|
HC HBA1/HBA2 GENE - GENE TEST BETA-THALASSEMIA
|
Facility
|
IP
|
$255.00
|
|
|
Service Code
|
CPT 81257
|
| Hospital Charge Code |
3008125701
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$127.50 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$127.50
|
|
|
HC HBA1/HBA2 GENE - GENE TEST BETA-THALASSEMIA
|
Facility
|
OP
|
$255.00
|
|
|
Service Code
|
CPT 81257
|
| Hospital Charge Code |
3108125702
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$71.58 |
| Max. Negotiated Rate |
$204.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$140.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$102.26
|
| Rate for Payer: Aetna Government |
$102.26
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$71.58
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$71.58
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$71.58
|
| Rate for Payer: Brighton Health Commercial |
$102.26
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$102.26
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$204.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$173.40
|
| Rate for Payer: Elderplan Medicare Advantage |
$102.26
|
| Rate for Payer: EmblemHealth Commercial |
$102.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$92.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$86.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$91.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$102.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$91.01
|
| Rate for Payer: Group Health Inc Commercial |
$102.26
|
| Rate for Payer: Group Health Inc Medicare |
$102.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$102.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$102.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$102.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$102.26
|
| Rate for Payer: Healthfirst QHP |
$102.26
|
| Rate for Payer: Humana Medicare |
$104.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$102.26
|
| Rate for Payer: United Healthcare Medicare Advantage |
$102.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$102.26
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$97.15
|
| Rate for Payer: Wellcare Medicare |
$92.03
|
|
|
HC HBB (HEMOGLOBIN, SUBUNIT BETA)
|
Facility
|
IP
|
$197.00
|
|
|
Service Code
|
CPT 81361
|
| Hospital Charge Code |
3108136101
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$98.50 |
| Max. Negotiated Rate |
$98.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$98.50
|
|
|
HC HBB (HEMOGLOBIN, SUBUNIT BETA)
|
Facility
|
OP
|
$197.00
|
|
|
Service Code
|
CPT 81361
|
| Hospital Charge Code |
3108136101
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$108.35 |
| Max. Negotiated Rate |
$336.33 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$108.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$174.81
|
| Rate for Payer: Aetna Government |
$174.81
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$122.37
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$122.37
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$122.37
|
| Rate for Payer: Brighton Health Commercial |
$174.81
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$174.81
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$157.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$133.96
|
| Rate for Payer: Elderplan Medicare Advantage |
$174.81
|
| Rate for Payer: EmblemHealth Commercial |
$174.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$157.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$148.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$155.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$174.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$155.58
|
| Rate for Payer: Group Health Inc Commercial |
$174.81
|
| Rate for Payer: Group Health Inc Medicare |
$174.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$174.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$174.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$149.48
|
| Rate for Payer: Healthfirst Essential Plan |
$336.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$174.81
|
| Rate for Payer: Healthfirst QHP |
$174.81
|
| Rate for Payer: Humana Medicare |
$178.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$174.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$174.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$174.81
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$149.48
|
| Rate for Payer: Wellcare Medicare |
$157.33
|
|
|
HC HBOT, FULL BODY CHAMBER, 30M
|
Facility
|
OP
|
$1,394.00
|
|
|
Service Code
|
CPT G0277
|
| Hospital Charge Code |
413G027701
|
|
Hospital Revenue Code
|
413
|
| Min. Negotiated Rate |
$117.94 |
| Max. Negotiated Rate |
$3,163.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$766.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$168.49
|
| Rate for Payer: Aetna Government |
$168.49
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$117.94
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$117.94
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$117.94
|
| Rate for Payer: Brighton Health Commercial |
$1,045.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$168.49
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$697.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$794.58
|
| Rate for Payer: Elderplan Medicare Advantage |
$168.49
|
| Rate for Payer: EmblemHealth Commercial |
$168.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$151.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$143.22
|
| Rate for Payer: Fidelis Essential Plan QHP |
$149.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$168.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$149.96
|
| Rate for Payer: Group Health Inc Commercial |
$168.49
|
| Rate for Payer: Group Health Inc Medicare |
$168.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$168.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$168.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$205.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$143.22
|
| Rate for Payer: Healthfirst QHP |
$168.49
|
| Rate for Payer: Humana Medicare |
$171.86
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$168.49
|
| Rate for Payer: United Healthcare Commercial |
$3,163.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$168.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$168.49
