|
HC IAAD IA MULT STEP METHOD NOS EACH ORGANISM, L. PNEUMOPHILA SEROGP 1 UR AG
|
Facility
|
OP
|
$29.00
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
3068744902
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$21.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.98
|
| Rate for Payer: Aetna Government |
$11.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.39
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.39
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.39
|
| Rate for Payer: Brighton Health Commercial |
$21.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.38
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.15
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.98
|
| Rate for Payer: EmblemHealth Commercial |
$11.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.66
|
| Rate for Payer: Group Health Inc Commercial |
$11.98
|
| Rate for Payer: Group Health Inc Medicare |
$11.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.25
|
| Rate for Payer: Healthfirst Essential Plan |
$11.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.98
|
| Rate for Payer: Healthfirst QHP |
$11.98
|
| Rate for Payer: Humana Medicare |
$12.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.98
|
| Rate for Payer: United Healthcare Commercial |
$15.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.25
|
| Rate for Payer: Wellcare Medicare |
$10.78
|
|
|
HC IAAD IA QUAL/SEMIQUAN MULTIPLE STEP ASPERGILLUS - ASPERGILLUS GALACT
|
Facility
|
IP
|
$517.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
3068730501
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$258.50 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$258.50
|
|
|
HC IAAD IA QUAL/SEMIQUAN MULTIPLE STEP ASPERGILLUS - ASPERGILLUS GALACT
|
Facility
|
OP
|
$517.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
3068730501
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$387.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$284.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.98
|
| Rate for Payer: Aetna Government |
$11.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.39
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.39
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.39
|
| Rate for Payer: Brighton Health Commercial |
$387.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.38
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.15
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.98
|
| Rate for Payer: EmblemHealth Commercial |
$11.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.66
|
| Rate for Payer: Group Health Inc Commercial |
$11.98
|
| Rate for Payer: Group Health Inc Medicare |
$11.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.11
|
| Rate for Payer: Healthfirst Essential Plan |
$18.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.98
|
| Rate for Payer: Healthfirst QHP |
$11.98
|
| Rate for Payer: Humana Medicare |
$12.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.98
|
| Rate for Payer: United Healthcare Commercial |
$15.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.11
|
| Rate for Payer: Wellcare Medicare |
$10.78
|
|
|
HC IAAD IA RESPIRATORY SYNCTIAL VIRUS - RSV RAPID ANTIGEN SCREEN
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT 87420
|
| Hospital Charge Code |
3068742001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$17.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.00
|
|
|
HC IAAD IA RESPIRATORY SYNCTIAL VIRUS - RSV RAPID ANTIGEN SCREEN
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 87420
|
| Hospital Charge Code |
3068742001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.11 |
| Max. Negotiated Rate |
$25.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$18.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13.91
|
| Rate for Payer: Aetna Government |
$13.91
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.74
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.74
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.74
|
| Rate for Payer: Brighton Health Commercial |
$25.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$13.91
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.38
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.15
|
| Rate for Payer: Elderplan Medicare Advantage |
$13.91
|
| Rate for Payer: EmblemHealth Commercial |
$13.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$12.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$12.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$13.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$12.38
|
| Rate for Payer: Group Health Inc Commercial |
$13.91
|
| Rate for Payer: Group Health Inc Medicare |
$13.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$13.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.11
|
| Rate for Payer: Healthfirst Essential Plan |
$18.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.91
|
| Rate for Payer: Healthfirst QHP |
$13.91
|
| Rate for Payer: Humana Medicare |
$14.19
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$13.91
|
| Rate for Payer: United Healthcare Commercial |
$15.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$13.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.91
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8.11
|
| Rate for Payer: Wellcare Medicare |
$12.52
|
|
|
HC IAAD IA ROTAVIRUS - ROTAVIRUS ANTIGEN
|
Facility
|
OP
|
$29.00
|
|
|
Service Code
|
CPT 87425
|
| Hospital Charge Code |
3068742501
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.39 |
| Max. Negotiated Rate |
$26.95 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.98
|
| Rate for Payer: Aetna Government |
$11.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.39
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.39
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.39
|
| Rate for Payer: Brighton Health Commercial |
$21.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.38
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.15
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.98
|
| Rate for Payer: EmblemHealth Commercial |
