|
HC ASSAY OF GGT - GAMMA GT
|
Facility
|
IP
|
$18.00
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
3018297701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.00
|
|
|
HC ASSAY OF GLUCAGON - GLUCAGON
|
Facility
|
IP
|
$35.00
|
|
|
Service Code
|
CPT 82943
|
| Hospital Charge Code |
3018294301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.50 |
| Max. Negotiated Rate |
$17.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.50
|
|
|
HC ASSAY OF GLUCAGON - GLUCAGON
|
Facility
|
OP
|
$35.00
|
|
|
Service Code
|
CPT 82943
|
| Hospital Charge Code |
3018294301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$32.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.29
|
| Rate for Payer: Aetna Government |
$14.29
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10.00
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10.00
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.00
|
| Rate for Payer: Brighton Health Commercial |
$26.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$14.29
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.28
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.44
|
| Rate for Payer: Elderplan Medicare Advantage |
$14.29
|
| Rate for Payer: EmblemHealth Commercial |
$14.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$12.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$12.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$12.72
|
| Rate for Payer: Group Health Inc Commercial |
$14.29
|
| Rate for Payer: Group Health Inc Medicare |
$14.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.29
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.29
|
| Rate for Payer: Healthfirst Essential Plan |
$32.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.29
|
| Rate for Payer: Healthfirst QHP |
$14.29
|
| Rate for Payer: Humana Medicare |
$14.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.29
|
| Rate for Payer: United Healthcare Commercial |
$18.10
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.29
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$14.29
|
| Rate for Payer: Wellcare Medicare |
$12.86
|
|
|
HC ASSAY OF HALOPERIDOL - HALOPERIDOL LEVEL
|
Facility
|
IP
|
$40.00
|
|
|
Service Code
|
CPT 80173
|
| Hospital Charge Code |
3018017301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$20.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20.00
|
|
|
HC ASSAY OF HALOPERIDOL - HALOPERIDOL LEVEL
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 80173
|
| Hospital Charge Code |
3018017301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$22.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.78
|
| Rate for Payer: Aetna Government |
$15.78
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$11.05
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$11.05
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$11.05
|
| Rate for Payer: Brighton Health Commercial |
$30.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.78
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.83
|
| Rate for Payer: Elderplan Medicare Advantage |
$15.78
|
| Rate for Payer: EmblemHealth Commercial |
$15.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$14.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$13.41
|
| Rate for Payer: Fidelis Essential Plan QHP |
$14.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$14.04
|
| Rate for Payer: Group Health Inc Commercial |
$15.78
|
| Rate for Payer: Group Health Inc Medicare |
$15.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$10.61
|
| Rate for Payer: Healthfirst Essential Plan |
$23.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.78
|
| Rate for Payer: Healthfirst QHP |
$15.78
|
| Rate for Payer: Humana Medicare |
$16.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.78
|
| Rate for Payer: United Healthcare Commercial |
$18.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.78
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.78
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.61
|
| Rate for Payer: Wellcare Medicare |
$14.20
|
|
|
HC ASSAY OF HAPTOGLOBIN, QUANT - HAPTOGLOBIN
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
3018301001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$28.30 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.58
|
| Rate for Payer: Aetna Government |
$12.58
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.81
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.81
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.81
|
| Rate for Payer: Brighton Health Commercial |
$23.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.58
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$21.38
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.99
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.58
|
| Rate for Payer: EmblemHealth Commercial |
$12.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.32
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.20
|
| Rate for Payer: Group Health Inc Commercial |
$12.58
|
| Rate for Payer: Group Health Inc Medicare |
$12.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.58
|
| Rate for Payer: Healthfirst Essential Plan |
$28.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.58
|
| Rate for Payer: Healthfirst QHP |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.58
|
| Rate for Payer: United Healthcare Commercial |
$15.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.58
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.58
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.58
|
| Rate for Payer: Wellcare Medicare |
$11.32
|
|
|
HC ASSAY OF HAPTOGLOBIN, QUANT - HAPTOGLOBIN
|
Facility
|
IP
|
$31.00
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
3018301001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.50 |
| Max. Negotiated Rate |
$15.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.50
|
|
|
HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
3018309002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$22.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.00
|
|
|
HC ASSAY OF HOMOCYSTINE - HOMOCYSTEINE
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
3018309002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.54 |
| Max. Negotiated Rate |
$40.32 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.92
|
| Rate for Payer: Aetna Government |
$17.92
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$12.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$12.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$12.54
|
| Rate for Payer: Brighton Health Commercial |
$33.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17.92
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28.68
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$24.14
