|
HC BLINK REFLEX TEST - BLINK REFLEX ELECTRODIAGNOSTIC TEST
|
Facility
|
OP
|
$1,400.00
|
|
|
Service Code
|
CPT 95933 TC
|
| Hospital Charge Code |
9229593301
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$39.25 |
| Max. Negotiated Rate |
$1,120.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$770.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$39.25
|
| Rate for Payer: Aetna Government |
$39.25
|
| Rate for Payer: Brighton Health Commercial |
$1,050.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,120.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$952.00
|
| Rate for Payer: EmblemHealth Commercial |
$700.00
|
| Rate for Payer: Group Health Inc Commercial |
$700.00
|
| Rate for Payer: Group Health Inc Medicare |
$490.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$700.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$700.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$57.68
|
| Rate for Payer: United Healthcare Commercial |
$120.00
|
|
|
HC BLM GENE ANALYSIS - BLOOM SYNDROME
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 81209
|
| Hospital Charge Code |
3108120901
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.52 |
| Max. Negotiated Rate |
$78.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$53.90
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$39.31
|
| Rate for Payer: Aetna Government |
$39.31
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$27.52
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$27.52
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$27.52
|
| Rate for Payer: Brighton Health Commercial |
$39.31
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$39.31
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$78.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$66.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$39.31
|
| Rate for Payer: EmblemHealth Commercial |
$39.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$35.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$33.41
|
| Rate for Payer: Fidelis Essential Plan QHP |
$34.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$39.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34.99
|
| Rate for Payer: Group Health Inc Commercial |
$39.31
|
| Rate for Payer: Group Health Inc Medicare |
$39.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$39.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$39.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$39.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$39.31
|
| Rate for Payer: Healthfirst QHP |
$39.31
|
| Rate for Payer: Humana Medicare |
$40.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$39.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.31
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$37.34
|
| Rate for Payer: Wellcare Medicare |
$35.38
|
|
|
HC BLM GENE ANALYSIS - BLOOM SYNDROME
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 81209
|
| Hospital Charge Code |
3108120901
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$49.00 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$49.00
|
|
|
HC BLOOC CLOT FACTOR V TEST - FACTOR 5 ACTIVITY
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 85220
|
| Hospital Charge Code |
3058522001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.36 |
| Max. Negotiated Rate |
$39.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.65
|
| Rate for Payer: Aetna Government |
$17.65
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$12.36
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$12.36
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$12.36
|
| Rate for Payer: Brighton Health Commercial |
$33.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17.65
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$30.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$25.25
|
| Rate for Payer: Elderplan Medicare Advantage |
$17.65
|
| Rate for Payer: EmblemHealth Commercial |
$17.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$15.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$15.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.65
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.71
|
| Rate for Payer: Group Health Inc Commercial |
$17.65
|
| Rate for Payer: Group Health Inc Medicare |
$17.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.65
|
| Rate for Payer: Healthfirst Essential Plan |
$39.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.65
|
| Rate for Payer: Healthfirst QHP |
$17.65
|
| Rate for Payer: Humana Medicare |
$18.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.65
|
| Rate for Payer: United Healthcare Commercial |
$22.35
|
| Rate for Payer: United Healthcare Medicare Advantage |
$17.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.65
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$17.65
|
| Rate for Payer: Wellcare Medicare |
$15.88
|
|
|
HC BLOOC CLOT FACTOR V TEST - FACTOR 5 ACTIVITY
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 85220
|
| Hospital Charge Code |
3058522001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$22.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.00
|
|
|
HC BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAM W/O MANUAL DIFFERENTIAL WBC COUNT
|
Facility
|
OP
|
$37.00
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
3058500801
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$27.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.43
|
| Rate for Payer: Aetna Government |
$3.43
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2.40