$11.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.66
|
| Rate for Payer: Group Health Inc Commercial |
$11.98
|
| Rate for Payer: Group Health Inc Medicare |
$11.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$11.98
|
| Rate for Payer: Healthfirst Essential Plan |
$26.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.98
|
| Rate for Payer: Healthfirst QHP |
$11.98
|
| Rate for Payer: Humana Medicare |
$12.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.98
|
| Rate for Payer: United Healthcare Commercial |
$15.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$11.98
|
| Rate for Payer: Wellcare Medicare |
$10.78
|
|
|
HC IAAD IA ROTAVIRUS - ROTAVIRUS ANTIGEN
|
Facility
|
IP
|
$29.00
|
|
|
Service Code
|
CPT 87425
|
| Hospital Charge Code |
3068742501
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.50 |
| Max. Negotiated Rate |
$14.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.50
|
|
|
HC IAAD IA SHIGA-LIKE TOXIN - SHIGA-LIKE TOXIN ANTIGEN, EIA
|
Facility
|
IP
|
$29.00
|
|
|
Service Code
|
CPT 87427
|
| Hospital Charge Code |
3068742701
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.50 |
| Max. Negotiated Rate |
$14.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.50
|
|
|
HC IAAD IA SHIGA-LIKE TOXIN - SHIGA-LIKE TOXIN ANTIGEN, EIA
|
Facility
|
OP
|
$29.00
|
|
|
Service Code
|
CPT 87427
|
| Hospital Charge Code |
3068742701
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.39 |
| Max. Negotiated Rate |
$26.95 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.98
|
| Rate for Payer: Aetna Government |
$11.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.39
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.39
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.39
|
| Rate for Payer: Brighton Health Commercial |
$21.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.38
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.15
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.98
|
| Rate for Payer: EmblemHealth Commercial |
$11.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.66
|
| Rate for Payer: Group Health Inc Commercial |
$11.98
|
| Rate for Payer: Group Health Inc Medicare |
$11.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$11.98
|
| Rate for Payer: Healthfirst Essential Plan |
$26.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.98
|
| Rate for Payer: Healthfirst QHP |
$11.98
|
| Rate for Payer: Humana Medicare |
$12.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.98
|
| Rate for Payer: United Healthcare Commercial |
$15.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$11.98
|
| Rate for Payer: Wellcare Medicare |
$10.78
|
|
|
HC IAAD IA TECHNIQUE, RAPID STREP
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
CPT 87430
|
| Hospital Charge Code |
3068743001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.00
|
|
|
HC IAAD IA TECHNIQUE, RAPID STREP
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87430
|
| Hospital Charge Code |
3068743001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.25 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.81
|
| Rate for Payer: Aetna Government |
$16.81
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$11.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$11.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$11.77
|
| Rate for Payer: Brighton Health Commercial |
$31.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.81
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.38
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.15
|
| Rate for Payer: Elderplan Medicare Advantage |
$16.81
|
| Rate for Payer: EmblemHealth Commercial |
$16.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$15.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$14.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$14.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$16.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$14.96
|
| Rate for Payer: Group Health Inc Commercial |
$16.81
|
| Rate for Payer: Group Health Inc Medicare |
$16.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.25
|
| Rate for Payer: Healthfirst Essential Plan |
$11.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$16.81
|
| Rate for Payer: Healthfirst QHP |
$16.81
|
| Rate for Payer: Humana Medicare |
$17.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16.81
|
| Rate for Payer: United Healthcare Commercial |
$15.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.81
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.25
|
| Rate for Payer: Wellcare Medicare |
$15.13
|
|
|
HC, IADNA-DNA/RNA PROBE TQ 12-25 - GASTROINTESTINAL PANEL
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
3068750701
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$63.25 |
| Max. Negotiated Rate |
$510.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$63.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$416.78
|
| Rate for Payer: Aetna Government |
$416.78
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$291.75
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$291.75
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$291.75
|
| Rate for Payer: Brighton Health Commercial |
$86.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$416.78
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$92.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$78.20
|
| Rate for Payer: Elderplan Medicare Advantage |
$416.78
|
| Rate for Payer: EmblemHealth Commercial |
$416.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$375.10
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$354.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$370.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$416.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$370.93
|
| Rate for Payer: Group Health Inc Commercial |
$416.78
|
| Rate for Payer: Group Health Inc Medicare |
$416.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$416.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$416.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$416.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$416.78