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$160.07
|
| Rate for Payer: Wellcare Medicare |
$160.07
|
|
|
HC HBOT, FULL BODY CHAMBER, 30M
|
Facility
|
IP
|
$1,394.00
|
|
|
Service Code
|
CPT G0277
|
| Hospital Charge Code |
413G027701
|
|
Hospital Revenue Code
|
413
|
| Min. Negotiated Rate |
$697.00 |
| Max. Negotiated Rate |
$697.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$697.00
|
|
|
HC HEARING AID CHECK, BOTH EARS LEVEL ONE
|
Facility
|
IP
|
$177.00
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
4719259301
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$88.50 |
| Max. Negotiated Rate |
$88.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$88.50
|
|
|
HC HEARING AID CHECK, BOTH EARS LEVEL ONE
|
Facility
|
OP
|
$177.00
|
|
|
Service Code
|
CPT 92593
|
| Hospital Charge Code |
4719259301
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$31.14 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$97.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$31.14
|
| Rate for Payer: Aetna Government |
$31.14
|
| Rate for Payer: Brighton Health Commercial |
$132.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$141.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$120.36
|
| Rate for Payer: EmblemHealth Commercial |
$88.50
|
| Rate for Payer: Group Health Inc Commercial |
$88.50
|
| Rate for Payer: Group Health Inc Medicare |
$61.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$88.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$88.50
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
|
|
HC HEARING AID CHECK, ONE EAR LEVEL ONE
|
Facility
|
OP
|
$106.00
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
4719259201
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$18.79 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$58.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18.79
|
| Rate for Payer: Aetna Government |
$18.79
|
| Rate for Payer: Brighton Health Commercial |
$79.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$84.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$72.08
|
| Rate for Payer: EmblemHealth Commercial |
$53.00
|
| Rate for Payer: Group Health Inc Commercial |
$53.00
|
| Rate for Payer: Group Health Inc Medicare |
$37.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$53.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$53.00
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
|
|
HC HEARING AID CHECK, ONE EAR LEVEL ONE
|
Facility
|
IP
|
$106.00
|
|
|
Service Code
|
CPT 92592
|
| Hospital Charge Code |
4719259201
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$53.00 |
| Max. Negotiated Rate |
$53.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$53.00
|
|
|
HC HEARING AID EXAM, BOTH EARS
|
Facility
|
OP
|
$212.00
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
4719259101
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$60.74 |
| Max. Negotiated Rate |
$169.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$116.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$60.74
|
| Rate for Payer: Aetna Government |
$60.74
|
| Rate for Payer: Brighton Health Commercial |
$159.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$169.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$144.16
|
| Rate for Payer: EmblemHealth Commercial |
$106.00
|
| Rate for Payer: Group Health Inc Commercial |
$106.00
|
| Rate for Payer: Group Health Inc Medicare |
$74.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$106.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$106.00
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
|
|
HC HEARING AID EXAM, BOTH EARS
|
Facility
|
IP
|
$212.00
|
|
|
Service Code
|
CPT 92591
|
| Hospital Charge Code |
4719259101
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$106.00 |
| Max. Negotiated Rate |
$106.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$106.00
|
|
|
HC HEARING AID EXAM, ONE EAR
|
Facility
|
OP
|
$141.00
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
4719259001
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$77.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$47.77
|
| Rate for Payer: Aetna Government |
$47.77
|
| Rate for Payer: Brighton Health Commercial |
$105.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$112.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$95.88
|
| Rate for Payer: EmblemHealth Commercial |
$70.50
|
| Rate for Payer: Group Health Inc Commercial |
$70.50
|
| Rate for Payer: Group Health Inc Medicare |
$49.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$70.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$70.50
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
|
|
HC HEARING AID EXAM, ONE EAR
|
Facility
|
IP
|
$141.00
|
|
|
Service Code
|
CPT 92590
|
| Hospital Charge Code |
4719259001
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$70.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$70.50
|
|
|
HC HEART IMAGE (PET) MULTIPLE - NM PET MYOCARDIAL PERFUSION MULTIPLE
|
Facility
|
IP
|
$4,370.00
|
|
|
Service Code
|
CPT 78492 TC
|
| Hospital Charge Code |
4047849201
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$2,185.00 |
| Max. Negotiated Rate |
$2,185.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,185.00
|
|
|
HC HEART IMAGE (PET) MULTIPLE - NM PET MYOCARDIAL PERFUSION MULTIPLE
|
Facility
|
OP
|
$4,370.00
|
|
|
Service Code
|
CPT 78492 TC
|
| Hospital Charge Code |
4047849201
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$342.00 |
| Max. Negotiated Rate |
$3,277.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$875.00
|
| Rate for Payer: Aetna Government |
$875.00
|
| Rate for Payer: Brighton Health Commercial |
$3,277.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,369.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,994.69
|
| Rate for Payer: EmblemHealth Commercial |
$2,185.00
|
| Rate for Payer: Group Health Inc Commercial |
$2,185.00
|
| Rate for Payer: Group Health Inc Medicare |
$1,529.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,185.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,185.00
|
| Rate for Payer: Healthfirst Essential Plan |
$1,802.09
|
| Rate for Payer: United Healthcare Commercial |
$885.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$800.93
|
|
|
HC HEART IMAGE (PET) SINGLE - NM PET MYOCARDIAL PERFUSION SINGLE
|
Facility
|
OP
|
$4,370.00
|
|
|
Service Code
