|
HC HEART/LUNG RESUSCITATION (CPR)
|
Facility
|
OP
|
$766.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
4609295001
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$202.50 |
| Max. Negotiated Rate |
$612.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$421.30
|
| 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 |
$574.50
|
| 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 |
$612.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$520.88
|
| Rate for Payer: Elderplan Medicare Advantage |
$380.47
|
| Rate for Payer: EmblemHealth Commercial |
$380.47
|
| 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 |
$380.47
|
| Rate for Payer: Group Health Inc Medicare |
$380.47
|
| 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 |
$202.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$323.40
|
| Rate for Payer: Healthfirst QHP |
$380.47
|
| Rate for Payer: Humana Medicare |
$388.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$380.47
|
| Rate for Payer: United Healthcare Commercial |
$383.00
|
| 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
|
OP
|
$766.00
|
|
|
Service Code
|
CPT 92950
|
| Hospital Charge Code |
4809295001
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$202.50 |
| Max. Negotiated Rate |
$612.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$421.30
|
| 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 |
$574.50
|
| 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 |
$612.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$520.88
|
| Rate for Payer: Elderplan Medicare Advantage |
$380.47
|
| Rate for Payer: EmblemHealth Commercial |
$380.47
|
| 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 |
$380.47
|
| Rate for Payer: Group Health Inc Medicare |
$380.47
|
| 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 |
$202.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$323.40
|
| Rate for Payer: Healthfirst QHP |
$380.47
|
| Rate for Payer: Humana Medicare |
$388.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$380.47
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| 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 |
4809295001
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$383.00 |
| Max. Negotiated Rate |
$383.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$383.00
|
|
|
HC HEART MUSCLE IMAGING (PET) - NM PET MYOCARDIAL METABOLIC EVALUATION
|
Facility
|
IP
|
$3,939.00
|
|
|
Service Code
|
CPT 78459 TC
|
| Hospital Charge Code |
4047845901
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$1,969.50 |
| Max. Negotiated Rate |
$1,969.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,969.50
|
|
|
HC HEART MUSCLE IMAGING (PET) - NM PET MYOCARDIAL METABOLIC EVALUATION
|
Facility
|
OP
|
$3,939.00
|
|
|
Service Code
|
CPT 78459 TC
|
| Hospital Charge Code |
4047845901
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$342.00 |
| Max. Negotiated Rate |
$2,954.25 |
| 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 |
$2,954.25
|
| 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 |
$1,969.50
|
| Rate for Payer: Group Health Inc Commercial |
$1,969.50
|
| Rate for Payer: Group Health Inc Medicare |
$1,378.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,969.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,969.50
|
| Rate for Payer: Healthfirst Essential Plan |
$1,090.80
|
| Rate for Payer: United Healthcare Commercial |
$885.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$484.80
|
|
|
HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGA
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
3028667701
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.85
|
| Rate for Payer: Aetna Government |
$16.85
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$11.79
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$11.79
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$11.79
|
| Rate for Payer: Brighton Health Commercial |
$31.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.85
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.64
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.74
|
| Rate for Payer: Elderplan Medicare Advantage |
$16.85
|
| Rate for Payer: EmblemHealth Commercial |
$16.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$15.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$14.32
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$16.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.00
|
| Rate for Payer: Group Health Inc Commercial |
$16.85
|
| Rate for Payer: Group Health Inc Medicare |
$16.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.11
|
| Rate for Payer: Healthfirst Essential Plan |
$18.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$16.85
|
| Rate for Payer: Healthfirst QHP |
$16.85
|
| Rate for Payer: Humana Medicare |
$17.19
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16.85
|
| Rate for Payer: United Healthcare Commercial |
$18.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.85
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.85
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.11
|
| Rate for Payer: Wellcare Medicare |
$15.16
|
|
|
HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGA
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
3028667701
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.00
|
|
|
HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGG
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
3028667702
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.85
|
| Rate for Payer: Aetna Government |
$16.85
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$11.79
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$11.79
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$11.79
|
| Rate for Payer: Brighton Health Commercial |
$31.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.85
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.64
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.74
|
| Rate for Payer: Elderplan Medicare Advantage |
$16.85
|
| Rate for Payer: EmblemHealth Commercial |
$16.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$15.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$14.32
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$16.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.00
|
| Rate for Payer: Group Health Inc Commercial |
$16.85
|
| Rate for Payer: Group Health Inc Medicare |
$16.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.11
|
| Rate for Payer: Healthfirst Essential Plan |
$18.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$16.85
|
| Rate for Payer: Healthfirst QHP |
$16.85
|
| Rate for Payer: Humana Medicare |
$17.19
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16.85
|
| Rate for Payer: United Healthcare Commercial |
$18.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.85
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.85
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.11
|
| Rate for Payer: Wellcare Medicare |
$15.16
|
|
|
HC HELICOBACTER PYLORI - HELICOBACTER PYLORI IGG
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
3028667702
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.00
