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Service Code HCPCS 83491
Hospital Charge Code 40609884
Hospital Revenue Code 301
Min. Negotiated Rate $14.32
Max. Negotiated Rate $27.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial $24.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $17.90
Rate for Payer: Aetna Government $17.90
Rate for Payer: Cash Price $17.90
Rate for Payer: Cash Price $17.90
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $17.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $27.83
Rate for Payer: Cigna LocalPlus Benefit Plan $23.55
Rate for Payer: Elderplan Medicare Advantage $17.90
Rate for Payer: EmblemHealth Commercial $17.90
Rate for Payer: Fidelis CHP/HARP/Medicaid $16.11
Rate for Payer: Fidelis Essential Plan Aliesa $15.22
Rate for Payer: Fidelis Essential Plan QHP $15.93
Rate for Payer: Fidelis Medicare Advantage $17.90
Rate for Payer: Fidelis Qualified Health Plan $15.93
Rate for Payer: Group Health Inc Commercial $17.90
Rate for Payer: Group Health Inc Medicare $17.90
Rate for Payer: Hamaspik Choice Inc Medicaid $22.38
Rate for Payer: Hamaspik Choice Inc Medicare $17.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid $17.90
Rate for Payer: Healthfirst Medicare Advantage $17.90
Rate for Payer: Healthfirst QHP $17.90
Rate for Payer: Senior Whole Health Medicare Advantage $17.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $17.90
Rate for Payer: Wellcare CHP/FHP/Medicaid $14.32
Rate for Payer: Wellcare Medicare $16.11
Service Code HCPCS 84143
Hospital Charge Code 40609109
Hospital Revenue Code 300
Min. Negotiated Rate $18.25
Max. Negotiated Rate $36.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial $31.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $22.81
Rate for Payer: Aetna Government $22.81
Rate for Payer: Cash Price $22.81
Rate for Payer: Cash Price $22.81
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $22.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $36.30
Rate for Payer: Cigna LocalPlus Benefit Plan $30.71
Rate for Payer: Elderplan Medicare Advantage $22.81
Rate for Payer: EmblemHealth Commercial $22.81
Rate for Payer: Fidelis CHP/HARP/Medicaid $20.53
Rate for Payer: Fidelis Essential Plan Aliesa $19.39
Rate for Payer: Fidelis Essential Plan QHP $20.30
Rate for Payer: Fidelis Medicare Advantage $22.81
Rate for Payer: Fidelis Qualified Health Plan $20.30
Rate for Payer: Group Health Inc Commercial $22.81
Rate for Payer: Group Health Inc Medicare $22.81
Rate for Payer: Hamaspik Choice Inc Medicaid $28.52
Rate for Payer: Hamaspik Choice Inc Medicare $22.81
Rate for Payer: Healthfirst CHP/FHP/Medicaid $22.81
Rate for Payer: Healthfirst Medicare Advantage $22.81
Rate for Payer: Healthfirst QHP $22.81
Rate for Payer: Senior Whole Health Medicare Advantage $22.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $22.81
Rate for Payer: Wellcare CHP/FHP/Medicaid $18.25
Rate for Payer: Wellcare Medicare $20.53
Service Code HCPCS C1713
Hospital Charge Code 40209413
Hospital Revenue Code 278
Min. Negotiated Rate $93.66
Max. Negotiated Rate $280.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial $147.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $133.80
Rate for Payer: Cigna LocalPlus Benefit Plan $153.87
Rate for Payer: Fidelis Medicare Advantage $280.98
Rate for Payer: Group Health Inc Commercial $133.80
Rate for Payer: Group Health Inc Medicare $93.66
Rate for Payer: Hamaspik Choice Inc Medicaid $133.80
Rate for Payer: Hamaspik Choice Inc Medicare $133.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $173.94
Service Code HCPCS C1713
Hospital Charge Code 40209413
Hospital Revenue Code 278
Min. Negotiated Rate $133.80
Max. Negotiated Rate $133.80
Rate for Payer: Hamaspik Choice Inc Medicaid $133.80
Rate for Payer: Hamaspik Choice Inc Medicare $133.80
Service Code HCPCS C1781
Hospital Charge Code 40209798
Hospital Revenue Code 278
Min. Negotiated Rate $69.35
Max. Negotiated Rate $3,349.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,754.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $69.35
Rate for Payer: Aetna Government $69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1,595.00
Rate for Payer: Cigna LocalPlus Benefit Plan $1,834.25
Rate for Payer: Fidelis Medicare Advantage $3,349.50
Rate for Payer: Group Health Inc Commercial $1,595.00
Rate for Payer: Group Health Inc Medicare $1,116.50
Rate for Payer: Hamaspik Choice Inc Medicaid $1,595.00
