|
HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION
|
Facility
|
OP
|
$211.00
|
|
|
Service Code
|
CPT 92523 GN
|
| Hospital Charge Code |
4449252301
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$468.44 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$116.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$130.13
|
| Rate for Payer: Aetna Government |
$130.13
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$468.44
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$468.44
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$208.19
|
| Rate for Payer: Amida Care Medicaid |
$208.19
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$132.56
|
| Rate for Payer: EmblemHealth Commercial |
$105.50
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$468.44
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$208.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$208.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$468.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$468.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$218.60
|
| Rate for Payer: Group Health Inc Commercial |
$105.50
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$208.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$208.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$208.19
|
| Rate for Payer: Healthfirst Essential Plan |
$468.44
|
| Rate for Payer: Healthfirst QHP |
$339.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$208.19
|
| Rate for Payer: SOMOS Essential |
$468.44
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$468.44
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$229.01
|
| Rate for Payer: United Healthcare Medicaid |
$208.19
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$208.19
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
HC SLP EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION
|
Facility
|
IP
|
$211.00
|
|
|
Service Code
|
CPT 92523 GN
|
| Hospital Charge Code |
4449252301
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$105.50 |
| Max. Negotiated Rate |
$105.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$105.50
|
|
|
HC SLP EVAL,SWALLOW FUNCTION,CINE/VIDEO RECORD
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
CPT 92611 GN
|
| Hospital Charge Code |
4449261101
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$135.00 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$135.00
|
|
|
HC SLP EVAL,SWALLOW FUNCTION,CINE/VIDEO RECORD
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
CPT 92611 GN
|
| Hospital Charge Code |
4449261101
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$148.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$75.42
|
| Rate for Payer: Aetna Government |
$75.42
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$132.56
|
| Rate for Payer: EmblemHealth Commercial |
$135.00
|
| Rate for Payer: Group Health Inc Commercial |
$135.00
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$135.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$135.00
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
HC SLP EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
|
Facility
|
IP
|
$211.00
|
|
|
Service Code
|
CPT 92521 GN
|
| Hospital Charge Code |
4449252101
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$105.50 |
| Max. Negotiated Rate |
$105.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$105.50
|
|
|
HC SLP EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)
|
Facility
|
OP
|
$211.00
|
|
|
Service Code
|
CPT 92521 GN
|
| Hospital Charge Code |
4449252101
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$468.44 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$116.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$74.45
|
| Rate for Payer: Aetna Government |
$74.45
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$468.44
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$468.44
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$208.19
|
| Rate for Payer: Amida Care Medicaid |
$208.19
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$132.56
|
| Rate for Payer: EmblemHealth Commercial |
$105.50
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$468.44
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$208.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$208.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$468.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$468.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$218.60
|
| Rate for Payer: Group Health Inc Commercial |
$105.50
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$208.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$208.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$208.19
|
| Rate for Payer: Healthfirst Essential Plan |
$468.44
|
| Rate for Payer: Healthfirst QHP |
$339.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$208.19
|
| Rate for Payer: SOMOS Essential |
$468.44
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$468.44
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$229.01
|
| Rate for Payer: United Healthcare Medicaid |
$208.19
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$208.19
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
HC SLP EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE
|
Facility
|
IP
|
$211.00
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
4449252201
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$105.50 |
| Max. Negotiated Rate |
$105.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$105.50
|
|
|
HC SLP EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE
|
Facility
|
OP
|
$211.00
|
|
|
Service Code
|
CPT 92522 GN
|
| Hospital Charge Code |
4449252201
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$468.44 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$116.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$62.02
|
| Rate for Payer: Aetna Government |
$62.02
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$468.44
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$468.44
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$208.19
|
| Rate for Payer: Amida Care Medicaid |
$208.19
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$132.56
|
| Rate for Payer: EmblemHealth Commercial |
$105.50
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$468.44
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$208.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$208.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$468.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$468.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$218.60
|
| Rate for Payer: Group Health Inc Commercial |
$105.50
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$208.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$208.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$208.19
|
| Rate for Payer: Healthfirst Essential Plan |
$468.44
|
| Rate for Payer: Healthfirst QHP |
$339.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$208.19
|
| Rate for Payer: SOMOS Essential |
$468.44
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$468.44
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$229.01
|
| Rate for Payer: United Healthcare Medicaid |
$208.19
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$208.19
