|
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm)
|
Facility
OP
|
$4,031.47
|
|
|
Service Code
|
CPT 52235
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$307.06 |
| Max. Negotiated Rate |
$4,031.47 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,031.47
|
| Rate for Payer: Aetna Government |
$4,031.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,031.47
|
| 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 |
$4,031.47
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$307.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,426.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,588.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,031.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,588.01
|
| Rate for Payer: Group Health Inc Commercial |
$4,031.47
|
| Rate for Payer: Group Health Inc Medicare |
$4,031.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,031.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$341.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,426.75
|
| Rate for Payer: Healthfirst QHP |
$4,031.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,031.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,031.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,225.18
|
| Rate for Payer: Wellcare Medicare |
$3,829.90
|
|
|
Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-J type)
|
Facility
OP
|
$4,031.47
|
|
|
Service Code
|
CPT 52332
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$166.46 |
| Max. Negotiated Rate |
$4,031.47 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,031.47
|
| Rate for Payer: Aetna Government |
$4,031.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,031.47
|
| 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 |
$4,031.47
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$166.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,426.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,588.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,031.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,588.01
|
| Rate for Payer: Group Health Inc Commercial |
$4,031.47
|
| Rate for Payer: Group Health Inc Medicare |
$4,031.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,031.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$184.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,426.75
|
| Rate for Payer: Healthfirst QHP |
$4,031.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,031.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,031.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,225.18
|
| Rate for Payer: Wellcare Medicare |
$3,829.90
|
|
|
Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 52310
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$162.07 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,355.42
|
| Rate for Payer: Aetna Government |
$2,355.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,355.42
|
| 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 |
$2,355.42
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$162.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,002.11
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,096.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,355.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,096.32
|
| Rate for Payer: Group Health Inc Commercial |
$2,355.42
|
| Rate for Payer: Group Health Inc Medicare |
$2,355.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,355.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$180.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,002.11
|
| Rate for Payer: Healthfirst QHP |
$2,355.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,355.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,355.42
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,884.34
|
| Rate for Payer: Wellcare Medicare |
$2,237.65
|
|
|
Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)
|
Facility
OP
|
$4,031.47
|
|
|
Service Code
|
CPT 52341
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$303.06 |
| Max. Negotiated Rate |
$4,031.47 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,031.47
|
| Rate for Payer: Aetna Government |
$4,031.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,031.47
|
| 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 |
$4,031.47
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$303.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,426.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,588.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,031.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,588.01
|
| Rate for Payer: Group Health Inc Commercial |
$4,031.47
|
| Rate for Payer: Group Health Inc Medicare |
$4,031.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,031.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$336.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,426.75
|
| Rate for Payer: Healthfirst QHP |
$4,031.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,031.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,031.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,225.18
|
| Rate for Payer: Wellcare Medicare |
$3,829.90
|
|
|
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)
|
Facility
OP
|
$5,983.74
|
|
|
Service Code
|
CPT 52356
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$441.30 |
| Max. Negotiated Rate |
$5,983.74 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5,983.74
|
| Rate for Payer: Aetna Government |
$5,983.74
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5,983.74
|
| 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 |
$5,983.74
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$441.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,086.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,325.53
|
| Rate for Payer: Fidelis Medicare Advantage |
$5,983.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,325.53
|
| Rate for Payer: Group Health Inc Commercial |
$5,983.74
|
| Rate for Payer: Group Health Inc Medicare |
$5,983.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,983.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$490.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,086.18
|
| Rate for Payer: Healthfirst QHP |
$5,983.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5,983.74
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5,983.74
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4,786.99
|
| Rate for Payer: Wellcare Medicare |
$5,684.55
|
|
|
