|
COLONOSCOPY/CONTROL BLEEDING
|
Facility
|
OP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 45382
|
| Hospital Charge Code |
41118205
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| 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 |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,520.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
COLONOSCOPY, DIAGNOSTIC
|
Facility
|
OP
|
$2,313.60
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
30300013
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$222.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,056.92
|
| Rate for Payer: Aetna Government |
$1,056.92
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$739.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$739.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$739.84
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,056.92
|
| 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 |
$1,056.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$898.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$940.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,056.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$940.66
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,156.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,056.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$898.38
|
| Rate for Payer: Healthfirst QHP |
$1,056.92
|
| Rate for Payer: Humana Medicare |
$1,078.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,056.92
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,056.92
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,056.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,056.92
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$845.54
|
| Rate for Payer: Wellcare Medicare |
$1,004.07
|
|
|
COLONOSCOPY, DIAGNOSTIC
|
Facility
|
IP
|
$2,313.60
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
40000044
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,056.92
|
|
|
COLONOSCOPY, DIAGNOSTIC
|
Facility
|
OP
|
$2,313.60
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
40000044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$739.84 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,056.92
|
| Rate for Payer: Aetna Government |
$1,056.92
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$739.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$739.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$739.84
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,056.92
|
| 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 |
$1,056.92
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$898.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$940.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,056.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$940.66
|
| Rate for Payer: Group Health Inc Commercial |
$1,056.92
|
| Rate for Payer: Group Health Inc Medicare |
$1,056.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,156.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,056.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$898.38
|
| Rate for Payer: Healthfirst QHP |
$1,056.92
|
| Rate for Payer: Humana Medicare |
$1,078.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,056.92
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,056.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,056.92
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$845.54
|
| Rate for Payer: Wellcare Medicare |
$1,004.07
|
|
|
COLONOSCOPY, DIAGNOSTIC
|
Facility
|
IP
|
$2,313.60
|
|
|
Service Code
|
HCPCS 45378
|
| Hospital Charge Code |
30300013
|
|
Hospital Revenue Code
|
510
|
| Rate for Payer: Cash Price |
$1,056.92
|
|
|
Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 45378
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$739.84 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,056.92
|
| Rate for Payer: Aetna Government |
$1,056.92
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$739.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$739.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$739.84
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,056.92
|
| 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 |
$1,056.92
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$898.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$940.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,056.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$940.66
|
| Rate for Payer: Group Health Inc Commercial |
$1,056.92
|
| Rate for Payer: Group Health Inc Medicare |
$1,056.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,056.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$898.38
|
| Rate for Payer: Healthfirst QHP |
$1,056.92
|
| Rate for Payer: Humana Medicare |
$1,078.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,056.92
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,056.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,056.92
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$845.54
|
| Rate for Payer: Wellcare Medicare |
$1,004.07
|
|
|
Colonoscopy, flexible; with biopsy, single or multiple
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 45380
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| 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 |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
Colonoscopy, flexible; with control of bleeding, any method
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 45382
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| 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 |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
Colonoscopy, flexible; with directed submucosal injection(s), any substance
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 45381
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| 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 |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
Colonoscopy, flexible; with endoscopic mucosal resection
|
Facility
|
OP
|
$3,311.93
|
|
|
Service Code
|
CPT 45390
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$3,311.93 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,246.99
|
| Rate for Payer: Aetna Government |
$3,246.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,272.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,272.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,272.89
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,246.99
|
| 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 |
$3,246.99
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,759.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,889.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,246.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,889.82
|
| Rate for Payer: Group Health Inc Commercial |
$3,246.99
|
| Rate for Payer: Group Health Inc Medicare |
$3,246.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,246.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,759.94
|
| Rate for Payer: Healthfirst QHP |
$3,246.99
|
| Rate for Payer: Humana Medicare |
$3,311.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,246.99
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,246.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,246.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,597.59
|
| Rate for Payer: Wellcare Medicare |
$3,084.64
|
|
|
Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 45385
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| 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 |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
COLONOSCOPY SUBMUCOUS
|
Facility
|
OP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 45381
|
| Hospital Charge Code |
41114202
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| 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 |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,520.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
COLONOSCOPY SUBMUCOUS
|
Facility
|
IP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 45381
|
| Hospital Charge Code |
41114202
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,364.66
|
|
|
COLONOSCOPY THROUGH STOMA
|
Facility
|
OP
|
$2,313.60
|
|
|
Service Code
|
HCPCS 44388
|
| Hospital Charge Code |
40019916
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$739.84 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,056.92
|
| Rate for Payer: Aetna Government |
$1,056.92
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$739.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$739.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$739.84
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,056.92
|
| 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 |
$1,056.92
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$898.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$940.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,056.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$940.66
|
| Rate for Payer: Group Health Inc Commercial |
$1,056.92
|
| Rate for Payer: Group Health Inc Medicare |
$1,056.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,156.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,056.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$898.38
|
| Rate for Payer: Healthfirst QHP |
$1,056.92
|
| Rate for Payer: Humana Medicare |
$1,078.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,056.92
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,056.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,056.92
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$845.54
|
| Rate for Payer: Wellcare Medicare |
$1,004.07
|
|
|
COLONOSCOPY THROUGH STOMA
|
Facility
|
IP
|
$2,313.60
|
|
|
Service Code
|
HCPCS 44388
|
| Hospital Charge Code |
40019916
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,056.92
|
|
|
COLONOSCOPY W/ABLATION
|
Facility
|
IP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
41118919
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,364.66
|
|
|
COLONOSCOPY W/ABLATION
|
Facility
|
OP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 45388
|
| Hospital Charge Code |
41118919
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| 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 |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,520.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
COLONOSCOPY W/ENDOSCOPE US
|
Facility
|
IP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 45391
|
| Hospital Charge Code |
41112834
|
|
Hospital Revenue Code
|
750
|
| Rate for Payer: Cash Price |
$1,364.66
|
|
|
COLONOSCOPY W/ENDOSCOPE US
|
Facility
|
OP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 45391
|
| Hospital Charge Code |
41112834
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| 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 |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,520.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
COLONOSCOPY W/ENDOSCOPIC FNB
|
Facility
|
IP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 45392
|
| Hospital Charge Code |
41112835
|
|
Hospital Revenue Code
|
750
|
| Rate for Payer: Cash Price |
$1,364.66
|
|
|
COLONOSCOPY W/ENDOSCOPIC FNB
|
Facility
|
OP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 45392
|
| Hospital Charge Code |
41112835
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| 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 |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,520.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
COLONOSCOPY W/FB REMOVAL
|
Facility
|
IP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 45379
|
| Hospital Charge Code |
41118926
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,364.66
|
|
|
COLONOSCOPY W/FB REMOVAL
|
Facility
|
OP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 45379
|
| Hospital Charge Code |
41118926
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| 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 |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,520.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
COLONOSCOPY WITH BIOPSY
|
Facility
|
IP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 44389
|
| Hospital Charge Code |
40019704
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,364.66
|
|
|
COLONOSCOPY WITH BIOPSY
|
Facility
|
OP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 44389
|
| Hospital Charge Code |
40019704
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$955.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$955.00
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| 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 |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,520.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
