|
HC CT SCAN UPPER EXTREMITY W/O DYE - CT UPPER EXT WO IV CONTRAST
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 73200 TC
|
| Hospital Charge Code |
3527320010
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$169.50 |
| Max. Negotiated Rate |
$169.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$169.50
|
|
|
HC CT SCAN UPPER EXTREMITY W/O DYE - CT WRIST WO IV CONTRAST
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
CPT 73200 TC
|
| Hospital Charge Code |
3527320005
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$117.06 |
| Max. Negotiated Rate |
$443.27 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$186.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$117.06
|
| Rate for Payer: Aetna Government |
$117.06
|
| Rate for Payer: Brighton Health Commercial |
$254.25
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$414.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$349.19
|
| Rate for Payer: EmblemHealth Commercial |
$122.34
|
| Rate for Payer: Group Health Inc Commercial |
$169.50
|
| Rate for Payer: Group Health Inc Medicare |
$118.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$169.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$169.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$122.34
|
| Rate for Payer: Healthfirst Essential Plan |
$443.27
|
| Rate for Payer: United Healthcare Commercial |
$155.08
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$197.01
|
|
|
HC CT SCAN UPPER EXTREMITY W/O DYE - CT WRIST WO IV CONTRAST
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 73200 TC
|
| Hospital Charge Code |
3527320005
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$169.50 |
| Max. Negotiated Rate |
$169.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$169.50
|
|
|
HC CULTURE, ANAEROBIC
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
3068707001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.03
|
| Rate for Payer: Brighton Health Commercial |
$15.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.62
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.33
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.62
|
| Rate for Payer: EmblemHealth Commercial |
$8.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.67
|
| Rate for Payer: Group Health Inc Commercial |
$8.62
|
| Rate for Payer: Group Health Inc Medicare |
$8.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Healthfirst Essential Plan |
$18.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Humana Medicare |
$8.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.62
|
| Rate for Payer: United Healthcare Commercial |
$10.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.62
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
HC CULTURE, ANAEROBIC
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
3068707001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.50
|
|
|
HC CULTURE, BACTERIA, ANAEROBIC ISOLATE, DEFINITIVE ID, EACH
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
3068707601
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$18.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.08
|
| Rate for Payer: Aetna Government |
$8.08
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5.66
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5.66
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5.66
|
| Rate for Payer: Brighton Health Commercial |
$15.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.73
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.56
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.08
|
| Rate for Payer: EmblemHealth Commercial |
$8.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6.87
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.19
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.19
|
| Rate for Payer: Group Health Inc Commercial |
$8.08
|
| Rate for Payer: Group Health Inc Medicare |
$8.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.08
|
| Rate for Payer: Healthfirst Essential Plan |
$18.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.08
|
| Rate for Payer: Healthfirst QHP |
$8.08
|
| Rate for Payer: Humana Medicare |
$8.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.08
|
| Rate for Payer: United Healthcare Commercial |
$10.23
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.08
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.08
|
| Rate for Payer: Wellcare Medicare |
$7.27
|
|
|
HC CULTURE, BACTERIA, ANAEROBIC ISOLATE, DEFINITIVE ID, EACH
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 87076
|
| Hospital Charge Code |
3068707601
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$10.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.00
|
|
|
HC CULTURE, BACTERIA, ANAEROBIC ISOLATE, NON-BLOOD, PRESUMPTIVE ID
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
3068707501
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$11.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.50
|
|
|
HC CULTURE, BACTERIA, ANAEROBIC ISOLATE, NON-BLOOD, PRESUMPTIVE ID
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
CPT 87075
|
| Hospital Charge Code |
3068707501
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$21.31 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$12.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.47
|
| Rate for Payer: Aetna Government |
$9.47
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.63
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.63
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.63
|
| Rate for Payer: Brighton Health Commercial |
$17.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.47
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$16.07
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$13.53
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.47
|
| Rate for Payer: EmblemHealth Commercial |
$9.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.43
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.43
|
| Rate for Payer: Group Health Inc Commercial |
$9.47
|
| Rate for Payer: Group Health Inc Medicare |
$9.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.47
|
| Rate for Payer: Healthfirst Essential Plan |
$21.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.47
|
| Rate for Payer: Healthfirst QHP |
$9.47
|
| Rate for Payer: Humana Medicare |
$9.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.47
