HC ASSAY OF APOLIPOPROTEIN - LIPOPROTEIN A-1
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
3018217201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.76 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$28.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21.09
|
| Rate for Payer: Aetna Government |
$21.09
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$14.76
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$14.76
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$14.76
|
| Rate for Payer: Brighton Health Commercial |
$39.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21.09
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$26.35
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$22.18
|
| Rate for Payer: Elderplan Medicare Advantage |
$21.09
|
| Rate for Payer: EmblemHealth Commercial |
$21.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$21.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18.77
|
| Rate for Payer: Group Health Inc Commercial |
$21.09
|
| Rate for Payer: Group Health Inc Medicare |
$21.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.09
|
| Rate for Payer: Healthfirst Essential Plan |
$36.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21.09
|
| Rate for Payer: Healthfirst QHP |
$21.09
|
| Rate for Payer: Humana Medicare |
$21.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21.09
|
| Rate for Payer: United Healthcare Commercial |
$19.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21.09
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$16.09
|
| Rate for Payer: Wellcare Medicare |
$18.98
|
|
|
HC ASSAY OF APOLIPOPROTEIN - LIPOPROTEIN B
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
3018217202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$26.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.00
|
|
|
HC ASSAY OF APOLIPOPROTEIN - LIPOPROTEIN B
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
3018217202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.76 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$28.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21.09
|
| Rate for Payer: Aetna Government |
$21.09
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$14.76
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$14.76
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$14.76
|
| Rate for Payer: Brighton Health Commercial |
$39.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21.09
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$26.35
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$22.18
|
| Rate for Payer: Elderplan Medicare Advantage |
$21.09
|
| Rate for Payer: EmblemHealth Commercial |
$21.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$21.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18.77
|
| Rate for Payer: Group Health Inc Commercial |
$21.09
|
| Rate for Payer: Group Health Inc Medicare |
$21.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.09
|
| Rate for Payer: Healthfirst Essential Plan |
$36.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21.09
|
| Rate for Payer: Healthfirst QHP |
$21.09
|
| Rate for Payer: Humana Medicare |
$21.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21.09
|
| Rate for Payer: United Healthcare Commercial |
$19.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21.09
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$16.09
|
| Rate for Payer: Wellcare Medicare |
$18.98
|
|
|
HC ASSAY OF ARSENIC - ARSENIC BLOOD
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3018217501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$42.68 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$25.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18.97
|
| Rate for Payer: Aetna Government |
$18.97
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$13.28
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$13.28
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$13.28
|
| Rate for Payer: Brighton Health Commercial |
$35.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32.25
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27.14
|
| Rate for Payer: Elderplan Medicare Advantage |
$18.97
|
| Rate for Payer: EmblemHealth Commercial |
$18.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$16.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$16.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$18.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$16.88
|
| Rate for Payer: Group Health Inc Commercial |
$18.97
|
| Rate for Payer: Group Health Inc Medicare |
$18.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.97
|
| Rate for Payer: Healthfirst Essential Plan |
$42.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.97
|
| Rate for Payer: Healthfirst QHP |
$18.97
|
| Rate for Payer: Humana Medicare |
$19.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18.97
|
| Rate for Payer: United Healthcare Commercial |
$24.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18.97
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18.97
|
| Rate for Payer: Wellcare Medicare |
$17.07
|
|
|
HC ASSAY OF ARSENIC - ARSENIC BLOOD
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3018217501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$23.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23.50
|
|
|
HC ASSAY OF ARSENIC - ARSENIC,FRACTIONATION,UR
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3018217502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$23.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23.50
|
|
|
HC ASSAY OF ARSENIC - ARSENIC,FRACTIONATION,UR
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3018217502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$42.68 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$25.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18.97
|
| Rate for Payer: Aetna Government |
$18.97
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$13.28
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$13.28
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$13.28
|
| Rate for Payer: Brighton Health Commercial |
$35.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32.25
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27.14
|
| Rate for Payer: Elderplan Medicare Advantage |
$18.97
|
| Rate for Payer: EmblemHealth Commercial |
$18.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$16.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$16.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$18.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$16.88
|
| Rate for Payer: Group Health Inc Commercial |
$18.97
|
| Rate for Payer: Group Health Inc Medicare |