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2.40
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2.40
|
| Rate for Payer: Brighton Health Commercial |
$27.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.43
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.93
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.43
|
| Rate for Payer: EmblemHealth Commercial |
$3.43
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.05
|
| Rate for Payer: Group Health Inc Commercial |
$3.43
|
| Rate for Payer: Group Health Inc Medicare |
$3.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.43
|
| Rate for Payer: Healthfirst QHP |
$3.43
|
| Rate for Payer: Humana Medicare |
$3.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.43
|
| Rate for Payer: United Healthcare Commercial |
$4.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.43
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.26
|
| Rate for Payer: Wellcare Medicare |
$3.09
|
|
|
HC BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAM W/O MANUAL DIFFERENTIAL WBC COUNT
|
Facility
|
IP
|
$37.00
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
3058500801
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.50 |
| Max. Negotiated Rate |
$18.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.50
|
|
|
HC BLOOD DRAW IMPLANTED VENOUS DEVICE
|
Facility
|
OP
|
$330.00
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
3613659101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$32.45 |
| Max. Negotiated Rate |
$3,092.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$157.49
|
| Rate for Payer: Aetna Government |
$157.49
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$110.24
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$110.24
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$110.24
|
| Rate for Payer: Brighton Health Commercial |
$247.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$157.49
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$157.49
|
| Rate for Payer: EmblemHealth Commercial |
$157.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$141.74
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$133.87
|
| Rate for Payer: Fidelis Essential Plan QHP |
$140.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$157.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$140.17
|
| Rate for Payer: Group Health Inc Commercial |
$157.49
|
| Rate for Payer: Group Health Inc Medicare |
$157.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$157.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$157.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$32.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$133.87
|
| Rate for Payer: Healthfirst QHP |
$157.49
|
| Rate for Payer: Humana Medicare |
$160.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$157.49
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$157.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$157.49
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$149.62
|
| Rate for Payer: Wellcare Medicare |
$149.62
|
|
|
HC BLOOD DRAW IMPLANTED VENOUS DEVICE
|
Facility
|
IP
|
$330.00
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
3613659101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$165.00
|
|
|
HC BLOOD FOLIC ACID SERUM - FOLATE
|
Facility
|
OP
|
$36.00
|
|
|
Service Code
|
CPT 82746
|
| Hospital Charge Code |
3018274601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.29 |
| Max. Negotiated Rate |
$28.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.70
|
| Rate for Payer: Aetna Government |
$14.70
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10.29
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10.29
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.29
|
| Rate for Payer: Brighton Health Commercial |
$27.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$14.70
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.99
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21.04
|
| Rate for Payer: Elderplan Medicare Advantage |
$14.70
|
| Rate for Payer: EmblemHealth Commercial |
$14.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$13.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13.08
|
| Rate for Payer: Group Health Inc Commercial |
$14.70
|
| Rate for Payer: Group Health Inc Medicare |
$14.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.63
|
| Rate for Payer: Healthfirst Essential Plan |
$28.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.70
|
| Rate for Payer: Healthfirst QHP |
$14.70
|
| Rate for Payer: Humana Medicare |
$14.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.70
|
| Rate for Payer: United Healthcare Commercial |
$18.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.70
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.63
|
| Rate for Payer: Wellcare Medicare |
$13.23
|
|
|
HC BLOOD FOLIC ACID SERUM - FOLATE
|
Facility
|
IP
|
$36.00
|
|
|
Service Code
|
CPT 82746
|
| Hospital Charge Code |
3018274601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.00
|
|
|
HC BLOOD GASES, O2 SAT ONLY - OXYGEN SATURATION
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 82810
|
| Hospital Charge Code |
3018281003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.00
|
|
|
HC BLOOD GASES, O2 SAT ONLY - OXYGEN SATURATION
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 82810
|
| Hospital Charge Code |
3018281003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$21.98 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.77
|
| Rate for Payer: Aetna Government |
$9.77
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.84
