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Hospital Charge Code 41651181
Hospital Revenue Code 250
Min. Negotiated Rate $0.28
Max. Negotiated Rate $0.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.40
Rate for Payer: Aetna Government $0.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.64
Rate for Payer: Cigna LocalPlus Benefit Plan $0.54
Rate for Payer: Group Health Inc Commercial $0.40
Rate for Payer: Group Health Inc Medicare $0.28
Rate for Payer: Hamaspik Choice Inc Medicaid $0.40
Rate for Payer: Hamaspik Choice Inc Medicare $0.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.52
Hospital Charge Code 41641181
Hospital Revenue Code 250
Min. Negotiated Rate $0.28
Max. Negotiated Rate $0.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.40
Rate for Payer: Aetna Government $0.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.64
Rate for Payer: Cigna LocalPlus Benefit Plan $0.54
Rate for Payer: Group Health Inc Commercial $0.40
Rate for Payer: Group Health Inc Medicare $0.28
Rate for Payer: Hamaspik Choice Inc Medicaid $0.40
Rate for Payer: Hamaspik Choice Inc Medicare $0.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.52
Hospital Charge Code 41650177
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Hospital Charge Code 41640177
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Service Code HCPCS J3490
Hospital Charge Code 41654155
Hospital Revenue Code 636
Min. Negotiated Rate $1.18
Max. Negotiated Rate $2.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.68
Rate for Payer: Aetna Government $1.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.68
Rate for Payer: Cigna LocalPlus Benefit Plan $1.93
Rate for Payer: Group Health Inc Commercial $1.68
Rate for Payer: Group Health Inc Medicare $1.18
Rate for Payer: Hamaspik Choice Inc Medicaid $1.68
Rate for Payer: Hamaspik Choice Inc Medicare $1.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2.18
Service Code HCPCS J3490
Hospital Charge Code 41654155
Hospital Revenue Code 636
Min. Negotiated Rate $1.68
Max. Negotiated Rate $1.68
Rate for Payer: Hamaspik Choice Inc Medicaid $1.68
Rate for Payer: Hamaspik Choice Inc Medicare $1.68
Service Code HCPCS J3490
Hospital Charge Code 41644155
Hospital Revenue Code 636
Min. Negotiated Rate $1.18
Max. Negotiated Rate $2.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.68
Rate for Payer: Aetna Government $1.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.68
Rate for Payer: Cigna LocalPlus Benefit Plan $1.93
Rate for Payer: Group Health Inc Commercial $1.68
Rate for Payer: Group Health Inc Medicare $1.18
Rate for Payer: Hamaspik Choice Inc Medicaid $1.68
Rate for Payer: Hamaspik Choice Inc Medicare $1.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2.18
Service Code HCPCS J3490
Hospital Charge Code 41644155
Hospital Revenue Code 636
Min. Negotiated Rate $1.68
Max. Negotiated Rate $1.68
Rate for Payer: Hamaspik Choice Inc Medicaid $1.68
Rate for Payer: Hamaspik Choice Inc Medicare $1.68
Service Code HCPCS S0077
Hospital Charge Code 41643044
Hospital Revenue Code 636
Min. Negotiated Rate $1.17
Max. Negotiated Rate $9.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial $8.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.17
Rate for Payer: Aetna Government $1.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $7.56
Rate for Payer: Cigna LocalPlus Benefit Plan $8.69
Rate for Payer: Group Health Inc Commercial $7.56
Rate for Payer: Group Health Inc Medicare $5.29
Rate for Payer: Hamaspik Choice Inc Medicaid $7.56
Rate for Payer: Hamaspik Choice Inc Medicare $7.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $9.83
Service Code HCPCS S0077
Hospital Charge Code 41653044
Hospital Revenue Code 636
Min. Negotiated Rate $1.17
Max. Negotiated Rate $9.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial $8.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.17
Rate for Payer: Aetna Government $1.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $7.56
Rate for Payer: Cigna LocalPlus Benefit Plan $8.69
Rate for Payer: Group Health Inc Commercial $7.56
Rate for Payer: Group Health Inc Medicare $5.29
Rate for Payer: Hamaspik Choice Inc Medicaid $7.56
Rate for Payer: Hamaspik Choice Inc Medicare $7.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $9.83
Service Code HCPCS S0077
Hospital Charge Code 41653044
Hospital Revenue Code 636
Min. Negotiated Rate $7.56
Max. Negotiated Rate $7.56
Rate for Payer: Hamaspik Choice Inc Medicaid $7.56
Rate for Payer: Hamaspik Choice Inc Medicare $7.56
Service Code HCPCS S0077
Hospital Charge Code 41643044
Hospital Revenue Code 636
Min. Negotiated Rate $7.56
Max. Negotiated Rate $7.56
Rate for Payer: Hamaspik Choice Inc Medicaid $7.56
Rate for Payer: Hamaspik Choice Inc Medicare $7.56
Service Code HCPCS J7040
Hospital Charge Code 41651456
Hospital Revenue Code 636
Min. Negotiated Rate $0.19
Max. Negotiated Rate $1.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.30
Rate for Payer: Aetna Government $1.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.27
Rate for Payer: Cigna LocalPlus Benefit Plan $0.31
Rate for Payer: Fidelis CHP/HARP/Medicaid $1.14