CYSTO W/URETER STRICTURE
|
Facility
OP
|
$9,142.40
|
|
|
Service Code
|
HCPCS 52341
|
| Hospital Charge Code |
40124280
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$303.06 |
| Max. Negotiated Rate |
$4,571.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,031.47
|
| Rate for Payer: Aetna Government |
$4,031.47
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,031.47
|
| 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 |
$4,031.47
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$303.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,426.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,588.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,031.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,588.01
|
| Rate for Payer: Group Health Inc Commercial |
$4,031.47
|
| Rate for Payer: Group Health Inc Medicare |
$4,031.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,571.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,031.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$336.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,426.75
|
| Rate for Payer: Healthfirst QHP |
$4,031.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,031.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,031.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,225.18
|
| Rate for Payer: Wellcare Medicare |
$3,829.90
|
|
|
CYSTSCOPE RIGID 30D 4 / 280MML
|
Facility
OP
|
$1,250.00
|
|
| Hospital Charge Code |
64905755
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$437.50 |
| Max. Negotiated Rate |
$1,000.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$687.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$625.00
|
| Rate for Payer: Aetna Government |
$625.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,000.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$850.00
|
| Rate for Payer: Group Health Inc Commercial |
$625.00
|
| Rate for Payer: Group Health Inc Medicare |
$437.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$625.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$625.00
|
|
|
CYTARABINE 100 MG/5 ML INJ
|
Facility
IP
|
$17.00
|
|
|
Service Code
|
HCPCS J9100
|
| Hospital Charge Code |
41653284
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$8.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.50
|
|
|
CYTARABINE 100 MG/5 ML INJ
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
HCPCS J9100
|
| Hospital Charge Code |
41643284
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$11.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.68
|
| Rate for Payer: Aetna Government |
$0.68
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$0.83
|
| Rate for Payer: Group Health Inc Commercial |
$8.50
|
| Rate for Payer: Group Health Inc Medicare |
$5.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.97
|
| Rate for Payer: SOMOS Essential |
$0.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.05
|
|
|
CYTARABINE 100 MG/5 ML INJ
|
Facility
OP
|
$17.00
|
|
|
Service Code
|
HCPCS J9100
|
| Hospital Charge Code |
41653284
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.68 |
| Max. Negotiated Rate |
$11.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.68
|
| Rate for Payer: Aetna Government |
$0.68
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$0.83
|
| Rate for Payer: Group Health Inc Commercial |
$8.50
|
| Rate for Payer: Group Health Inc Medicare |
$5.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.97
|
| Rate for Payer: SOMOS Essential |
$0.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.05
|
|
|
CYTARABINE 100 MG/5 ML INJ
|
Facility
IP
|
$17.00
|
|
|
Service Code
|
HCPCS J9100
|
| Hospital Charge Code |
41643284
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$8.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.50
|
|
|
CYTOGENETICS 25-99
|
Facility
OP
|
$105.95
|
|
|
Service Code
|
HCPCS 88274
|
| Hospital Charge Code |
30305617
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.90 |
| Max. Negotiated Rate |
$58.27 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$58.27
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$42.38
|
| Rate for Payer: Aetna Government |
$42.38
|
| Rate for Payer: Brighton Health Commercial |
$42.38
|
| Rate for Payer: Cash Price |
$42.38
|
| Rate for Payer: Cash Price |
$42.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$42.38
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$55.33
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$46.82
|
| Rate for Payer: Elderplan Medicare Advantage |
$42.38
|
| Rate for Payer: EmblemHealth Commercial |
$42.38
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$38.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$37.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$42.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$37.72
|
| Rate for Payer: Group Health Inc Commercial |
$42.38
|
| Rate for Payer: Group Health Inc Medicare |
$42.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$52.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$42.38
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$42.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$42.38
|
| Rate for Payer: Healthfirst QHP |
$42.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$42.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$42.38
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$33.90
|
| Rate for Payer: Wellcare Medicare |
$38.14
|
|
|
CYTOLOGY
|
Facility
OP
|
$101.25
|
|
|
Service Code
|
HCPCS 88104 TC
|
| Hospital Charge Code |
40635413
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$35.44 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$55.69
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$50.62
|
| Rate for Payer: Aetna Government |
$50.62
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$81.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$68.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$47.61
|
| Rate for Payer: Group Health Inc Commercial |
$50.62
|
| Rate for Payer: Group Health Inc Medicare |
$35.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$50.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$52.90
|
|
|
CYTOLOGY SAMPLE COLLECTION
|
Facility
OP
|
$150.00
|
|
|
Service Code
|
HCPCS D7287
|
| Hospital Charge Code |
42303447
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$44.15 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$82.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$44.15
|
| Rate for Payer: Aetna Government |