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
HC SLP EVAL VOICE PROSTH DEVICE
|
Facility
|
IP
|
$211.00
|
|
|
Service Code
|
CPT 92597 GN
|
| Hospital Charge Code |
4449259701
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$105.50 |
| Max. Negotiated Rate |
$105.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$105.50
|
|
|
HC SLP EVAL VOICE PROSTH DEVICE
|
Facility
|
OP
|
$211.00
|
|
|
Service Code
|
CPT 92597 GN
|
| Hospital Charge Code |
4449259701
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$468.44 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$116.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$61.99
|
| Rate for Payer: Aetna Government |
$61.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$468.44
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$468.44
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$208.19
|
| Rate for Payer: Amida Care Medicaid |
$208.19
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$132.56
|
| Rate for Payer: EmblemHealth Commercial |
$105.50
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$468.44
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$208.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$208.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$468.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$468.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$218.60
|
| Rate for Payer: Group Health Inc Commercial |
$105.50
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$208.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$208.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$208.19
|
| Rate for Payer: Healthfirst Essential Plan |
$468.44
|
| Rate for Payer: Healthfirst QHP |
$339.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$208.19
|
| Rate for Payer: SOMOS Essential |
$468.44
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$468.44
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$229.01
|
| Rate for Payer: United Healthcare Medicaid |
$208.19
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$208.19
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
HC SLP ORAL FUNCTION THERAPY
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
CPT 92526 GN
|
| Hospital Charge Code |
4409252601
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$344.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$138.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$73.81
|
| Rate for Payer: Aetna Government |
$73.81
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$344.72
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$344.72
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$153.21
|
| Rate for Payer: Amida Care Medicaid |
$153.21
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$132.56
|
| Rate for Payer: EmblemHealth Commercial |
$126.00
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$344.72
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$153.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$153.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$344.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$344.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$160.87
|
| Rate for Payer: Group Health Inc Commercial |
$126.00
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$153.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$153.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$153.21
|
| Rate for Payer: Healthfirst Essential Plan |
$344.72
|
| Rate for Payer: Healthfirst QHP |
$249.73
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$153.21
|
| Rate for Payer: SOMOS Essential |
$344.72
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$344.72
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$168.53
|
| Rate for Payer: United Healthcare Medicaid |
$153.21
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$153.21
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
HC SLP ORAL FUNCTION THERAPY
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
CPT 92526 GN
|
| Hospital Charge Code |
4409252601
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$126.00
|
|
|
HC SLP SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 97533 GN
|
| Hospital Charge Code |
4409753301
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$84.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.32
|
| Rate for Payer: Aetna Government |
$17.32
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$125.70
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$125.70
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$55.87
|
| Rate for Payer: Amida Care Medicaid |
$55.87
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$132.56
|
| Rate for Payer: EmblemHealth Commercial |
$76.50
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$125.70
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$55.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$55.87
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$125.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$125.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$58.66
|
| Rate for Payer: Group Health Inc Commercial |
$76.50
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$55.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$55.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$55.87
|
| Rate for Payer: Healthfirst Essential Plan |
$125.70
|
| Rate for Payer: Healthfirst QHP |
$91.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$55.87
|
| Rate for Payer: SOMOS Essential |
$125.70
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$125.70
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$61.45
|
| Rate for Payer: United Healthcare Medicaid |
$55.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$55.87
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
HC SLP SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 97533 GN
|
| Hospital Charge Code |
4409753301
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$76.50 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$76.50
|
|
|
HC SLP SPEECH/HEARING THERAPY, GROUP
|
Facility
|
IP
|
$69.00
|
|
|
Service Code
|
CPT 92508 GN
|
| Hospital Charge Code |
4409250801
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34.50
|
|
|
HC SLP SPEECH/HEARING THERAPY, GROUP
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 92508 GN
|
| Hospital Charge Code |
4409250801
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$37.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.71
|
| Rate for Payer: Aetna Government |
$15.71
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$132.56
|
| Rate for Payer: EmblemHealth Commercial |
$34.50
|
| Rate for Payer: Group Health Inc Commercial |
$34.50
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$34.50
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL
|
Facility
|
OP
|
$228.00
|
|
|
Service Code
|
CPT 92507 GN
|
| Hospital Charge Code |
4409250701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$52.82 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$125.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$52.82
|
| Rate for Payer: Aetna Government |
$52.82
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$132.56
|
| Rate for Payer: EmblemHealth Commercial |
$114.00
|
| Rate for Payer: Group Health Inc Commercial |