|
| Rate for Payer: Brighton Health Commercial |
$18.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.77
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14.83
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.48
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.77
|
| Rate for Payer: EmblemHealth Commercial |
$9.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.79
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.70
|
| Rate for Payer: Group Health Inc Commercial |
$9.77
|
| Rate for Payer: Group Health Inc Medicare |
$9.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.77
|
| Rate for Payer: Healthfirst Essential Plan |
$21.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.77
|
| Rate for Payer: Healthfirst QHP |
$9.77
|
| Rate for Payer: Humana Medicare |
$9.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.77
|
| Rate for Payer: United Healthcare Commercial |
$11.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.77
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.77
|
| Rate for Payer: Wellcare Medicare |
$8.79
|
|
|
HC BLOOD GASES, O2 SAT ONLY - OXYGEN SATURATION, ARTERIAL
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 82810
|
| Hospital Charge Code |
3018281001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$21.98 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.77
|
| Rate for Payer: Aetna Government |
$9.77
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.84
|
| Rate for Payer: Brighton Health Commercial |
$18.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.77
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14.83
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.48
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.77
|
| Rate for Payer: EmblemHealth Commercial |
$9.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.79
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.70
|
| Rate for Payer: Group Health Inc Commercial |
$9.77
|
| Rate for Payer: Group Health Inc Medicare |
$9.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.77
|
| Rate for Payer: Healthfirst Essential Plan |
$21.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.77
|
| Rate for Payer: Healthfirst QHP |
$9.77
|
| Rate for Payer: Humana Medicare |
$9.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.77
|
| Rate for Payer: United Healthcare Commercial |
$11.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.77
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.77
|
| Rate for Payer: Wellcare Medicare |
$8.79
|
|
|
HC BLOOD GASES, O2 SAT ONLY - OXYGEN SATURATION, ARTERIAL
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 82810
|
| Hospital Charge Code |
3018281001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.00
|
|
|
HC BLOOD GASES, O2 SAT ONLY - OXYGEN SATURATION, VENOUS
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 82810
|
| Hospital Charge Code |
3018281002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$21.98 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.77
|
| Rate for Payer: Aetna Government |
$9.77
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.84
|
| Rate for Payer: Brighton Health Commercial |
$18.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.77
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14.83
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.48
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.77
|
| Rate for Payer: EmblemHealth Commercial |
$9.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.79
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.70
|
| Rate for Payer: Group Health Inc Commercial |
$9.77
|
| Rate for Payer: Group Health Inc Medicare |
$9.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.77
|
| Rate for Payer: Healthfirst Essential Plan |
$21.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.77
|
| Rate for Payer: Healthfirst QHP |
$9.77
|
| Rate for Payer: Humana Medicare |
$9.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.77
|
| Rate for Payer: United Healthcare Commercial |
$11.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.77
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.77
|
| Rate for Payer: Wellcare Medicare |
$8.79
|
|
|
HC BLOOD GASES, O2 SAT ONLY - OXYGEN SATURATION, VENOUS
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 82810
|
| Hospital Charge Code |
3018281002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.00
|
|
|
HC BLOOD GASES: PH, PO2 & PCO2 - BLOOD GAS ARTERIAL
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
3018280301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$32.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.50
|
|
|
HC BLOOD GASES: PH, PO2 & PCO2 - BLOOD GAS ARTERIAL
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
3018280301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$35.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$26.07
|
| Rate for Payer: Aetna Government |
$26.07
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$18.25
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$18.25
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18.25
|
| Rate for Payer: Brighton Health Commercial |
$48.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26.07
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32.87
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27.67
|
| Rate for Payer: Elderplan Medicare Advantage |
$26.07
|
| Rate for Payer: EmblemHealth Commercial |
$26.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.20
|
| Rate for Payer: Group Health Inc Commercial |