|
|
|
HC HELMINTH, ANTIBODY - CYSTICERCOSIS ANTIBODY, IGG
|
Facility
|
IP
|
$32.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
3028668201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$16.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.00
|
|
|
HC HELMINTH, ANTIBODY - CYSTICERCOSIS ANTIBODY, IGG
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
3028668201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13.01
|
| Rate for Payer: Aetna Government |
$13.01
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.11
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.11
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.11
|
| Rate for Payer: Brighton Health Commercial |
$24.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$13.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22.11
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18.61
|
| Rate for Payer: Elderplan Medicare Advantage |
$13.01
|
| Rate for Payer: EmblemHealth Commercial |
$13.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.71
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$13.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.58
|
| Rate for Payer: Group Health Inc Commercial |
$13.01
|
| Rate for Payer: Group Health Inc Medicare |
$13.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$13.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13.01
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.01
|
| Rate for Payer: Healthfirst QHP |
$13.01
|
| Rate for Payer: Humana Medicare |
$13.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$13.01
|
| Rate for Payer: United Healthcare Commercial |
$16.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.01
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.36
|
| Rate for Payer: Wellcare Medicare |
$11.71
|
|
|
HC HELMINTH, ANTIBODY - ECHINOCOCCUS ANTIBODY, IGG
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
3028668202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13.01
|
| Rate for Payer: Aetna Government |
$13.01
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.11
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.11
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.11
|
| Rate for Payer: Brighton Health Commercial |
$24.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$13.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22.11
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18.61
|
| Rate for Payer: Elderplan Medicare Advantage |
$13.01
|
| Rate for Payer: EmblemHealth Commercial |
$13.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.71
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$13.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.58
|
| Rate for Payer: Group Health Inc Commercial |
$13.01
|
| Rate for Payer: Group Health Inc Medicare |
$13.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$13.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13.01
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.01
|
| Rate for Payer: Healthfirst QHP |
$13.01
|
| Rate for Payer: Humana Medicare |
$13.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$13.01
|
| Rate for Payer: United Healthcare Commercial |
$16.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.01
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.36
|
| Rate for Payer: Wellcare Medicare |
$11.71
|
|
|
HC HELMINTH, ANTIBODY - ECHINOCOCCUS ANTIBODY, IGG
|
Facility
|
IP
|
$32.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
3028668202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$16.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.00
|
|
|
HC HELMINTH, ANTIBODY - SCHISTOSOMA ANTIBODY, IGG
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
3028668204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13.01
|
| Rate for Payer: Aetna Government |
$13.01
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.11
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.11
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.11
|
| Rate for Payer: Brighton Health Commercial |
$24.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$13.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22.11
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18.61
|
| Rate for Payer: Elderplan Medicare Advantage |
$13.01
|
| Rate for Payer: EmblemHealth Commercial |
$13.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.71
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$13.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.58
|
| Rate for Payer: Group Health Inc Commercial |
$13.01
|
| Rate for Payer: Group Health Inc Medicare |
$13.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$13.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13.01
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.01
|
| Rate for Payer: Healthfirst QHP |
$13.01
|
| Rate for Payer: Humana Medicare |
$13.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$13.01
|
| Rate for Payer: United Healthcare Commercial |
$16.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.01
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.36
|
| Rate for Payer: Wellcare Medicare |
$11.71
|
|
|
HC HELMINTH, ANTIBODY - SCHISTOSOMA ANTIBODY, IGG
|
Facility
|
IP
|
$32.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
3028668204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$16.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.00
|
|
|
HC HELMINTH ANTIBODY - STRONGYLOIDES ANTIBODY, IGG
|
Facility
|
IP
|
$32.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
3028668203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$16.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.00
|
|
|
HC HELMINTH ANTIBODY - STRONGYLOIDES ANTIBODY, IGG
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
3028668203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13.01
|
| Rate for Payer: Aetna Government |
$13.01
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.11
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.11
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.11
|
| Rate for Payer: Brighton Health Commercial |
$24.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$13.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22.11
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18.61
|
| Rate for Payer: Elderplan Medicare Advantage |
$13.01
|
| Rate for Payer: EmblemHealth Commercial |
$13.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.71
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$13.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.58
|
| Rate for Payer: Group Health Inc Commercial |
$13.01
|
| Rate for Payer: Group Health Inc Medicare |
$13.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$13.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13.01
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.01
|
| Rate for Payer: Healthfirst QHP |
$13.01
|
| Rate for Payer: Humana Medicare |
$13.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$13.01
|
| Rate for Payer: United Healthcare Commercial |
$16.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.01
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.36