$18.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.97
|
| Rate for Payer: Healthfirst Essential Plan |
$42.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.97
|
| Rate for Payer: Healthfirst QHP |
$18.97
|
| Rate for Payer: Humana Medicare |
$19.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18.97
|
| Rate for Payer: United Healthcare Commercial |
$24.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18.97
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18.97
|
| Rate for Payer: Wellcare Medicare |
$17.07
|
|
|
HC ASSAY OF ARSENIC - ARSENIC RANDOM URINE
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3018217503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$23.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23.50
|
|
|
HC ASSAY OF ARSENIC - ARSENIC RANDOM URINE
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3018217503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$42.68 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$25.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18.97
|
| Rate for Payer: Aetna Government |
$18.97
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$13.28
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$13.28
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$13.28
|
| Rate for Payer: Brighton Health Commercial |
$35.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32.25
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27.14
|
| Rate for Payer: Elderplan Medicare Advantage |
$18.97
|
| Rate for Payer: EmblemHealth Commercial |
$18.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$16.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$16.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$18.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$16.88
|
| Rate for Payer: Group Health Inc Commercial |
$18.97
|
| Rate for Payer: Group Health Inc Medicare |
$18.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.97
|
| Rate for Payer: Healthfirst Essential Plan |
$42.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.97
|
| Rate for Payer: Healthfirst QHP |
$18.97
|
| Rate for Payer: Humana Medicare |
$19.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18.97
|
| Rate for Payer: United Healthcare Commercial |
$24.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18.97
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18.97
|
| Rate for Payer: Wellcare Medicare |
$17.07
|
|
|
HC ASSAY OF ARSENIC - HEAVY METALS PANEL, URINE
|
Facility
|
OP
|
$47.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3018217504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$42.68 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$25.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18.97
|
| Rate for Payer: Aetna Government |
$18.97
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$13.28
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$13.28
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$13.28
|
| Rate for Payer: Brighton Health Commercial |
$35.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32.25
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27.14
|
| Rate for Payer: Elderplan Medicare Advantage |
$18.97
|
| Rate for Payer: EmblemHealth Commercial |
$18.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$16.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$16.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$18.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$16.88
|
| Rate for Payer: Group Health Inc Commercial |
$18.97
|
| Rate for Payer: Group Health Inc Medicare |
$18.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.97
|
| Rate for Payer: Healthfirst Essential Plan |
$42.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.97
|
| Rate for Payer: Healthfirst QHP |
$18.97
|
| Rate for Payer: Humana Medicare |
$19.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18.97
|
| Rate for Payer: United Healthcare Commercial |
$24.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18.97
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18.97
|
| Rate for Payer: Wellcare Medicare |
$17.07
|
|
|
HC ASSAY OF ARSENIC - HEAVY METALS PANEL, URINE
|
Facility
|
IP
|
$47.00
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
3018217504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.50 |
| Max. Negotiated Rate |
$23.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23.50
|
|
|
HC ASSAY OF ASCORBIC ACID - VITAMIN C
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
3018218001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$22.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.89
|
| Rate for Payer: Aetna Government |
$9.89
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.92
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.92
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.92
|
| Rate for Payer: Brighton Health Commercial |
$18.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.89
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$16.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$14.15
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.89
|
| Rate for Payer: EmblemHealth Commercial |
$9.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.90
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.41
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.80
|
| Rate for Payer: Group Health Inc Commercial |
$9.89
|
| Rate for Payer: Group Health Inc Medicare |
$9.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.89
|
| Rate for Payer: Healthfirst Essential Plan |
$22.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.89
|
| Rate for Payer: Healthfirst QHP |
$9.89
|
| Rate for Payer: Humana Medicare |
$10.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.89
|
| Rate for Payer: United Healthcare Commercial |
$12.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.89
|
| Rate for Payer: Wellcare Medicare |
$8.90
|
|
|
HC ASSAY OF ASCORBIC ACID - VITAMIN C
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
3018218001
|
|
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 BLOOD CHLORIDE - CHLORIDE
|
Facility
|
OP
|
$11.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
3018243501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.22 |
| Max. Negotiated Rate |
$10.35 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.60
|
| Rate for Payer: Aetna Government |
$4.60
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.22
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.22
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.22
|
| Rate for Payer: Brighton Health Commercial |
$8.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$7.83
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.59