|
| Rate for Payer: United Healthcare Commercial |
$11.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.47
|
| Rate for Payer: Wellcare Medicare |
$8.52
|
|
|
HC CULTURE, BACTERIA, BLOOD, ISOLCATION & PRELIM EXAM
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
3068704001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.22 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$10.32
|
| Rate for Payer: Aetna Government |
$10.32
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$7.22
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$7.22
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$7.22
|
| Rate for Payer: Brighton Health Commercial |
$18.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$10.32
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$17.54
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$14.77
|
| Rate for Payer: Elderplan Medicare Advantage |
$10.32
|
| Rate for Payer: EmblemHealth Commercial |
$10.32
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.77
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$10.32
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.18
|
| Rate for Payer: Group Health Inc Commercial |
$10.32
|
| Rate for Payer: Group Health Inc Medicare |
$10.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.32
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.32
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Healthfirst Essential Plan |
$18.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10.32
|
| Rate for Payer: Healthfirst QHP |
$10.32
|
| Rate for Payer: Humana Medicare |
$10.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$10.32
|
| Rate for Payer: United Healthcare Commercial |
$13.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$10.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.32
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Wellcare Medicare |
$9.29
|
|
|
HC CULTURE, BACTERIA, BLOOD, ISOLCATION & PRELIM EXAM
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
3068704001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.50 |
| Max. Negotiated Rate |
$12.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.50
|
|
|
HC CULTURE, BACTERIA, ISOLATION&ID, URINE
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
3068708801
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$18.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.09
|
| Rate for Payer: Aetna Government |
$8.09
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5.66
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5.66
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5.66
|
| Rate for Payer: Brighton Health Commercial |
$15.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.09
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.58
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.09
|
| Rate for Payer: EmblemHealth Commercial |
$8.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6.88
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.20
|
| Rate for Payer: Group Health Inc Commercial |
$8.09
|
| Rate for Payer: Group Health Inc Medicare |
$8.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.09
|
| Rate for Payer: Healthfirst Essential Plan |
$18.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.09
|
| Rate for Payer: Healthfirst QHP |
$8.09
|
| Rate for Payer: Humana Medicare |
$8.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.09
|
| Rate for Payer: United Healthcare Commercial |
$10.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.09
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.09
|
| Rate for Payer: Wellcare Medicare |
$7.28
|
|
|
HC CULTURE, BACTERIA, ISOLATION&ID, URINE
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
3068708801
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$10.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.00
|
|
|
HC CULTURE, BACTERIA, QUANTITATIVE, URINE
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
3068708601
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$18.16 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.07
|
| Rate for Payer: Aetna Government |
$8.07
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5.65
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5.65
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5.65
|
| Rate for Payer: Brighton Health Commercial |
$15.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.07
|
| 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 |
$8.07
|
| Rate for Payer: EmblemHealth Commercial |
$8.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.18
|
| Rate for Payer: Group Health Inc Commercial |
$8.07
|
| Rate for Payer: Group Health Inc Medicare |
$8.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.07
|
| Rate for Payer: Healthfirst Essential Plan |
$18.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.07
|
| Rate for Payer: Healthfirst QHP |
$8.07
|
| Rate for Payer: Humana Medicare |
$8.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.07
|
| Rate for Payer: United Healthcare Commercial |
$10.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.07
|
| Rate for Payer: Wellcare Medicare |
$7.26
|
|
|
HC CULTURE, BACTERIA, QUANTITATIVE, URINE
|
Facility
|
IP
|
$20.00
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
3068708601
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$10.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.00
|
|
|
HC CULTURE, BACTERIA, STOOL, ISOLCATION & PRELIM EXAM
|
Facility
|
OP
|
$23.00
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
3068704501
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$12.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.44
|
| Rate for Payer: Aetna Government |
$9.44
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.61
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.61
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.61
|
| Rate for Payer: Brighton Health Commercial |
$17.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.44
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$16.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$13.50
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.44
|
| Rate for Payer: EmblemHealth Commercial |
$9.44
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.50
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.40
