|
CUFF TOURNIQ, STER DISP 18
|
Facility
OP
|
$223.10
|
|
| Hospital Charge Code |
64906301
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$78.08 |
| Max. Negotiated Rate |
$178.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$122.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$111.55
|
| Rate for Payer: Aetna Government |
$111.55
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$178.48
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$151.71
|
| Rate for Payer: Group Health Inc Commercial |
$111.55
|
| Rate for Payer: Group Health Inc Medicare |
$78.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$111.55
|
|
|
CUFF TOURNIQUET 18
|
Facility
OP
|
$447.50
|
|
| Hospital Charge Code |
64902878
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$156.62 |
| Max. Negotiated Rate |
$358.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$246.12
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$223.75
|
| Rate for Payer: Aetna Government |
$223.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$358.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$304.30
|
| Rate for Payer: Group Health Inc Commercial |
$223.75
|
| Rate for Payer: Group Health Inc Medicare |
$156.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$223.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$223.75
|
|
|
CUFF TOURNIQUET 3.5X12IN
|
Facility
OP
|
$395.00
|
|
| Hospital Charge Code |
64905087
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$138.25 |
| Max. Negotiated Rate |
$316.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$217.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$197.50
|
| Rate for Payer: Aetna Government |
$197.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$316.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$268.60
|
| Rate for Payer: Group Health Inc Commercial |
$197.50
|
| Rate for Payer: Group Health Inc Medicare |
$138.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$197.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$197.50
|
|
|
CUFF TOURNIQUET SING BLAD 8
|
Facility
OP
|
$462.50
|
|
|
Service Code
|
HCPCS C1815
|
| Hospital Charge Code |
64901474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.88 |
| Max. Negotiated Rate |
$2,453.47 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$254.38
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,453.47
|
| Rate for Payer: Aetna Government |
$2,453.47
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$231.25
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$265.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$485.62
|
| Rate for Payer: Group Health Inc Commercial |
$231.25
|
| Rate for Payer: Group Health Inc Medicare |
$161.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$231.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$231.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$300.62
|
|
|
CUFF TOURNIQUET SING BLAD 8
|
Facility
IP
|
$462.50
|
|
|
Service Code
|
HCPCS C1815
|
| Hospital Charge Code |
64901474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$231.25 |
| Max. Negotiated Rate |
$231.25 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$231.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$231.25
|
|
|
CUFF TOURN SGL BLD 2HS 12
|
Facility
OP
|
$517.50
|
|
| Hospital Charge Code |
64904442
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$181.12 |
| Max. Negotiated Rate |
$414.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$284.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$258.75
|
| Rate for Payer: Aetna Government |
$258.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$414.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$351.90
|
| Rate for Payer: Group Health Inc Commercial |
$258.75
|
| Rate for Payer: Group Health Inc Medicare |
$181.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$258.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$258.75
|
|
|
CULDOCENTESIS
|
Facility
OP
|
$12,937.43
|
|
|
Service Code
|
HCPCS 57020
|
| Hospital Charge Code |
40052260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$88.82 |
| Max. Negotiated Rate |
$6,468.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5,751.94
|
| Rate for Payer: Aetna Government |
$5,751.94
|
| Rate for Payer: Cash Price |
$5,751.94
|
| Rate for Payer: Cash Price |
$5,751.94
|
| Rate for Payer: Cash Price |
$5,751.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5,751.94
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$5,751.94
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$88.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4,889.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,119.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$5,751.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,119.23
|
| Rate for Payer: Group Health Inc Commercial |
$5,751.94
|
| Rate for Payer: Group Health Inc Medicare |
$5,751.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,468.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,751.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$98.69
|
| Rate for Payer: Healthfirst Medicare Advantage |
$4,889.15
|
| Rate for Payer: Healthfirst QHP |
$5,751.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5,751.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5,751.94
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4,601.55
|
| Rate for Payer: Wellcare Medicare |
$5,464.34
|
|
|
CULTR BACTERIA EXCEPT BLOOD
|
Facility
OP
|
$23.68
|
|
|
Service Code
|
HCPCS 87075
|
| Hospital Charge Code |
40614313
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.02
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.47
|
| Rate for Payer: Aetna Government |
$9.47
|
| Rate for Payer: Cash Price |
$9.47
|
| Rate for Payer: Cash Price |
$9.47
|
| 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 |
$15.03
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.72
|
| 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 |
$11.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.47
|
| Rate for Payer: Healthfirst QHP |
$9.47
|
| Rate for Payer: Senior Whole Health 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 |
$7.58
|
| Rate for Payer: Wellcare Medicare |
$8.52
|
|
|
CULTURE AEROBIC IDENTIFY
|
Facility
OP
|
$20.20
|
|
|
Service Code
|
HCPCS 87077
|
| Hospital Charge Code |
40614315
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$12.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.11