|
CPT 78491 TC
|
| Hospital Charge Code |
4047849101
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$342.00 |
| Max. Negotiated Rate |
$3,277.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$875.00
|
| Rate for Payer: Aetna Government |
$875.00
|
| Rate for Payer: Brighton Health Commercial |
$3,277.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,369.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,994.69
|
| Rate for Payer: EmblemHealth Commercial |
$2,185.00
|
| Rate for Payer: Group Health Inc Commercial |
$2,185.00
|
| Rate for Payer: Group Health Inc Medicare |
$1,529.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,185.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,185.00
|
| Rate for Payer: Healthfirst Essential Plan |
$1,097.62
|
| Rate for Payer: United Healthcare Commercial |
$885.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$487.83
|
|
|
HC HEART IMAGE (PET) SINGLE - NM PET MYOCARDIAL PERFUSION SINGLE
|
Facility
|
IP
|
$4,370.00
|
|
|
Service Code
|
CPT 78491 TC
|
| Hospital Charge Code |
4047849101
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$2,185.00 |
| Max. Negotiated Rate |
$2,185.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,185.00
|
|
|
HC HEART INFARCT IMAGE - NM HEART INFARCTION
|
Facility
|
IP
|
$1,114.00
|
|
|
Service Code
|
CPT 78466 TC
|
| Hospital Charge Code |
3407846601
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$557.00 |
| Max. Negotiated Rate |
$557.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$557.00
|
|
|
HC HEART INFARCT IMAGE - NM HEART INFARCTION
|
Facility
|
OP
|
$1,114.00
|
|
|
Service Code
|
CPT 78466 TC
|
| Hospital Charge Code |
3407846601
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$107.15 |
| Max. Negotiated Rate |
$835.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$612.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$107.15
|
| Rate for Payer: Aetna Government |
$107.15
|
| Rate for Payer: Brighton Health Commercial |
$835.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$623.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$524.89
|
| Rate for Payer: EmblemHealth Commercial |
$135.32
|
| Rate for Payer: Group Health Inc Commercial |
$557.00
|
| Rate for Payer: Group Health Inc Medicare |
$389.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$557.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$557.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$135.32
|
| Rate for Payer: Healthfirst Essential Plan |
$262.37
|
| Rate for Payer: United Healthcare Commercial |
$233.11
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$116.61
|
|
|
HC HEART INFARCT IMAGE SPECT - NM HEART INFARCTION SPECT
|
Facility
|
IP
|
$3,853.00
|
|
|
Service Code
|
CPT 78469 TC
|
| Hospital Charge Code |
3407846901
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$1,926.50 |
| Max. Negotiated Rate |
$1,926.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,926.50
|
|
|
HC HEART INFARCT IMAGE SPECT - NM HEART INFARCTION SPECT
|
Facility
|
OP
|
$3,853.00
|
|
|
Service Code
|
CPT 78469 TC
|
| Hospital Charge Code |
3407846901
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$124.48 |
| Max. Negotiated Rate |
$2,889.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,119.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$124.48
|
| Rate for Payer: Aetna Government |
$124.48
|
| Rate for Payer: Brighton Health Commercial |
$2,889.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$623.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$524.89
|
| Rate for Payer: EmblemHealth Commercial |
$169.91
|
| Rate for Payer: Group Health Inc Commercial |
$1,926.50
|
| Rate for Payer: Group Health Inc Medicare |
$1,348.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,926.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,926.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$169.91
|
| Rate for Payer: Healthfirst Essential Plan |
$374.67
|
| Rate for Payer: United Healthcare Commercial |
$233.11
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$166.52
|
|
|
HC HEART/LUNG RESUSCITATION (CPR)
|
Facility
|
IP
|
$766.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
4509295001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$383.00 |
| Max. Negotiated Rate |
$383.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$383.00
|
|
|
HC HEART/LUNG RESUSCITATION (CPR)
|
Facility
|
OP
|
$766.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
4509295001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$874.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$694.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$380.47
|
| Rate for Payer: Aetna Government |
$380.47
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$266.33
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$266.33
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$266.33
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$380.47
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$380.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$380.47
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$792.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$673.89
|
| Rate for Payer: Elderplan Medicare Advantage |
$380.47
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$342.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$323.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$338.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$380.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$338.62
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$380.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$380.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$380.47
|
| Rate for Payer: Humana Medicare |
$388.08
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$399.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$380.47
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$380.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$380.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$361.45
|
| Rate for Payer: Wellcare Medicare |
$361.45
|
|
|
HC HEART/LUNG RESUSCITATION (CPR)
|
Facility
|
IP
|
$766.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
4609295001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$383.00 |
| Max. Negotiated Rate |
$383.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$383.00
|
|