|
| Rate for Payer: Group Health Inc Commercial |
$9.44
|
| Rate for Payer: Group Health Inc Medicare |
$9.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.44
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Healthfirst Essential Plan |
$18.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.44
|
| Rate for Payer: Healthfirst QHP |
$9.44
|
| Rate for Payer: Humana Medicare |
$9.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.44
|
| Rate for Payer: United Healthcare Commercial |
$11.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.44
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Wellcare Medicare |
$8.50
|
|
|
HC CULTURE, BACTERIA, STOOL, ISOLCATION & PRELIM EXAM
|
Facility
|
IP
|
$23.00
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
3068704501
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$11.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.50
|
|
|
HC CULTURE, BETA STREP B
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
3068707006
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.03
|
| Rate for Payer: Brighton Health Commercial |
$15.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.62
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.33
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.62
|
| Rate for Payer: EmblemHealth Commercial |
$8.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.67
|
| Rate for Payer: Group Health Inc Commercial |
$8.62
|
| Rate for Payer: Group Health Inc Medicare |
$8.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Healthfirst Essential Plan |
$18.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Humana Medicare |
$8.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.62
|
| Rate for Payer: United Healthcare Commercial |
$10.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.62
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
HC CULTURE, BETA STREP B
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
3068707006
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.50
|
|
|
HC CULTURE, B PERTUSSIS NASOPHAR
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
3068707012
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.03
|
| Rate for Payer: Brighton Health Commercial |
$15.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.62
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.33
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.62
|
| Rate for Payer: EmblemHealth Commercial |
$8.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.67
|
| Rate for Payer: Group Health Inc Commercial |
$8.62
|
| Rate for Payer: Group Health Inc Medicare |
$8.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Healthfirst Essential Plan |
$18.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Humana Medicare |
$8.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.62
|
| Rate for Payer: United Healthcare Commercial |
$10.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.62
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
HC CULTURE, B PERTUSSIS NASOPHAR
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
3068707012
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.50
|
|
|
HC CULTURE, CHLAMYDIA TRACHOMATIS
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
CPT 87110
|
| Hospital Charge Code |
3068711001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$36.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$26.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$19.60
|
| Rate for Payer: Aetna Government |
$19.60
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$13.72
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$13.72
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$13.72
|
| Rate for Payer: Brighton Health Commercial |
$36.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$33.29
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$28.02
|
| Rate for Payer: Elderplan Medicare Advantage |
$19.60
|
| Rate for Payer: EmblemHealth Commercial |
$19.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$16.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$17.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$19.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$17.44
|
| Rate for Payer: Group Health Inc Commercial |
$19.60
|
| Rate for Payer: Group Health Inc Medicare |
$19.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Healthfirst Essential Plan |
$18.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$19.60
|
| Rate for Payer: Healthfirst QHP |
$19.60
|
| Rate for Payer: Humana Medicare |
$19.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19.60
|
| Rate for Payer: United Healthcare Commercial |
$24.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.60
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Wellcare Medicare |
$17.64
|
|
|
HC CULTURE, CHLAMYDIA TRACHOMATIS
|
Facility
|
IP
|
$49.00
|
|
|
Service Code
|
CPT 87110
|
| Hospital Charge Code |
3068711001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.50 |
| Max. Negotiated Rate |
$24.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24.50
|
|
|
HC CULTURE, CSF
|
Facility
|
IP
|
$21.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
3068707005
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.50
|
|
|
HC CULTURE, CSF
|
Facility
|
OP
|
$21.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
3068707005
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$18.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.03
|
| Rate for Payer: Brighton Health Commercial |
$15.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.62
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.33
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.62
|
| Rate for Payer: EmblemHealth Commercial |
$8.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.67
|
| Rate for Payer: Group Health Inc Commercial |
$8.62
|
| Rate for Payer: Group Health Inc Medicare |
$8.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Healthfirst Essential Plan |
$18.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Humana Medicare |
$8.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.62
|
| Rate for Payer: United Healthcare Commercial |
$10.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.62
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.23
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