|
| Rate for Payer: Elderplan Medicare Advantage |
$17.92
|
| Rate for Payer: EmblemHealth Commercial |
$17.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$15.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.95
|
| Rate for Payer: Group Health Inc Commercial |
$17.92
|
| Rate for Payer: Group Health Inc Medicare |
$17.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.92
|
| Rate for Payer: Healthfirst Essential Plan |
$40.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.92
|
| Rate for Payer: Healthfirst QHP |
$17.92
|
| Rate for Payer: Humana Medicare |
$18.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.92
|
| Rate for Payer: United Healthcare Commercial |
$21.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.92
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$17.92
|
| Rate for Payer: Wellcare Medicare |
$16.13
|
|
|
HC ASSAY OF INORGANIC PHOSPHORUS - PHOSPHORUS
|
Facility
|
IP
|
$11.00
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
3018410004
|
|
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 INORGANIC PHOSPHORUS - PHOSPHORUS
|
Facility
|
OP
|
$11.00
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
3018410004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$10.66 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.74
|
| Rate for Payer: Aetna Government |
$4.74
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.32
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.32
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.32
|
| Rate for Payer: Brighton Health Commercial |
$8.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4.74
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.06
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.79
|
| Rate for Payer: Elderplan Medicare Advantage |
$4.74
|
| Rate for Payer: EmblemHealth Commercial |
$4.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$4.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.22
|
| Rate for Payer: Group Health Inc Commercial |
$4.74
|
| Rate for Payer: Group Health Inc Medicare |
$4.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$4.74
|
| Rate for Payer: Healthfirst Essential Plan |
$10.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$4.74
|
| Rate for Payer: Healthfirst QHP |
$4.74
|
| Rate for Payer: Humana Medicare |
$4.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4.74
|
| Rate for Payer: United Healthcare Commercial |
$6.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.74
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.74
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.74
|
| Rate for Payer: Wellcare Medicare |
$4.27
|
|
|
HC ASSAY OF INSULIN,TOTAL - INSULIN, FASTING
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
3018352501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$25.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.43
|
| Rate for Payer: Aetna Government |
$11.43
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.00
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.00
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.00
|
| Rate for Payer: Brighton Health Commercial |
$21.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.43
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.43
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.36
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.43
|
| Rate for Payer: EmblemHealth Commercial |
$11.43
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.17
|
| Rate for Payer: Group Health Inc Commercial |
$11.43
|
| Rate for Payer: Group Health Inc Medicare |
$11.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$11.43
|
| Rate for Payer: Healthfirst Essential Plan |
$25.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.43
|
| Rate for Payer: Healthfirst QHP |
$11.43
|
| Rate for Payer: Humana Medicare |
$11.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.43
|
| Rate for Payer: United Healthcare Commercial |
$14.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.43
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$11.43
|
| Rate for Payer: Wellcare Medicare |
$10.29
|
|
|
HC ASSAY OF INSULIN,TOTAL - INSULIN, FASTING
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
3018352501
|
|
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 INSULIN,TOTAL - INSULIN, TOTAL
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
3018352503
|
|
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 INSULIN,TOTAL - INSULIN, TOTAL
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
3018352503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$25.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.43
|
| Rate for Payer: Aetna Government |
$11.43
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.00
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.00
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.00
|
| Rate for Payer: Brighton Health Commercial |
$21.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.43
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.43
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.36
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.43
|
| Rate for Payer: EmblemHealth Commercial |
$11.43
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.17
|
| Rate for Payer: Group Health Inc Commercial |
$11.43
|
| Rate for Payer: Group Health Inc Medicare |
$11.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$11.43
|
| Rate for Payer: Healthfirst Essential Plan |
$25.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.43
|
| Rate for Payer: Healthfirst QHP |
$11.43
|
| Rate for Payer: Humana Medicare |
$11.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.43
|
| Rate for Payer: United Healthcare Commercial |
$14.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.43
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$11.43
|
| Rate for Payer: Wellcare Medicare |
$10.29
|
|
|
HC ASSAY OF IRON - IRON
|
Facility
|
OP
|
$16.00
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
3018354002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.47
|
| Rate for Payer: Aetna Government |
$6.47
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4.53
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4.53
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4.53
|
| Rate for Payer: Brighton Health Commercial |
$12.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.47
|
| 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 |
$6.47
|
| Rate for Payer: EmblemHealth Commercial |
$6.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.76
|
| Rate for Payer: Group Health Inc Commercial |
$6.47
|
| Rate for Payer: Group Health Inc Medicare |
$6.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Healthfirst Essential Plan |
