CC G/CATH IM 7F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521011
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JCL 3.0 6F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521013
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
CC G/CATH JCL 3.0 6F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521013
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JCL 3.5 6F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521015
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
CC G/CATH JCL 3.5 6F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521015
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JCL 3.5 7F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521017
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JCL 3.5 7F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521017
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
CC G/CATH JCL 4.0 6F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521019
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JCL 4.0 6F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521019
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
CC G/CATH JCL 4.0 7F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521021
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
CC G/CATH JCL 4.0 7F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521021
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JCL 4.5 6F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521023
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JCL 4.5 6F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521023
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
CC G/CATH JCL 5.0 6F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521025
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JCL 5.0 6F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521025
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
CC G/CATH JCR 3.5 6F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521027
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JCR 3.5 6F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521027
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
CC G/CATH JCR 3.5 7F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521029
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JCR 3.5 7F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521029
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
CC G/CATH JCR 4.0 6F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521031
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JCR 4.0 6F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521031
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
CC G/CATH JCR 4.0 7F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521033
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
CC G/CATH JCR 4.0 7F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521033
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JL 3.0 7F MED LAUNCHER
|
Facility
|
IP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521035
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$51.00 |
Max. Negotiated Rate |
$51.00 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
|
CC G/CATH JL 3.0 7F MED LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
Service Code
|
HCPCS C1887
|
Hospital Charge Code |
66521035
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3.21 |
Max. Negotiated Rate |
$107.10 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
Rate for Payer: Aetna Government |
$3.21
|
Rate for Payer: Brighton Health Commercial |
$61.20
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
Rate for Payer: EmblemHealth Commercial |
$51.00
|
Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
Rate for Payer: Group Health Inc Commercial |
$51.00
|
Rate for Payer: Group Health Inc Medicare |
$35.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|