$26.07
|
| Rate for Payer: Group Health Inc Medicare |
$26.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.36
|
| Rate for Payer: Healthfirst Essential Plan |
$36.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$26.07
|
| Rate for Payer: Healthfirst QHP |
$26.07
|
| Rate for Payer: Humana Medicare |
$26.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.07
|
| Rate for Payer: United Healthcare Commercial |
$24.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$16.36
|
| Rate for Payer: Wellcare Medicare |
$23.46
|
|
|
HC BLOOD GASES: PH, PO2 & PCO2 - BLOOD GAS CORD ARTERIAL
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
3018280305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$35.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$26.07
|
| Rate for Payer: Aetna Government |
$26.07
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$18.25
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$18.25
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18.25
|
| Rate for Payer: Brighton Health Commercial |
$48.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26.07
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32.87
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27.67
|
| Rate for Payer: Elderplan Medicare Advantage |
$26.07
|
| Rate for Payer: EmblemHealth Commercial |
$26.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.20
|
| Rate for Payer: Group Health Inc Commercial |
$26.07
|
| Rate for Payer: Group Health Inc Medicare |
$26.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.36
|
| Rate for Payer: Healthfirst Essential Plan |
$36.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$26.07
|
| Rate for Payer: Healthfirst QHP |
$26.07
|
| Rate for Payer: Humana Medicare |
$26.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.07
|
| Rate for Payer: United Healthcare Commercial |
$24.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$16.36
|
| Rate for Payer: Wellcare Medicare |
$23.46
|
|
|
HC BLOOD GASES: PH, PO2 & PCO2 - BLOOD GAS CORD ARTERIAL
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
3018280305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$32.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.50
|
|
|
HC BLOOD GASES: PH, PO2 & PCO2 - BLOOD GAS CORD VENOUS
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
3018280302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$32.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.50
|
|
|
HC BLOOD GASES: PH, PO2 & PCO2 - BLOOD GAS CORD VENOUS
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
3018280302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$35.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$26.07
|
| Rate for Payer: Aetna Government |
$26.07
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$18.25
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$18.25
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18.25
|
| Rate for Payer: Brighton Health Commercial |
$48.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26.07
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32.87
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27.67
|
| Rate for Payer: Elderplan Medicare Advantage |
$26.07
|
| Rate for Payer: EmblemHealth Commercial |
$26.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.20
|
| Rate for Payer: Group Health Inc Commercial |
$26.07
|
| Rate for Payer: Group Health Inc Medicare |
$26.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.36
|
| Rate for Payer: Healthfirst Essential Plan |
$36.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$26.07
|
| Rate for Payer: Healthfirst QHP |
$26.07
|
| Rate for Payer: Humana Medicare |
$26.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.07
|
| Rate for Payer: United Healthcare Commercial |
$24.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$16.36
|
| Rate for Payer: Wellcare Medicare |
$23.46
|
|
|
HC BLOOD GASES: PH, PO2 & PCO2 - BLOOD GAS PLUS
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
3018280303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$35.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$26.07
|
| Rate for Payer: Aetna Government |
$26.07
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$18.25
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$18.25
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18.25
|
| Rate for Payer: Brighton Health Commercial |
$48.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26.07
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32.87
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27.67
|
| Rate for Payer: Elderplan Medicare Advantage |
$26.07
|
| Rate for Payer: EmblemHealth Commercial |
$26.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.20
|
| Rate for Payer: Group Health Inc Commercial |
$26.07
|
| Rate for Payer: Group Health Inc Medicare |
$26.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.36
|
| Rate for Payer: Healthfirst Essential Plan |
$36.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$26.07
|
| Rate for Payer: Healthfirst QHP |
$26.07
|
| Rate for Payer: Humana Medicare |
$26.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.07
|
| Rate for Payer: United Healthcare Commercial |
$24.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$16.36
|
| Rate for Payer: Wellcare Medicare |
$23.46
|
|
|
HC BLOOD GASES: PH, PO2 & PCO2 - BLOOD GAS PLUS
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
3018280303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$32.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.50
|
|
