|
HC COCCIDIOIDES, ANTIBODY - COCCIDIOIDES ANTIBODIES
|
Facility
|
IP
|
$28.00
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
3028663501
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$14.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.00
|
|
|
HC COCCIDIOIDES, ANTIBODY - COCCIDIOIDES ANTIBODIES
|
Facility
|
OP
|
$28.00
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
3028663501
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.03 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.47
|
| Rate for Payer: Aetna Government |
$11.47
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.03
|
| Rate for Payer: Brighton Health Commercial |
$21.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.47
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.43
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.47
|
| Rate for Payer: EmblemHealth Commercial |
$11.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.32
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.21
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.21
|
| Rate for Payer: Group Health Inc Commercial |
$11.47
|
| Rate for Payer: Group Health Inc Medicare |
$11.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.11
|
| Rate for Payer: Healthfirst Essential Plan |
$18.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.47
|
| Rate for Payer: Healthfirst QHP |
$11.47
|
| Rate for Payer: Humana Medicare |
$11.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.47
|
| Rate for Payer: United Healthcare Commercial |
$14.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.11
|
| Rate for Payer: Wellcare Medicare |
$10.32
|
|
|
HC COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC - PARALDEHYDE
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
3018254202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.86 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$24.09
|
| Rate for Payer: Aetna Government |
$24.09
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$16.86
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$16.86
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$16.86
|
| Rate for Payer: Brighton Health Commercial |
$45.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$24.09
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$30.69
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$25.83
|
| Rate for Payer: Elderplan Medicare Advantage |
$24.09
|
| Rate for Payer: EmblemHealth Commercial |
$24.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$20.48
|
| Rate for Payer: Fidelis Essential Plan QHP |
$21.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$24.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21.44
|
| Rate for Payer: Group Health Inc Commercial |
$24.09
|
| Rate for Payer: Group Health Inc Medicare |
$24.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$24.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24.09
|
| Rate for Payer: Healthfirst QHP |
$24.09
|
| Rate for Payer: Humana Medicare |
$24.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$24.09
|
| Rate for Payer: United Healthcare Commercial |
$22.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$24.09
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$22.89
|
| Rate for Payer: Wellcare Medicare |
$21.68
|
|
|
HC COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC - PARALDEHYDE
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
3018254202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.00
|
|
|
HC COLD AGGLUTININ, TITER - COLD AGGLUTININ TITER
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 86157
|
| Hospital Charge Code |
3028615701
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$10.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.00
|
|
|
HC COLD AGGLUTININ, TITER - COLD AGGLUTININ TITER
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 86157
|
| Hospital Charge Code |
3028615701
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.06
|
| Rate for Payer: Aetna Government |
$8.06
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5.64
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5.64
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5.64
|
| Rate for Payer: Brighton Health Commercial |
$15.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.06
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.72
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.55
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.06
|
| Rate for Payer: EmblemHealth Commercial |
$8.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.25
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6.85
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.17
|
| Rate for Payer: Group Health Inc Commercial |
$8.06
|
| Rate for Payer: Group Health Inc Medicare |
$8.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.25
|
| Rate for Payer: Healthfirst Essential Plan |
$11.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.06
|
| Rate for Payer: Healthfirst QHP |
$8.06
|
| Rate for Payer: Humana Medicare |
$8.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.06
|
| Rate for Payer: United Healthcare Commercial |
$10.21
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.06
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.25
|
| Rate for Payer: Wellcare Medicare |
$7.25
|
|
|
HC COLLECT BLOOD FROM CATHETER VENOUS NOS - BUNDLED CHARGE
|
Facility
|
IP
|
$330.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
3613659202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$165.00
|
|
|
HC COLLECT BLOOD FROM CATHETER VENOUS NOS - BUNDLED CHARGE
|
Facility
|
OP
|
$330.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
3613659202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$34.78 |
| 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 |
$34.78
|
| 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 COLLECTION CAPILLARY BLOOD SPECIMEN
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
3003641601
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.00
|
| Rate for Payer: Aetna Government |
$3.00
|
| Rate for Payer: Brighton Health Commercial |
$86.25
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.83
|
| Rate for Payer: EmblemHealth Commercial |
$57.50
|
| Rate for Payer: Group Health Inc Commercial |
$57.50
|
| Rate for Payer: Group Health Inc Medicare |
$40.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$57.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$57.50
|
| Rate for Payer: United Healthcare Commercial |
$2.58
|
|
|
HC COLLECTION CAPILLARY BLOOD SPECIMEN
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
3003641601
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$57.50 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$57.50
|
|
|
HC COLLECTION CAPILLARY BLOOD SPECIMEN - BUNDLED CHARGE
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
3003641602
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.00
|
| Rate for Payer: Aetna Government |
$3.00
|
| Rate for Payer: Brighton Health Commercial |
$86.25
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.83
|
| Rate for Payer: EmblemHealth Commercial |
$57.50
|
| Rate for Payer: Group Health Inc Commercial |
$57.50
|
| Rate for Payer: Group Health Inc Medicare |
$40.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$57.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$57.50
|
| Rate for Payer: United Healthcare Commercial |