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.08
|
| Rate for Payer: Aetna Government |
$8.08
|
| Rate for Payer: Cash Price |
$8.08
|
| Rate for Payer: Cash Price |
$8.08
|
| 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 |
$12.84
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$10.87
|
| 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 |
$10.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.08
|
| Rate for Payer: Healthfirst QHP |
$8.08
|
| Rate for Payer: Senior Whole Health 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 |
$6.46
|
| Rate for Payer: Wellcare Medicare |
$7.27
|
|
|
CULTURE ANAEROBE IDENT EACH
|
Facility
OP
|
$20.20
|
|
|
Service Code
|
HCPCS 87076
|
| Hospital Charge Code |
40614314
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$12.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.11
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.08
|
| Rate for Payer: Aetna Government |
$8.08
|
| Rate for Payer: Cash Price |
$8.08
|
| Rate for Payer: Cash Price |
$8.08
|
| 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 |
$12.84
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$10.87
|
| 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 |
$10.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.08
|
| Rate for Payer: Healthfirst QHP |
$8.08
|
| Rate for Payer: Senior Whole Health 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 |
$6.46
|
| Rate for Payer: Wellcare Medicare |
$7.27
|
|
|
CULTURE, BETA STREP B
|
Facility
OP
|
$21.55
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40614201
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$13.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| 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 |
$13.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.59
|
| 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 |
$10.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Senior Whole Health 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 |
$6.90
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
CULTURE, BODY FLUID ANAEROBIC
|
Facility
OP
|
$23.68
|
|
|
Service Code
|
HCPCS 87075
|
| Hospital Charge Code |
40614230
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.02
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.47
|
| Rate for Payer: Aetna Government |
$9.47
|
| Rate for Payer: Cash Price |
$9.47
|
| Rate for Payer: Cash Price |
$9.47
|
| 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 |
$15.03
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.72
|
| 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 |
$11.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.47
|
| Rate for Payer: Healthfirst QHP |
$9.47
|
| Rate for Payer: Senior Whole Health 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 |
$7.58
|
| Rate for Payer: Wellcare Medicare |
$8.52
|
|
|
CULTURE, CSF
|
Facility
OP
|
$21.55
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40614195
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$13.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| 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 |
$13.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.59
|
| 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 |
$10.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Senior Whole Health 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 |
$6.90
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
CULTURE, GC
|
Facility
OP
|
$21.55
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40614215
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$13.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| 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 |
$13.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.59
|
| 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 |
$10.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Senior Whole Health 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 |
$6.90
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
CULTURE, NASAL
|
Facility
OP
|
$21.55
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40614210
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$13.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| 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 |
$13.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.59
|
| 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 |
$10.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Senior Whole Health 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 |
$6.90
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
CULTURE OTHR SPECIMN AEROBIC
|
Facility
OP
|
$21.55
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40614312
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$13.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| 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 |
$13.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.59
|
| 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 |
$10.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Senior Whole Health 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 |
$6.90
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
CULTURE, RESPIRATORY
|
Facility
OP
|
$21.55
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40614180
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$13.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| 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 |
$13.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.59
|
| 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 |
$10.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Senior Whole Health 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 |
$6.90
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
CULTURE, ROUTINE AEROBIC
|
Facility
OP
|
$21.55
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40614190
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$13.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| 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 |
$13.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.59
|
| 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 |
$10.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Senior Whole Health 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 |
$6.90
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