|
| Rate for Payer: Elderplan Medicare Advantage |
$4.60
|
| Rate for Payer: EmblemHealth Commercial |
$4.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.91
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.09
|
| Rate for Payer: Fidelis Medicare Advantage |
$4.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.09
|
| Rate for Payer: Group Health Inc Commercial |
$4.60
|
| Rate for Payer: Group Health Inc Medicare |
$4.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$4.60
|
| Rate for Payer: Healthfirst Essential Plan |
$10.35
|
| Rate for Payer: Healthfirst Medicare Advantage |
$4.60
|
| Rate for Payer: Healthfirst QHP |
$4.60
|
| Rate for Payer: Humana Medicare |
$4.69
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4.60
|
| Rate for Payer: United Healthcare Commercial |
$5.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.60
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.60
|
| Rate for Payer: Wellcare Medicare |
$4.14
|
|
|
HC ASSAY OF BLOOD CHLORIDE - CHLORIDE
|
Facility
|
IP
|
$11.00
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
3018243501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.50 |
| Max. Negotiated Rate |
$5.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.50
|
|
|
HC ASSAY OF BLOOD LIPOPROTEIN,HDL CHOLEST - HDL CHOLESTEROL
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
3018371801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.00
|
|
|
HC ASSAY OF BLOOD LIPOPROTEIN,HDL CHOLEST - HDL CHOLESTEROL
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 83718
|
| Hospital Charge Code |
3018371801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.08 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.19
|
| Rate for Payer: Aetna Government |
$8.19
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5.73
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5.73
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5.73
|
| Rate for Payer: Brighton Health Commercial |
$21.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.19
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.91
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.71
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.19
|
| Rate for Payer: EmblemHealth Commercial |
$8.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.29
|
| Rate for Payer: Group Health Inc Commercial |
$8.19
|
| Rate for Payer: Group Health Inc Medicare |
$8.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Healthfirst Essential Plan |
$11.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.19
|
| Rate for Payer: Healthfirst QHP |
$8.19
|
| Rate for Payer: Humana Medicare |
$8.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.19
|
| Rate for Payer: United Healthcare Commercial |
$10.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.19
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Wellcare Medicare |
$7.37
|
|
|
HC ASSAY OF BLOOD LIPOPROTEIN,LDL CHOLEST - POCT LDL CHOLESTEROL
|
Facility
|
IP
|
$19.00
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
3018372102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$9.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.50
|
|
|
HC ASSAY OF BLOOD LIPOPROTEIN,LDL CHOLEST - POCT LDL CHOLESTEROL
|
Facility
|
OP
|
$19.00
|
|
|
Service Code
|
CPT 83721
|
| Hospital Charge Code |
3018372102
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$16.19 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$10.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$10.50
|
| Rate for Payer: Aetna Government |
$10.50
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$7.35
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$7.35
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$7.35
|
| Rate for Payer: Brighton Health Commercial |
$14.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$10.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$16.19
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$13.63
|
| Rate for Payer: Elderplan Medicare Advantage |
$10.50
|
| Rate for Payer: EmblemHealth Commercial |
$10.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$10.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.35
|
| Rate for Payer: Group Health Inc Commercial |
$10.50
|
| Rate for Payer: Group Health Inc Medicare |
$10.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$10.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10.50
|
| Rate for Payer: Healthfirst QHP |
$10.50
|
| Rate for Payer: Humana Medicare |
$10.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$10.50
|
| Rate for Payer: United Healthcare Commercial |
$12.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.50
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.97
|
| Rate for Payer: Wellcare Medicare |
$9.45
|
|
|
HC ASSAY OF BLOOD OSMOLALITY - OSMOLALITY
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
3018393001
|
|
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 BLOOD OSMOLALITY - OSMOLALITY
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
3018393001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.63 |
| Max. Negotiated Rate |
$13.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.61
|
| Rate for Payer: Aetna Government |
$6.61
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4.63
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4.63
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4.63
|
| Rate for Payer: Brighton Health Commercial |
$12.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.61
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11.25
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9.47
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.61
|
| Rate for Payer: EmblemHealth Commercial |
$6.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.88
|
| Rate for Payer: Group Health Inc Commercial |
$6.61
|
| Rate for Payer: Group Health Inc Medicare |
$6.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$6.10
|
| Rate for Payer: Healthfirst Essential Plan |
$13.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.61
|
| Rate for Payer: Healthfirst QHP |
$6.61
|
| Rate for Payer: Humana Medicare |
$6.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.61
|
| Rate for Payer: United Healthcare Commercial |
$8.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.61
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6.10
|
| Rate for Payer: Wellcare Medicare |
$5.95
|
|
|
HC ASSAY OF CADMIUM - CADMIUM 24 HR URINE
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
3018230001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.50 |
| Max. Negotiated Rate |
$29.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.50
|
|