$2.58
|
|
|
HC COLLECTION CAPILLARY BLOOD SPECIMEN - BUNDLED CHARGE
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 36416
|
| Hospital Charge Code |
3003641602
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$57.50 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$57.50
|
|
|
HC COLLECTION VENOUS BLOOD,VENIPUNCTURE
|
Facility
|
OP
|
$9.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
3003641501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$22.91 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.09
|
| Rate for Payer: Aetna Government |
$9.09
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$22.91
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$22.91
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.18
|
| Rate for Payer: Amida Care Medicaid |
$10.18
|
| Rate for Payer: Brighton Health Commercial |
$6.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.09
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.63
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.05
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.09
|
| Rate for Payer: EmblemHealth Commercial |
$9.09
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$22.91
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$10.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.91
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.69
|
| Rate for Payer: Group Health Inc Commercial |
$9.09
|
| Rate for Payer: Group Health Inc Medicare |
$9.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$10.18
|
| Rate for Payer: Healthfirst Essential Plan |
$22.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.73
|
| Rate for Payer: Healthfirst QHP |
$16.60
|
| Rate for Payer: Humana Medicare |
$9.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$10.18
|
| Rate for Payer: SOMOS Essential |
$22.91
|
| Rate for Payer: United Healthcare Commercial |
$2.70
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$22.91
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$11.20
|
| Rate for Payer: United Healthcare Medicaid |
$10.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.09
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.18
|
| Rate for Payer: Wellcare Medicare |
$8.18
|
|
|
HC COLLECTION VENOUS BLOOD,VENIPUNCTURE
|
Facility
|
IP
|
$9.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
3003641501
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$4.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.50
|
|
|
HC COLLECTION VENOUS BLOOD,VENIPUNCTURE - BUNDLED CHARGE
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
3003641502
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$12.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.00
|
|
|
HC COLLECTION VENOUS BLOOD,VENIPUNCTURE - BUNDLED CHARGE
|
Facility
|
OP
|
$24.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
3003641502
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$22.91 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.09
|
| Rate for Payer: Aetna Government |
$9.09
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$22.91
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$22.91
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.18
|
| Rate for Payer: Amida Care Medicaid |
$10.18
|
| Rate for Payer: Brighton Health Commercial |
$18.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.09
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.63
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.05
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.09
|
| Rate for Payer: EmblemHealth Commercial |
$9.09
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$22.91
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$10.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.91
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.69
|
| Rate for Payer: Group Health Inc Commercial |
$9.09
|
| Rate for Payer: Group Health Inc Medicare |
$9.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$10.18
|
| Rate for Payer: Healthfirst Essential Plan |
$22.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.73
|
| Rate for Payer: Healthfirst QHP |
$16.60
|
| Rate for Payer: Humana Medicare |
$9.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$10.18
|
| Rate for Payer: SOMOS Essential |
$22.91
|
| Rate for Payer: United Healthcare Commercial |
$2.70
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$22.91
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$11.20
|
| Rate for Payer: United Healthcare Medicaid |
$10.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.09
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.18
|
| Rate for Payer: Wellcare Medicare |
$8.18
|
|
|
HC COLON CA SCRN NOT HI RSK IND
|
Facility
|
IP
|
$2,492.00
|
|
|
Service Code
|
CPT G0121
|
| Hospital Charge Code |
361G012101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,246.00 |
| Max. Negotiated Rate |
$1,246.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,246.00
|
|
|
HC COLON CA SCRN NOT HI RSK IND
|
Facility
|
OP
|
$2,492.00
|
|
|
Service Code
|
CPT G0121
|
| Hospital Charge Code |
361G012101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$208.98 |
| Max. Negotiated Rate |
$1,993.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,113.95
|
| Rate for Payer: Aetna Government |
$1,113.95
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$779.76
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$779.76
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$779.76
|
| Rate for Payer: Brighton Health Commercial |
$1,869.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,113.95
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,993.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,694.56
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,113.95
|
| Rate for Payer: EmblemHealth Commercial |
$1,113.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,002.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$946.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$991.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,113.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$991.42
|
| Rate for Payer: Group Health Inc Commercial |
$1,113.95
|
| Rate for Payer: Group Health Inc Medicare |
$1,113.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,113.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$489.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$208.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$946.86
|
| Rate for Payer: Healthfirst QHP |
$1,113.95
|
| Rate for Payer: Humana Medicare |
$1,136.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,113.95
|
| Rate for Payer: United Healthcare Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,113.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,113.95
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,058.25
|
| Rate for Payer: Wellcare Medicare |
$1,058.25
|
|
|
HC COLONOSCOPY, DIAGNOSTIC
|
Facility
|
OP
|
$2,313.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
7504537801
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$208.36 |
| Max. Negotiated Rate |
$3,092.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,113.95
|
| Rate for Payer: Aetna Government |
$1,113.95
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$779.76
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$779.76
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$779.76