Rate for Payer: Hamaspik Choice Inc Medicare $1,595.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2,073.50
Service Code HCPCS C1781
Hospital Charge Code 40209798
Hospital Revenue Code 278
Min. Negotiated Rate $1,595.00
Max. Negotiated Rate $1,595.00
Rate for Payer: Hamaspik Choice Inc Medicaid $1,595.00
Rate for Payer: Hamaspik Choice Inc Medicare $1,595.00
Service Code HCPCS C1781
Hospital Charge Code 40209799
Hospital Revenue Code 278
Min. Negotiated Rate $69.35
Max. Negotiated Rate $3,349.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,754.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $69.35
Rate for Payer: Aetna Government $69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1,595.00
Rate for Payer: Cigna LocalPlus Benefit Plan $1,834.25
Rate for Payer: Fidelis Medicare Advantage $3,349.50
Rate for Payer: Group Health Inc Commercial $1,595.00
Rate for Payer: Group Health Inc Medicare $1,116.50
Rate for Payer: Hamaspik Choice Inc Medicaid $1,595.00
Rate for Payer: Hamaspik Choice Inc Medicare $1,595.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2,073.50
Service Code HCPCS C1781
Hospital Charge Code 40209799
Hospital Revenue Code 278
Min. Negotiated Rate $1,595.00
Max. Negotiated Rate $1,595.00
Rate for Payer: Hamaspik Choice Inc Medicaid $1,595.00
Rate for Payer: Hamaspik Choice Inc Medicare $1,595.00
Hospital Charge Code 40200163
Hospital Revenue Code 272
Min. Negotiated Rate $1,365.00
Max. Negotiated Rate $3,120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2,145.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1,950.00
Rate for Payer: Aetna Government $1,950.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $3,120.00
Rate for Payer: Cigna LocalPlus Benefit Plan $2,652.00
Rate for Payer: Group Health Inc Commercial $1,950.00
Rate for Payer: Group Health Inc Medicare $1,365.00
Rate for Payer: Hamaspik Choice Inc Medicaid $1,950.00
Rate for Payer: Hamaspik Choice Inc Medicare $1,950.00
Service Code HCPCS 83498
Hospital Charge Code 40609086
Hospital Revenue Code 300
Min. Negotiated Rate $21.74
Max. Negotiated Rate $43.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial $37.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $27.17
Rate for Payer: Aetna Government $27.17
Rate for Payer: Cash Price $27.17
Rate for Payer: Cash Price $27.17
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $27.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $43.19
Rate for Payer: Cigna LocalPlus Benefit Plan $36.54
Rate for Payer: Elderplan Medicare Advantage $27.17
Rate for Payer: EmblemHealth Commercial $27.17
Rate for Payer: Fidelis CHP/HARP/Medicaid $24.45
Rate for Payer: Fidelis Essential Plan Aliesa $23.09
Rate for Payer: Fidelis Essential Plan QHP $24.18
Rate for Payer: Fidelis Medicare Advantage $27.17
Rate for Payer: Fidelis Qualified Health Plan $24.18
Rate for Payer: Group Health Inc Commercial $27.17
Rate for Payer: Group Health Inc Medicare $27.17
Rate for Payer: Hamaspik Choice Inc Medicaid $34.38
Rate for Payer: Hamaspik Choice Inc Medicare $27.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid $27.17
Rate for Payer: Healthfirst Medicare Advantage $27.17
Rate for Payer: Healthfirst QHP $27.17
Rate for Payer: Senior Whole Health Medicare Advantage $27.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $27.17
Rate for Payer: Wellcare CHP/FHP/Medicaid $21.74
Rate for Payer: Wellcare Medicare $24.45
Service Code HCPCS C1713
Hospital Charge Code 40200587
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $863.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial $452.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $411.00
Rate for Payer: Cigna LocalPlus Benefit Plan $472.65
Rate for Payer: Fidelis Medicare Advantage $863.10
Rate for Payer: Group Health Inc Commercial $411.00
Rate for Payer: Group Health Inc Medicare $287.70
Rate for Payer: Hamaspik Choice Inc Medicaid $411.00
Rate for Payer: Hamaspik Choice Inc Medicare $411.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $534.30
Service Code HCPCS C1713
Hospital Charge Code 40200587
Hospital Revenue Code 278
Min. Negotiated Rate $411.00
Max. Negotiated Rate $411.00
Rate for Payer: Hamaspik Choice Inc Medicaid $411.00
Rate for Payer: Hamaspik Choice Inc Medicare $411.00
Service Code HCPCS C1781
Hospital Charge Code 40209813
Hospital Revenue Code 278
Min. Negotiated Rate $411.00
Max. Negotiated Rate $411.00
Rate for Payer: Hamaspik Choice Inc Medicaid $411.00
Rate for Payer: Hamaspik Choice Inc Medicare $411.00
Service Code HCPCS C1781