|
| Rate for Payer: Healthfirst QHP |
$416.78
|
| Rate for Payer: Humana Medicare |
$425.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$416.78
|
| Rate for Payer: United Healthcare Commercial |
$510.46
|
| Rate for Payer: United Healthcare Medicare Advantage |
$416.78
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$416.78
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$395.94
|
| Rate for Payer: Wellcare Medicare |
$375.10
|
|
|
HC, IADNA-DNA/RNA PROBE TQ 12-25 - GASTROINTESTINAL PANEL
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
3068750701
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$57.50 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$57.50
|
|
|
HC IADNA HEPATITIS C AMPLIFIED PROBE&REVRSE TRANSCR - HEPATITIS C GENO
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 87521
|
| Hospital Charge Code |
3068752101
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$78.95 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$47.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$35.09
|
| Rate for Payer: Aetna Government |
$35.09
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$24.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$24.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$24.56
|
| Rate for Payer: Brighton Health Commercial |
$65.25
|
| 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 |
$59.64
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$50.20
|
| 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 |
$35.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$35.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$35.09
|
| Rate for Payer: Healthfirst Essential Plan |
$78.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$35.09
|
| Rate for Payer: Healthfirst QHP |
$35.09
|
| Rate for Payer: Humana Medicare |
$35.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$35.09
|
| Rate for Payer: United Healthcare Commercial |
$44.45
|
| Rate for Payer: United Healthcare 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 |
$35.09
|
| Rate for Payer: Wellcare Medicare |
$31.58
|
|
|
HC IADNA HEPATITIS C AMPLIFIED PROBE&REVRSE TRANSCR - HEPATITIS C GENO
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 87521
|
| Hospital Charge Code |
3068752101
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.50
|
|
|
HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HCV QUANT PCR
|
Facility
|
OP
|
$107.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
3068752201
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.99 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$58.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$42.84
|
| Rate for Payer: Aetna Government |
$42.84
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$29.99
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$29.99
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$29.99
|
| Rate for Payer: Brighton Health Commercial |
$80.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$42.84
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$72.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$61.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$42.84
|
| Rate for Payer: EmblemHealth Commercial |
$42.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$38.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.41
|
| Rate for Payer: Fidelis Essential Plan QHP |
$38.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$42.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$38.13
|
| Rate for Payer: Group Health Inc Commercial |
$42.84
|
| Rate for Payer: Group Health Inc Medicare |
$42.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$42.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$42.84
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$42.84
|
| Rate for Payer: Healthfirst Essential Plan |
$96.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$42.84
|
| Rate for Payer: Healthfirst QHP |
$42.84
|
| Rate for Payer: Humana Medicare |
$43.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$42.84
|
| Rate for Payer: United Healthcare Commercial |
$54.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$42.84
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$42.84
|
| Rate for Payer: Wellcare Medicare |
$38.56
|
|
|
HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HCV QUANT PCR
|
Facility
|
IP
|
$107.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
3068752201
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$53.50 |
| Max. Negotiated Rate |
$53.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$53.50
|
|
|
HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HEPATITIS C BDNA
|
Facility
|
OP
|
$107.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
3068752202
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.99 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$58.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$42.84
|
| Rate for Payer: Aetna Government |
$42.84
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$29.99
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$29.99
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$29.99
|
| Rate for Payer: Brighton Health Commercial |
$80.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$42.84
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$72.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$61.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$42.84
|
| Rate for Payer: EmblemHealth Commercial |
$42.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$38.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.41
|
| Rate for Payer: Fidelis Essential Plan QHP |
$38.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$42.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$38.13
|
| Rate for Payer: Group Health Inc Commercial |
$42.84
|
| Rate for Payer: Group Health Inc Medicare |
$42.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$42.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$42.84
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$42.84
|