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,113.95
|
| 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 |
$1,113.95
|
| Rate for Payer: EmblemHealth Commercial |
$1,113.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,002.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$946.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$991.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,113.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$991.42
|
| Rate for Payer: Group Health Inc Commercial |
$1,113.95
|
| Rate for Payer: Group Health Inc Medicare |
$1,113.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,113.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$489.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$208.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$946.86
|
| Rate for Payer: Healthfirst QHP |
$1,113.95
|
| Rate for Payer: Humana Medicare |
$1,136.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,113.95
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,113.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,113.95
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,058.25
|
| Rate for Payer: Wellcare Medicare |
$1,058.25
|
|
|
HC COLONOSCOPY, DIAGNOSTIC
|
Facility
|
IP
|
$2,313.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
7504537801
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,156.50 |
| Max. Negotiated Rate |
$1,156.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,156.50
|
|
|
HC COLORECTAL SCRN; HI RISK IND
|
Facility
|
IP
|
$2,492.00
|
|
|
Service Code
|
CPT G0105
|
| Hospital Charge Code |
361G010501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,246.00 |
| Max. Negotiated Rate |
$1,246.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,246.00
|
|
|
HC COLORECTAL SCRN; HI RISK IND
|
Facility
|
OP
|
$2,492.00
|
|
|
Service Code
|
CPT G0105
|
| Hospital Charge Code |
361G010501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$208.36 |
| Max. Negotiated Rate |
$1,993.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,113.95
|
| Rate for Payer: Aetna Government |
$1,113.95
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$779.76
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$779.76
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$779.76
|
| Rate for Payer: Brighton Health Commercial |
$1,869.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,113.95
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,993.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,694.56
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,113.95
|
| Rate for Payer: EmblemHealth Commercial |
$1,113.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,002.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$946.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$991.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,113.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$991.42
|
| Rate for Payer: Group Health Inc Commercial |
$1,113.95
|
| Rate for Payer: Group Health Inc Medicare |
$1,113.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,113.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$489.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$208.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$946.86
|
| Rate for Payer: Healthfirst QHP |
$1,113.95
|
| Rate for Payer: Humana Medicare |
$1,136.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,113.95
|
| Rate for Payer: United Healthcare Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,113.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,113.95
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,058.25
|
| Rate for Payer: Wellcare Medicare |
$1,058.25
|
|
|
HC COLOR VISION EXAMINATION
|
Facility
|
IP
|
$166.00
|
|
|
Service Code
|
CPT 92283
|
| Hospital Charge Code |
5109228301
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$83.00
|
|
|
HC COLOR VISION EXAMINATION
|
Facility
|
OP
|
$166.00
|
|
|
Service Code
|
CPT 92283
|
| Hospital Charge Code |
5109228301
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.81 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$91.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$72.58
|
| Rate for Payer: Aetna Government |
$72.58
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$50.81
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$50.81
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$50.81
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$72.58
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$217.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.48
|
| Rate for Payer: Elderplan Medicare Advantage |
$72.58
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$65.32
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$61.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$64.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$72.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$64.60
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$72.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$72.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$62.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$61.69
|
| Rate for Payer: Healthfirst QHP |
$72.58
|
| Rate for Payer: Humana Medicare |
$74.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$76.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$72.58
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$72.58
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$72.58
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$68.95
|
| Rate for Payer: Wellcare Medicare |
$68.95
|
|
|
HC COLPOCLEISIS
|
Facility
|
OP
|
$13,573.00
|
|
|
Service Code
|
CPT 57120
|
| Hospital Charge Code |
3615712001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$615.41 |
| Max. Negotiated Rate |
$10,179.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,031.45
|
| Rate for Payer: Aetna Government |
$6,031.45
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,222.02
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,222.02
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,222.02
|
| Rate for Payer: Brighton Health Commercial |
$10,179.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,031.45
|
| 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 |
$6,031.45
|
| Rate for Payer: EmblemHealth Commercial |
$6,031.45
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5,428.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,126.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,367.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,031.45
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,367.99
|
| Rate for Payer: Group Health Inc Commercial |
$6,031.45
|
| Rate for Payer: Group Health Inc Medicare |
$6,031.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,031.45
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,225.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$615.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,126.73
|
| Rate for Payer: Healthfirst QHP |
$6,031.45
|
| Rate for Payer: Humana Medicare |
$6,152.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,031.45
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,031.45
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,031.45
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,729.88
|
| Rate for Payer: Wellcare Medicare |
$5,729.88
|
|