CULTURE, ROUTINE ANAEROBIC
|
Facility
OP
|
$23.68
|
|
|
Service Code
|
HCPCS 87075
|
| Hospital Charge Code |
40614205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.58 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.02
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.47
|
| Rate for Payer: Aetna Government |
$9.47
|
| Rate for Payer: Cash Price |
$9.47
|
| Rate for Payer: Cash Price |
$9.47
|
| 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 |
$15.03
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.72
|
| 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 |
$11.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.47
|
| Rate for Payer: Healthfirst QHP |
$9.47
|
| Rate for Payer: Senior Whole Health 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 |
$7.58
|
| Rate for Payer: Wellcare Medicare |
$8.52
|
|
|
CULTURE SCREEN ONLY
|
Facility
OP
|
$16.58
|
|
|
Service Code
|
HCPCS 87081
|
| Hospital Charge Code |
40614316
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$10.53 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9.12
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.63
|
| Rate for Payer: Aetna Government |
$6.63
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.63
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$10.53
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$8.91
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.63
|
| Rate for Payer: EmblemHealth Commercial |
$6.63
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.90
|
| Rate for Payer: Group Health Inc Commercial |
$6.63
|
| Rate for Payer: Group Health Inc Medicare |
$6.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$6.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.63
|
| Rate for Payer: Healthfirst QHP |
$6.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.63
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.30
|
| Rate for Payer: Wellcare Medicare |
$5.97
|
|
|
CULTURE, SPORE
|
Facility
OP
|
$21.55
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40614220
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$13.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| 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 |
$13.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.59
|
| 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 |
$10.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Senior Whole Health 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 |
$6.90
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
CULTURE, STOOL
|
Facility
OP
|
$23.60
|
|
|
Service Code
|
HCPCS 87046
|
| Hospital Charge Code |
40614200
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.55 |
| Max. Negotiated Rate |
$15.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$12.98
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.44
|
| Rate for Payer: Aetna Government |
$9.44
|
| Rate for Payer: Cash Price |
$9.44
|
| Rate for Payer: Cash Price |
$9.44
|
| 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 |
$15.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.69
|
| 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 |
$11.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.44
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.44
|
| Rate for Payer: Healthfirst QHP |
$9.44
|
| Rate for Payer: Senior Whole Health 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 |
$7.55
|
| Rate for Payer: Wellcare Medicare |
$8.50
|
|
|
CULTURE TYPE IMMUNOFLUORESC
|
Facility
OP
|
$13.93
|
|
|
Service Code
|
HCPCS 87140
|
| Hospital Charge Code |
40619613
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$8.87 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.66
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.57
|
| Rate for Payer: Aetna Government |
$5.57
|
| Rate for Payer: Cash Price |
$5.57
|
| Rate for Payer: Cash Price |
$5.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.87
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.50
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.57
|
| Rate for Payer: EmblemHealth Commercial |
$5.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5.01
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.96
|
| Rate for Payer: Group Health Inc Commercial |
$5.57
|
| Rate for Payer: Group Health Inc Medicare |
$5.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.57
|
| Rate for Payer: Healthfirst QHP |
$5.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.46
|
| Rate for Payer: Wellcare Medicare |
$5.01
|
|
|
CULTURE TYPE IMMUNOLOGIC
|
Facility
OP
|
$12.95
|
|
|
Service Code
|
HCPCS 87147
|
| Hospital Charge Code |
40614324
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.14 |
| Max. Negotiated Rate |
$8.23 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.12
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.18
|
| Rate for Payer: Aetna Government |
$5.18
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.23
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.96
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.18
|
| Rate for Payer: EmblemHealth Commercial |
$5.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.61
|
| Rate for Payer: Group Health Inc Commercial |
$5.18
|
| Rate for Payer: Group Health Inc Medicare |
$5.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.18
|
| Rate for Payer: Healthfirst QHP |
$5.18
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.18
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.18
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.14
|
| Rate for Payer: Wellcare Medicare |
$4.66
|
|
|
CULTURE, URINE
|
Facility
OP
|
$20.18
|
|
|
Service Code
|
HCPCS 87086
|
| Hospital Charge Code |
40614185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$12.83 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.07
|
| Rate for Payer: Aetna Government |
$8.07
|
| Rate for Payer: Cash Price |
$8.07
|
| Rate for Payer: Cash Price |
$8.07
|
| 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 |
$12.83
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$10.86
|
| 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 |
$10.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.07
|
| Rate for Payer: Healthfirst QHP |
$8.07
|
| Rate for Payer: Senior Whole Health 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 |
$6.46
|
| Rate for Payer: Wellcare Medicare |
$7.26
|
|