Hospital Charge Code 40209813
Hospital Revenue Code 278
Min. Negotiated Rate $69.35
Max. Negotiated Rate $863.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial $452.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $69.35
Rate for Payer: Aetna Government $69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $411.00
Rate for Payer: Cigna LocalPlus Benefit Plan $472.65
Rate for Payer: Fidelis Medicare Advantage $863.10
Rate for Payer: Group Health Inc Commercial $411.00
Rate for Payer: Group Health Inc Medicare $287.70
Rate for Payer: Hamaspik Choice Inc Medicaid $411.00
Rate for Payer: Hamaspik Choice Inc Medicare $411.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $534.30
Service Code HCPCS C1713
Hospital Charge Code 40202751
Hospital Revenue Code 278
Min. Negotiated Rate $135.00
Max. Negotiated Rate $135.00
Rate for Payer: Hamaspik Choice Inc Medicaid $135.00
Rate for Payer: Hamaspik Choice Inc Medicare $135.00
Service Code HCPCS C1713
Hospital Charge Code 40202751
Hospital Revenue Code 278
Min. Negotiated Rate $94.50
Max. Negotiated Rate $283.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $148.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $135.00
Rate for Payer: Cigna LocalPlus Benefit Plan $155.25
Rate for Payer: Fidelis Medicare Advantage $283.50
Rate for Payer: Group Health Inc Commercial $135.00
Rate for Payer: Group Health Inc Medicare $94.50
Rate for Payer: Hamaspik Choice Inc Medicaid $135.00
Rate for Payer: Hamaspik Choice Inc Medicare $135.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $175.50
Service Code HCPCS C1713
Hospital Charge Code 40005308
Hospital Revenue Code 278
Min. Negotiated Rate $58.62
Max. Negotiated Rate $58.62
Rate for Payer: Hamaspik Choice Inc Medicaid $58.62
Rate for Payer: Hamaspik Choice Inc Medicare $58.62
Service Code HCPCS C1713
Hospital Charge Code 40005308
Hospital Revenue Code 278
Min. Negotiated Rate $41.03
Max. Negotiated Rate $134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial $64.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $58.62
Rate for Payer: Cigna LocalPlus Benefit Plan $67.41
Rate for Payer: Fidelis Medicare Advantage $123.10
Rate for Payer: Group Health Inc Commercial $58.62
Rate for Payer: Group Health Inc Medicare $41.03
Rate for Payer: Hamaspik Choice Inc Medicaid $58.62
Rate for Payer: Hamaspik Choice Inc Medicare $58.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $76.21
Service Code HCPCS 99492
Hospital Charge Code 30300186
Hospital Revenue Code 900
Min. Negotiated Rate $82.46
Max. Negotiated Rate $190.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial $130.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $103.08
Rate for Payer: Aetna Government $103.08
Rate for Payer: Cash Price $103.08
Rate for Payer: Cash Price $103.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $103.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $190.30
Rate for Payer: Cigna LocalPlus Benefit Plan $161.76
Rate for Payer: Elderplan Medicare Advantage $103.08
Rate for Payer: EmblemHealth Commercial $103.08
Rate for Payer: Fidelis CHP/HARP/Medicaid $96.34
Rate for Payer: Fidelis Essential Plan Aliesa $87.62
Rate for Payer: Fidelis Essential Plan QHP $91.74
Rate for Payer: Fidelis Medicare Advantage $103.08
Rate for Payer: Fidelis Qualified Health Plan $91.74
Rate for Payer: Group Health Inc Commercial $103.08
Rate for Payer: Group Health Inc Medicare $103.08
Rate for Payer: Hamaspik Choice Inc Medicaid $118.94
Rate for Payer: Hamaspik Choice Inc Medicare $103.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid $107.05
Rate for Payer: Healthfirst Medicare Advantage $87.62
Rate for Payer: Healthfirst QHP $103.08
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage $103.08
Rate for Payer: Senior Whole Health Medicare Advantage $103.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $103.08
Rate for Payer: Wellcare CHP/FHP/Medicaid $82.46
Rate for Payer: Wellcare Medicare $97.93
Service Code HCPCS 99494
Hospital Charge Code 30300188
Hospital Revenue Code 900
Min. Negotiated Rate $32.00
Max. Negotiated Rate $90.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $61.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $32.00
Rate for Payer: Aetna Government $32.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $90.00
Rate for Payer: Cigna LocalPlus Benefit Plan $76.50
Rate for Payer: Fidelis CHP/HARP/Medicaid $42.46
Rate for Payer: Group Health Inc Commercial $56.25
Rate for Payer: Group Health Inc Medicare $39.38