$114.00
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$114.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$114.00
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
HC SLP SPEECH/HEARING THERAPY, INDIVIDUAL
|
Facility
|
IP
|
$228.00
|
|
|
Service Code
|
CPT 92507 GN
|
| Hospital Charge Code |
4409250701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$114.00 |
| Max. Negotiated Rate |
$114.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$114.00
|
|
|
HC SLP THER SRVC(S),NON-SPEECH GEN DEV, W/PROG
|
Facility
|
OP
|
$436.00
|
|
|
Service Code
|
CPT 92606 GN
|
| Hospital Charge Code |
4409260601
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$344.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$239.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$71.57
|
| Rate for Payer: Aetna Government |
$71.57
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$344.72
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$344.72
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$153.21
|
| Rate for Payer: Amida Care Medicaid |
$153.21
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$132.56
|
| Rate for Payer: EmblemHealth Commercial |
$218.00
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$344.72
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$153.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$153.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$344.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$344.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$160.87
|
| Rate for Payer: Group Health Inc Commercial |
$218.00
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$153.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$153.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$153.21
|
| Rate for Payer: Healthfirst Essential Plan |
$344.72
|
| Rate for Payer: Healthfirst QHP |
$249.73
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$153.21
|
| Rate for Payer: SOMOS Essential |
$344.72
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$344.72
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$168.53
|
| Rate for Payer: United Healthcare Medicaid |
$153.21
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$153.21
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
HC SLP THER SRVC(S),NON-SPEECH GEN DEV, W/PROG
|
Facility
|
IP
|
$436.00
|
|
|
Service Code
|
CPT 92606 GN
|
| Hospital Charge Code |
4409260601
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$218.00 |
| Max. Negotiated Rate |
$218.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$218.00
|
|
|
HC SLP THER SRVC, SPEECH GEN DEV USE, W/PROG
|
Facility
|
OP
|
$315.00
|
|
|
Service Code
|
CPT 92609 GN
|
| Hospital Charge Code |
4409260901
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$55.00 |
| Max. Negotiated Rate |
$344.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$173.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$95.24
|
| Rate for Payer: Aetna Government |
$95.24
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$344.72
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$344.72
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$153.21
|
| Rate for Payer: Amida Care Medicaid |
$153.21
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$132.56
|
| Rate for Payer: EmblemHealth Commercial |
$157.50
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$344.72
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$153.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$153.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$344.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$344.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$160.87
|
| Rate for Payer: Group Health Inc Commercial |
$157.50
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$153.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$153.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$153.21
|
| Rate for Payer: Healthfirst Essential Plan |
$344.72
|
| Rate for Payer: Healthfirst QHP |
$249.73
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$153.21
|
| Rate for Payer: SOMOS Essential |
$344.72
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$344.72
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$168.53
|
| Rate for Payer: United Healthcare Medicaid |
$153.21
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$153.21
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
HC SLP THER SRVC, SPEECH GEN DEV USE, W/PROG
|
Facility
|
IP
|
$315.00
|
|
|
Service Code
|
CPT 92609 GN
|
| Hospital Charge Code |
4409260901
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$157.50
|
|
|
HC SMALL VAKU-PAK DRESSING WITH PUMP
|
Facility
|
OP
|
$3,920.00
|
|
|
Service Code
|
CPT E2402
|
| Hospital Charge Code |
270E240201
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,372.00 |
| Max. Negotiated Rate |
$9,052.47 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,156.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9,052.47
|
| Rate for Payer: Aetna Government |
$9,052.47
|
| Rate for Payer: Brighton Health Commercial |
$2,940.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,136.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,665.60
|
| Rate for Payer: EmblemHealth Commercial |
$1,960.00
|
| Rate for Payer: Group Health Inc Commercial |
$1,960.00
|
| Rate for Payer: Group Health Inc Medicare |
$1,372.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,960.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,960.00
|
|
|
HC SMALL VAKU-PAK DRESSING WITH PUMP
|
Facility
|
IP
|
$3,920.00
|
|
|
Service Code
|
CPT E2402
|
| Hospital Charge Code |
270E240201
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,960.00 |
| Max. Negotiated Rate |
$1,960.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,960.00
|
|
|
HC SMEAR,FLUOR STAIN,INTERP - AFB STAIN
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
CPT 87206
|
| Hospital Charge Code |
3068720601
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$12.13 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.39
|
| Rate for Payer: Aetna Government |
$5.39
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.77
|
| Rate for Payer: Brighton Health Commercial |
$9.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.39
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$9.12
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.68
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.39
|
| Rate for Payer: EmblemHealth Commercial |
$5.39
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.85
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.58
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.80
|
| Rate for Payer: Group Health Inc Commercial |
$5.39
|
| Rate for Payer: Group Health Inc Medicare |
$5.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.39
|
| Rate for Payer: Healthfirst Essential Plan |
$12.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.39
|
| Rate for Payer: Healthfirst QHP |
$5.39
|
| Rate for Payer: Humana Medicare |
$5.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.39
|
| Rate for Payer: United Healthcare Commercial |
$6.80
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.39
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.39
|
| Rate for Payer: Wellcare Medicare |
$4.85
|
|