$44.15
|
| 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: Group Health Inc Commercial |
$75.00
|
| Rate for Payer: Group Health Inc Medicare |
$52.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$75.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$75.00
|
|
|
CYTOMEGALOV AMPLIF NA PROBE
|
Facility
OP
|
$87.73
|
|
|
Service Code
|
HCPCS 87496
|
| Hospital Charge Code |
30305720
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.07 |
| Max. Negotiated Rate |
$55.78 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$48.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$35.09
|
| Rate for Payer: Aetna Government |
$35.09
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$35.09
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$55.78
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$47.20
|
| Rate for Payer: Elderplan Medicare Advantage |
$35.09
|
| Rate for Payer: EmblemHealth Commercial |
$35.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$31.58
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$29.83
|
| Rate for Payer: Fidelis Essential Plan QHP |
$31.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$35.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31.23
|
| Rate for Payer: Group Health Inc Commercial |
$35.09
|
| Rate for Payer: Group Health Inc Medicare |
$35.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.86
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$35.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$35.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$35.09
|
| Rate for Payer: Healthfirst QHP |
$35.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$35.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$35.09
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$28.07
|
| Rate for Payer: Wellcare Medicare |
$31.58
|
|
|
CYTOMEGALOVIRUS (CMV) AB, IGG
|
Facility
OP
|
$35.98
|
|
|
Service Code
|
HCPCS 86644
|
| Hospital Charge Code |
40729356
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.51 |
| Max. Negotiated Rate |
$22.87 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.39
|
| Rate for Payer: Aetna Government |
$14.39
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$14.39
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22.87
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19.35
|
| Rate for Payer: Elderplan Medicare Advantage |
$14.39
|
| Rate for Payer: EmblemHealth Commercial |
$14.39
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$12.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$12.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$12.81
|
| Rate for Payer: Group Health Inc Commercial |
$14.39
|
| Rate for Payer: Group Health Inc Medicare |
$14.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.39
|
| Rate for Payer: Healthfirst QHP |
$14.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.39
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$11.51
|
| Rate for Payer: Wellcare Medicare |
$12.95
|
|
|
CYTOMEGALOVIRUS (CMV) AB, IGM
|
Facility
OP
|
$42.13
|
|
|
Service Code
|
HCPCS 86645
|
| Hospital Charge Code |
40729357
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.48 |
| Max. Negotiated Rate |
$26.78 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23.17
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.85
|
| Rate for Payer: Aetna Government |
$16.85
|
| Rate for Payer: Cash Price |
$16.85
|
| Rate for Payer: Cash Price |
$16.85
|
| 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 |
$26.78
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$22.66
|
| 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 |
$21.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.85
|
| Rate for Payer: Healthfirst Medicare Advantage |
$16.85
|
| Rate for Payer: Healthfirst QHP |
$16.85
|
| Rate for Payer: Senior Whole Health 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 |
$13.48
|
| Rate for Payer: Wellcare Medicare |
$15.16
|
|
|
CYTOMEGALOVIRUS (CMV) CULTURE
|
Facility
OP
|
$65.18
|
|
|
Service Code
|
HCPCS 87252
|
| Hospital Charge Code |
40619190
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.86 |
| Max. Negotiated Rate |
$41.43 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$35.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$26.07
|
| Rate for Payer: Aetna Government |
$26.07
|
| Rate for Payer: Cash Price |
$26.07
|
| Rate for Payer: Cash Price |
$26.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26.07
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$41.43
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$35.06
|
| Rate for Payer: Elderplan Medicare Advantage |
$26.07
|
| Rate for Payer: EmblemHealth Commercial |
$26.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.20
|
| Rate for Payer: Group Health Inc Commercial |
$26.07
|
| Rate for Payer: Group Health Inc Medicare |
$26.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$26.07
|
| Rate for Payer: Healthfirst QHP |
$26.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20.86
|
| Rate for Payer: Wellcare Medicare |
$23.46
|
|
|
CYTOMEGALOVIRUS IGG AB/CSF
|
Facility
OP
|
$35.98
|
|
|
Service Code
|
HCPCS 86644
|
| Hospital Charge Code |
40717064
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.51 |
| Max. Negotiated Rate |
$22.87 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.39
|
| Rate for Payer: Aetna Government |
$14.39
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$14.39
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22.87
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19.35
|
| Rate for Payer: Elderplan Medicare Advantage |
$14.39
|
| Rate for Payer: EmblemHealth Commercial |
$14.39
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$12.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$12.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$12.81
|
| Rate for Payer: Group Health Inc Commercial |
$14.39
|
| Rate for Payer: Group Health Inc Medicare |
$14.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.39
|
| Rate for Payer: Healthfirst QHP |
$14.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.39
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$11.51
|
| Rate for Payer: Wellcare Medicare |
$12.95
|
|
|
CYTO/MOLECULAR REPORT
|
Facility
OP
|
$58.54
|
|
|
Service Code
|
HCPCS 88291
|
| Hospital Charge Code |
30305613
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$19.57 |
| Max. Negotiated Rate |
$37.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$32.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$19.57