Rate for Payer: Group Health Inc Commercial $0.27
Rate for Payer: Group Health Inc Medicare $0.19
Rate for Payer: Hamaspik Choice Inc Medicaid $0.27
Rate for Payer: Hamaspik Choice Inc Medicare $0.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid $1.27
Rate for Payer: SOMOS CHP/HARP/Medicaid $1.38
Rate for Payer: SOMOS Essential $1.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.35
Service Code HCPCS J7040
Hospital Charge Code 41651456
Hospital Revenue Code 636
Min. Negotiated Rate $0.27
Max. Negotiated Rate $0.27
Rate for Payer: Hamaspik Choice Inc Medicaid $0.27
Rate for Payer: Hamaspik Choice Inc Medicare $0.27
Service Code HCPCS J7040
Hospital Charge Code 41641456
Hospital Revenue Code 636
Min. Negotiated Rate $0.27
Max. Negotiated Rate $0.27
Rate for Payer: Hamaspik Choice Inc Medicaid $0.27
Rate for Payer: Hamaspik Choice Inc Medicare $0.27
Service Code HCPCS J7040
Hospital Charge Code 41641456
Hospital Revenue Code 636
Min. Negotiated Rate $0.19
Max. Negotiated Rate $1.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.30
Rate for Payer: Aetna Government $1.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.27
Rate for Payer: Cigna LocalPlus Benefit Plan $0.31
Rate for Payer: Fidelis CHP/HARP/Medicaid $1.14
Rate for Payer: Group Health Inc Commercial $0.27
Rate for Payer: Group Health Inc Medicare $0.19
Rate for Payer: Hamaspik Choice Inc Medicaid $0.27
Rate for Payer: Hamaspik Choice Inc Medicare $0.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid $1.27
Rate for Payer: SOMOS CHP/HARP/Medicaid $1.38
Rate for Payer: SOMOS Essential $1.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.35
Service Code HCPCS J3490
Hospital Charge Code 41651898
Hospital Revenue Code 636
Min. Negotiated Rate $9.18
Max. Negotiated Rate $17.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial $14.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $13.12
Rate for Payer: Aetna Government $13.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $13.12
Rate for Payer: Cigna LocalPlus Benefit Plan $15.08
Rate for Payer: Group Health Inc Commercial $13.12
Rate for Payer: Group Health Inc Medicare $9.18
Rate for Payer: Hamaspik Choice Inc Medicaid $13.12
Rate for Payer: Hamaspik Choice Inc Medicare $13.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $17.05
Service Code HCPCS J3490
Hospital Charge Code 41641898
Hospital Revenue Code 636
Min. Negotiated Rate $9.18
Max. Negotiated Rate $17.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial $14.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $13.12
Rate for Payer: Aetna Government $13.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $13.12
Rate for Payer: Cigna LocalPlus Benefit Plan $15.08
Rate for Payer: Group Health Inc Commercial $13.12
Rate for Payer: Group Health Inc Medicare $9.18
Rate for Payer: Hamaspik Choice Inc Medicaid $13.12
Rate for Payer: Hamaspik Choice Inc Medicare $13.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $17.05
Service Code HCPCS J3490
Hospital Charge Code 41641898
Hospital Revenue Code 636
Min. Negotiated Rate $13.12
Max. Negotiated Rate $13.12
Rate for Payer: Hamaspik Choice Inc Medicaid $13.12
Rate for Payer: Hamaspik Choice Inc Medicare $13.12
Service Code HCPCS J3490
Hospital Charge Code 41651898
Hospital Revenue Code 636
Min. Negotiated Rate $13.12
Max. Negotiated Rate $13.12
Rate for Payer: Hamaspik Choice Inc Medicaid $13.12
Rate for Payer: Hamaspik Choice Inc Medicare $13.12
Hospital Charge Code 41644164
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Hospital Charge Code 41654164
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Service Code HCPCS J3490
Hospital Charge Code 41657040
Hospital Revenue Code 636
Min. Negotiated Rate $3.56
Max. Negotiated Rate $3.56
Rate for Payer: Hamaspik Choice Inc Medicaid $3.56
Rate for Payer: Hamaspik Choice Inc Medicare $3.56
Service Code HCPCS J3490
Hospital Charge Code 41657040
Hospital Revenue Code 636
Min. Negotiated Rate $2.49
Max. Negotiated Rate $4.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial $3.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $3.56
Rate for Payer: Aetna Government $3.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $3.56
Rate for Payer: Cigna LocalPlus Benefit Plan $4.09
Rate for Payer: Group Health Inc Commercial $3.56
Rate for Payer: Group Health Inc Medicare $2.49
Rate for Payer: Hamaspik Choice Inc Medicaid $3.56
Rate for Payer: Hamaspik Choice Inc Medicare $3.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $4.63
Service Code HCPCS J3490
Hospital Charge Code 41647040
Hospital Revenue Code 636
Min. Negotiated Rate $2.49
Max. Negotiated Rate $4.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial $3.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $3.56
Rate for Payer: Aetna Government $3.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $3.56
Rate for Payer: Cigna LocalPlus Benefit Plan $4.09
Rate for Payer: Group Health Inc Commercial $3.56
Rate for Payer: Group Health Inc Medicare $2.49
Rate for Payer: Hamaspik Choice Inc Medicaid $3.56
Rate for Payer: Hamaspik Choice Inc Medicare $3.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $4.63