Rate for Payer: Hamaspik Choice Inc Medicaid $56.25
Rate for Payer: Hamaspik Choice Inc Medicare $56.25
Rate for Payer: Healthfirst CHP/FHP/Medicaid $47.18
Service Code HCPCS P9010
Hospital Charge Code 40701001
Hospital Revenue Code 382
Min. Negotiated Rate $192.62
Max. Negotiated Rate $308.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial $211.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $246.51
Rate for Payer: Aetna Government $246.51
Rate for Payer: Brighton Health Commercial $246.51
Rate for Payer: Cash Price $246.51
Rate for Payer: Cash Price $246.51
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $246.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $308.20
Rate for Payer: Cigna LocalPlus Benefit Plan $261.97
Rate for Payer: Elderplan Medicare Advantage $246.51
Rate for Payer: EmblemHealth Commercial $246.51
Rate for Payer: Fidelis Essential Plan Aliesa $209.53
Rate for Payer: Fidelis Essential Plan QHP $219.39
Rate for Payer: Fidelis Medicare Advantage $246.51
Rate for Payer: Fidelis Qualified Health Plan $219.39
Rate for Payer: Group Health Inc Commercial $246.51
Rate for Payer: Group Health Inc Medicare $246.51
Rate for Payer: Hamaspik Choice Inc Medicaid $192.62
Rate for Payer: Hamaspik Choice Inc Medicare $246.51
Rate for Payer: Healthfirst Medicare Advantage $209.53
Rate for Payer: Healthfirst QHP $246.51
Rate for Payer: Senior Whole Health Medicare Advantage $246.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $246.51
Rate for Payer: Wellcare CHP/FHP/Medicaid $197.21
Rate for Payer: Wellcare Medicare $221.86
Service Code HCPCS 86927
Hospital Charge Code 40701011
Hospital Revenue Code 300
Min. Negotiated Rate $12.66
Max. Negotiated Rate $252.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial $252.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $197.52
Rate for Payer: Aetna Government $197.52
Rate for Payer: Cash Price $197.52
Rate for Payer: Cash Price $197.52
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $197.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $14.96
Rate for Payer: Cigna LocalPlus Benefit Plan $12.66
Rate for Payer: Elderplan Medicare Advantage $197.52
Rate for Payer: EmblemHealth Commercial $197.52
Rate for Payer: Fidelis Essential Plan Aliesa $167.89
Rate for Payer: Fidelis Essential Plan QHP $175.79
Rate for Payer: Fidelis Medicare Advantage $197.52
Rate for Payer: Fidelis Qualified Health Plan $175.79
Rate for Payer: Group Health Inc Commercial $197.52
Rate for Payer: Group Health Inc Medicare $197.52
Rate for Payer: Hamaspik Choice Inc Medicaid $229.55
Rate for Payer: Hamaspik Choice Inc Medicare $197.52
Rate for Payer: Healthfirst Medicare Advantage $197.52
Rate for Payer: Healthfirst QHP $197.52
Rate for Payer: Senior Whole Health Medicare Advantage $197.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $197.52
Rate for Payer: Wellcare CHP/FHP/Medicaid $158.02
Rate for Payer: Wellcare Medicare $177.77
Hospital Charge Code 40501251
Hospital Revenue Code 260
Min. Negotiated Rate $4.47
Max. Negotiated Rate $10.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial $7.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $6.38
Rate for Payer: Aetna Government $6.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $10.21
Rate for Payer: Cigna LocalPlus Benefit Plan $8.68
Rate for Payer: Group Health Inc Commercial $6.38
Rate for Payer: Group Health Inc Medicare $4.47
Rate for Payer: Hamaspik Choice Inc Medicaid $6.38
Rate for Payer: Hamaspik Choice Inc Medicare $6.38
Service Code HCPCS C1713
Hospital Charge Code 40209823
Hospital Revenue Code 278
Min. Negotiated Rate $134.20
Max. Negotiated Rate $907.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial $475.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $134.20
Rate for Payer: Aetna Government $134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $432.00
Rate for Payer: Cigna LocalPlus Benefit Plan $496.80
Rate for Payer: Fidelis Medicare Advantage $907.20
Rate for Payer: Group Health Inc Commercial $432.00
Rate for Payer: Group Health Inc Medicare $302.40
Rate for Payer: Hamaspik Choice Inc Medicaid $432.00
Rate for Payer: Hamaspik Choice Inc Medicare $432.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $561.60
Service Code HCPCS C1713
Hospital Charge Code 40209823
Hospital Revenue Code 278
Min. Negotiated Rate $432.00
Max. Negotiated Rate $432.00
Rate for Payer: Hamaspik Choice Inc Medicaid $432.00
Rate for Payer: Hamaspik Choice Inc Medicare $432.00