|
| Rate for Payer: Aetna Government |
$19.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$33.01
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$33.68
|
| Rate for Payer: Group Health Inc Commercial |
$29.27
|
| Rate for Payer: Group Health Inc Medicare |
$20.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$37.42
|
|
|
CYTOPATH CELL ENHANCE TECH
|
Facility
OP
|
$149.83
|
|
|
Service Code
|
HCPCS 88112
|
| Hospital Charge Code |
40635498
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$82.41 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$82.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$62.66
|
| Rate for Payer: Aetna Government |
$62.66
|
| Rate for Payer: Brighton Health Commercial |
$62.66
|
| Rate for Payer: Cash Price |
$62.66
|
| Rate for Payer: Cash Price |
$62.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$62.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$52.21
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$44.18
|
| Rate for Payer: Elderplan Medicare Advantage |
$62.66
|
| Rate for Payer: EmblemHealth Commercial |
$62.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$71.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$53.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$55.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$62.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$55.77
|
| Rate for Payer: Group Health Inc Commercial |
$62.66
|
| Rate for Payer: Group Health Inc Medicare |
$62.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$74.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$62.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$79.51
|
| Rate for Payer: Healthfirst Medicare Advantage |
$62.66
|
| Rate for Payer: Healthfirst QHP |
$62.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$62.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$62.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$50.13
|
| Rate for Payer: Wellcare Medicare |
$56.39
|
|
|
CYTOPATH CONCENTRATE TECH
|
Facility
OP
|
$101.25
|
|
|
Service Code
|
HCPCS 88108
|
| Hospital Charge Code |
40635407
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$37.10 |
| Max. Negotiated Rate |
$79.33 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$55.69
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$46.38
|
| Rate for Payer: Aetna Government |
$46.38
|
| Rate for Payer: Brighton Health Commercial |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$46.38
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$54.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$46.11
|
| Rate for Payer: Elderplan Medicare Advantage |
$46.38
|
| Rate for Payer: EmblemHealth Commercial |
$46.38
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$71.40
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$39.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$41.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$46.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41.28
|
| Rate for Payer: Group Health Inc Commercial |
$46.38
|
| Rate for Payer: Group Health Inc Medicare |
$46.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$46.38
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$79.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$46.38
|
| Rate for Payer: Healthfirst QHP |
$46.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$46.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$46.38
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$37.10
|
| Rate for Payer: Wellcare Medicare |
$41.74
|
|
|
CYTOPATH C/V AUTO FLUID REDO
|
Facility
OP
|
$104.92
|
|
|
Service Code
|
HCPCS 88175
|
| Hospital Charge Code |
40618029
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$21.29 |
| Max. Negotiated Rate |
$57.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$57.71
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$26.61
|
| Rate for Payer: Aetna Government |
$26.61
|
| Rate for Payer: Brighton Health Commercial |
$26.61
|
| Rate for Payer: Cash Price |
$26.61
|
| Rate for Payer: Cash Price |
$26.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26.61
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$42.11
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$35.63
|
| Rate for Payer: Elderplan Medicare Advantage |
$26.61
|
| Rate for Payer: EmblemHealth Commercial |
$26.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.68
|
| Rate for Payer: Group Health Inc Commercial |
$26.61
|
| Rate for Payer: Group Health Inc Medicare |
$26.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$52.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$26.61
|
| Rate for Payer: Healthfirst QHP |
$26.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.61
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$21.29
|
| Rate for Payer: Wellcare Medicare |
$23.95
|
|
|
CYTOPATH FLUID, WASHINGS, ETC
|
Facility
OP
|
$101.25
|
|
|
Service Code
|
HCPCS 88104 TC
|
| Hospital Charge Code |
40635466
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$35.44 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$55.69
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$50.62
|
| Rate for Payer: Aetna Government |
$50.62
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$81.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$68.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$47.61
|
| Rate for Payer: Group Health Inc Commercial |
$50.62
|
| Rate for Payer: Group Health Inc Medicare |
$35.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$50.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$52.90
|
|
|
Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 88174
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$20.30 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$25.37
|
| Rate for Payer: Aetna Government |
$25.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25.37
|
| 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 |
$25.37
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22.83
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.58
|
| Rate for Payer: Group Health Inc Commercial |
$25.37
|
| Rate for Payer: Group Health Inc Medicare |
$25.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21.56
|
| Rate for Payer: Healthfirst QHP |
$25.37
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.37
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20.30
|
| Rate for Payer: Wellcare Medicare |
$24.10
|
|