| Rate for Payer: Healthfirst Essential Plan |
$96.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$42.84
|
| Rate for Payer: Healthfirst QHP |
$42.84
|
| Rate for Payer: Humana Medicare |
$43.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$42.84
|
| Rate for Payer: United Healthcare Commercial |
$54.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$42.84
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$42.84
|
| Rate for Payer: Wellcare Medicare |
$38.56
|
|
|
HC IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION - HEPATITIS C BDNA
|
Facility
|
IP
|
$107.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
3068752202
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$53.50 |
| Max. Negotiated Rate |
$53.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$53.50
|
|
|
HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, DIRECT
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
3068762403
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.50
|
|
|
HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV DNA PROBE, DIRECT
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
3068762403
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$69.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$47.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$35.09
|
| Rate for Payer: Aetna Government |
$35.09
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$24.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$24.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$24.56
|
| Rate for Payer: Brighton Health Commercial |
$65.25
|
| 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 |
$69.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$59.16
|
| 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 |
$35.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$35.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28.13
|
| Rate for Payer: Healthfirst Essential Plan |
$63.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$35.09
|
| Rate for Payer: Healthfirst QHP |
$35.09
|
| Rate for Payer: Humana Medicare |
$35.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$35.09
|
| Rate for Payer: United Healthcare Commercial |
$42.98
|
| Rate for Payer: United Healthcare 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 |
$28.13
|
| Rate for Payer: Wellcare Medicare |
$31.58
|
|
|
HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV HIGH RISK PCR
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
3068762402
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$69.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$47.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$35.09
|
| Rate for Payer: Aetna Government |
$35.09
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$24.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$24.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$24.56
|
| Rate for Payer: Brighton Health Commercial |
$65.25
|
| 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 |
$69.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$59.16
|
| 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 |
$35.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$35.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28.13
|
| Rate for Payer: Healthfirst Essential Plan |
$63.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$35.09
|
| Rate for Payer: Healthfirst QHP |
$35.09
|
| Rate for Payer: Humana Medicare |
$35.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$35.09
|
| Rate for Payer: United Healthcare Commercial |
$42.98
|
| Rate for Payer: United Healthcare 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 |
$28.13
|
| Rate for Payer: Wellcare Medicare |
$31.58
|
|
|
HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES - HPV HIGH RISK PCR
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
3068762402
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.50 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.50
|
|
|
HC IA NFCT AB SARSCOV2 COVID19 - POCT KIT COVID-19 ANTIBODIES, IGG AND IGM
|
Facility
|
IP
|
$32.00
|
|
|
Service Code
|
CPT 86328
|
| Hospital Charge Code |
3028632801
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$16.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.00
|
|
|
HC IA NFCT AB SARSCOV2 COVID19 - POCT KIT COVID-19 ANTIBODIES, IGG AND IGM
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 86328
|
| Hospital Charge Code |
3028632801
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$61.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$45.28
|
| Rate for Payer: Aetna Government |
$45.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$31.70
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$31.70
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$31.70
|
| Rate for Payer: Brighton Health Commercial |
$24.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$45.28
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$25.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21.76
|
| Rate for Payer: Elderplan Medicare Advantage |
$45.28
|
| Rate for Payer: EmblemHealth Commercial |
$45.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$40.75
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$38.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$40.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$45.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$40.30
|
| Rate for Payer: Group Health Inc Commercial |
$45.28
|
| Rate for Payer: Group Health Inc Medicare |
$45.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$45.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27.14
|
| Rate for Payer: Healthfirst Essential Plan |
$61.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$45.28
|
| Rate for Payer: Healthfirst QHP |
$45.28
|
| Rate for Payer: Humana Medicare |
$46.19
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$45.28
|
| Rate for Payer: United Healthcare Commercial |
$40.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$45.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$27.14
|
| Rate for Payer: Wellcare Medicare |
$40.75
|
|