$11.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.47
|
| Rate for Payer: Healthfirst QHP |
$6.47
|
| Rate for Payer: Humana Medicare |
$6.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.47
|
| Rate for Payer: United Healthcare Commercial |
$8.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Wellcare Medicare |
$5.82
|
|
|
HC ASSAY OF IRON - IRON
|
Facility
|
IP
|
$16.00
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
3018354002
|
|
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 LACTIC ACID - LACTATE
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
3018360502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.10 |
| Max. Negotiated Rate |
$21.13 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.57
|
| Rate for Payer: Aetna Government |
$11.57
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.10
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.10
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.10
|
| Rate for Payer: Brighton Health Commercial |
$21.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.57
|
| Rate for Payer: EmblemHealth Commercial |
$11.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.41
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.83
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.30
|
| Rate for Payer: Group Health Inc Commercial |
$11.57
|
| Rate for Payer: Group Health Inc Medicare |
$11.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.39
|
| Rate for Payer: Healthfirst Essential Plan |
$21.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.57
|
| Rate for Payer: Healthfirst QHP |
$11.57
|
| Rate for Payer: Humana Medicare |
$11.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.57
|
| Rate for Payer: United Healthcare Commercial |
$13.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.39
|
| Rate for Payer: Wellcare Medicare |
$10.41
|
|
|
HC ASSAY OF LACTIC ACID - LACTATE
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
3018360502
|
|
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 LACTIC ACID - LACTIC ACID, ARTERIAL, WHOLE BLOOD
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
3018360505
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.10 |
| Max. Negotiated Rate |
$21.13 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.57
|
| Rate for Payer: Aetna Government |
$11.57
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.10
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.10
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.10
|
| Rate for Payer: Brighton Health Commercial |
$21.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.57
|
| Rate for Payer: EmblemHealth Commercial |
$11.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.41
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.83
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.30
|
| Rate for Payer: Group Health Inc Commercial |
$11.57
|
| Rate for Payer: Group Health Inc Medicare |
$11.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.39
|
| Rate for Payer: Healthfirst Essential Plan |
$21.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.57
|
| Rate for Payer: Healthfirst QHP |
$11.57
|
| Rate for Payer: Humana Medicare |
$11.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.57
|
| Rate for Payer: United Healthcare Commercial |
$13.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.39
|
| Rate for Payer: Wellcare Medicare |
$10.41
|
|
|
HC ASSAY OF LACTIC ACID - LACTIC ACID, ARTERIAL, WHOLE BLOOD
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
3018360505
|
|
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 LACTIC ACID - LACTIC ACID BODY FLUID
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
3018360504
|
|
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 LACTIC ACID - LACTIC ACID BODY FLUID
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
3018360504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.10 |
| Max. Negotiated Rate |
$21.13 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.57
|
| Rate for Payer: Aetna Government |
$11.57
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.10
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.10
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.10
|
| Rate for Payer: Brighton Health Commercial |
$21.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.57
|
| Rate for Payer: EmblemHealth Commercial |
$11.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.41
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.83
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.30
|
| Rate for Payer: Group Health Inc Commercial |
$11.57
|
| Rate for Payer: Group Health Inc Medicare |
$11.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.39
|
| Rate for Payer: Healthfirst Essential Plan |
$21.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.57
|
| Rate for Payer: Healthfirst QHP |
$11.57
|
| Rate for Payer: Humana Medicare |
$11.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.57
|
| Rate for Payer: United Healthcare Commercial |
$13.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.39
|
| Rate for Payer: Wellcare Medicare |
$10.41
|
|
|
HC ASSAY OF LACTIC ACID - LACTIC ACID, VENOUS, WHOLE BLOOD
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
3018360506
|
|
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 LACTIC ACID - LACTIC ACID, VENOUS, WHOLE BLOOD
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
3018360506
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.10 |
| Max. Negotiated Rate |
$21.13 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.57
|
| Rate for Payer: Aetna Government |
$11.57
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.10
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.10
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.10
|
| Rate for Payer: Brighton Health Commercial |
$21.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.57
|
| Rate for Payer: EmblemHealth Commercial |
$11.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.41
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.83
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.30
|
| Rate for Payer: Group Health Inc Commercial |
$11.57
|
| Rate for Payer: Group Health Inc Medicare |
$11.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.39
|
| Rate for Payer: Healthfirst Essential Plan |
$21.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.57
|
| Rate for Payer: Healthfirst QHP |
$11.57
|
| Rate for Payer: Humana Medicare |
$11.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.57
|
| Rate for Payer: United Healthcare Commercial |
$13.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.39
|
| Rate for Payer: Wellcare Medicare |
$10.41
|
|