|
| Rate for Payer: Wellcare Medicare |
$11.71
|
|
|
HC HELMINTH, ANTIBODY - TOXACARA ANTIBODY
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
3028668205
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.11 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13.01
|
| Rate for Payer: Aetna Government |
$13.01
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.11
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.11
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.11
|
| Rate for Payer: Brighton Health Commercial |
$24.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$13.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22.11
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18.61
|
| Rate for Payer: Elderplan Medicare Advantage |
$13.01
|
| Rate for Payer: EmblemHealth Commercial |
$13.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.71
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$13.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.58
|
| Rate for Payer: Group Health Inc Commercial |
$13.01
|
| Rate for Payer: Group Health Inc Medicare |
$13.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$13.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13.01
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.01
|
| Rate for Payer: Healthfirst QHP |
$13.01
|
| Rate for Payer: Humana Medicare |
$13.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$13.01
|
| Rate for Payer: United Healthcare Commercial |
$16.48
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.01
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.36
|
| Rate for Payer: Wellcare Medicare |
$11.71
|
|
|
HC HELMINTH, ANTIBODY - TOXACARA ANTIBODY
|
Facility
|
IP
|
$32.00
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
3028668205
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$16.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.00
|
|
|
HC HEMATOCRIT - HEMATOCRIT
|
Facility
|
IP
|
$5.00
|
|
|
Service Code
|
CPT 85014
|
| Hospital Charge Code |
3058501401
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$2.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.50
|
|
|
HC HEMATOCRIT - HEMATOCRIT
|
Facility
|
OP
|
$5.00
|
|
|
Service Code
|
CPT 85014
|
| Hospital Charge Code |
3058501401
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.66 |
| Max. Negotiated Rate |
$4.54 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.37
|
| Rate for Payer: Aetna Government |
$2.37
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1.66
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1.66
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1.66
|
| Rate for Payer: Brighton Health Commercial |
$3.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2.37
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.38
|
| Rate for Payer: Elderplan Medicare Advantage |
$2.37
|
| Rate for Payer: EmblemHealth Commercial |
$2.37
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2.01
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2.11
|
| Rate for Payer: Fidelis Medicare Advantage |
$2.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2.11
|
| Rate for Payer: Group Health Inc Commercial |
$2.37
|
| Rate for Payer: Group Health Inc Medicare |
$2.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2.02
|
| Rate for Payer: Healthfirst Essential Plan |
$4.54
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2.37
|
| Rate for Payer: Healthfirst QHP |
$2.37
|
| Rate for Payer: Humana Medicare |
$2.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2.37
|
| Rate for Payer: United Healthcare Commercial |
$3.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2.37
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2.02
|
| Rate for Payer: Wellcare Medicare |
$2.13
|
|
|
HC HEMATOLOGY/COAGULATION OTHER - EOSINOPHIL COUNT
|
Facility
|
IP
|
$162.00
|
|
|
Service Code
|
CPT 85999
|
| Hospital Charge Code |
3058599901
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$81.00 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$81.00
|
|
|
HC HEMATOLOGY/COAGULATION OTHER - EOSINOPHIL COUNT
|
Facility
|
OP
|
$162.00
|
|
|
Service Code
|
CPT 85999
|
| Hospital Charge Code |
3058599901
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$121.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$89.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$81.00
|
| Rate for Payer: Aetna Government |
$81.00
|
| Rate for Payer: Brighton Health Commercial |
$121.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.71
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.65
|
| Rate for Payer: EmblemHealth Commercial |
$81.00
|
| Rate for Payer: Group Health Inc Commercial |
$81.00
|
| Rate for Payer: Group Health Inc Medicare |
$56.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$81.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$81.00
|
|
|
HC HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Facility
|
IP
|
$1,938.00
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
8219093501
|
|
Hospital Revenue Code
|
821
|
| Min. Negotiated Rate |
$969.00 |
| Max. Negotiated Rate |
$969.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$969.00
|
|
|
HC HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Facility
|
OP
|
$1,938.00
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
8219093501
|
|
Hospital Revenue Code
|
821
|
| Min. Negotiated Rate |
$76.89 |
| Max. Negotiated Rate |
$1,065.90 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,065.90
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$854.93
|
| Rate for Payer: Aetna Government |
$854.93
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$598.45
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$598.45
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$598.45
|
| Rate for Payer: Brighton Health Commercial |
$649.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$854.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$657.86
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$559.18
|
| Rate for Payer: Elderplan Medicare Advantage |
$854.93
|
| Rate for Payer: EmblemHealth Commercial |
$650.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$150.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$150.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$159.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$854.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$158.00
|
| Rate for Payer: Group Health Inc Commercial |
$650.00
|
| Rate for Payer: Group Health Inc Medicare |
$435.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$854.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$854.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$76.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$726.69
|
| Rate for Payer: Healthfirst QHP |
$854.93
|
| Rate for Payer: Humana Medicare |
$872.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$854.93
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$854.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$854.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$812.18
|
| Rate for Payer: Wellcare Medicare |
$370.00
|
|
