|
HC VISUAL FIELD EXAM,EXTENDED - MATRIX VISUAL FIELD - OD - RIGHT EYE
|
Facility
|
OP
|
$348.00
|
|
|
Service Code
|
CPT 92083 TC
|
| Hospital Charge Code |
9209208306
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$32.58 |
| Max. Negotiated Rate |
$278.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$191.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$32.58
|
| Rate for Payer: Aetna Government |
$32.58
|
| Rate for Payer: Brighton Health Commercial |
$261.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$278.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$236.64
|
| Rate for Payer: EmblemHealth Commercial |
$174.00
|
| Rate for Payer: Group Health Inc Commercial |
$174.00
|
| Rate for Payer: Group Health Inc Medicare |
$121.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$174.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$174.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$42.93
|
| Rate for Payer: United Healthcare Commercial |
$94.00
|
|
|
HC VISUAL FIELD EXAM,EXTENDED - MATRIX VISUAL FIELD - OS - LEFT EYE
|
Facility
|
OP
|
$348.00
|
|
|
Service Code
|
CPT 92083 TC
|
| Hospital Charge Code |
9209208307
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$32.58 |
| Max. Negotiated Rate |
$278.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$191.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$32.58
|
| Rate for Payer: Aetna Government |
$32.58
|
| Rate for Payer: Brighton Health Commercial |
$261.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$278.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$236.64
|
| Rate for Payer: EmblemHealth Commercial |
$174.00
|
| Rate for Payer: Group Health Inc Commercial |
$174.00
|
| Rate for Payer: Group Health Inc Medicare |
$121.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$174.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$174.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$42.93
|
| Rate for Payer: United Healthcare Commercial |
$94.00
|
|
|
HC VISUAL FIELD EXAM,EXTENDED - MATRIX VISUAL FIELD - OS - LEFT EYE
|
Facility
|
IP
|
$348.00
|
|
|
Service Code
|
CPT 92083 TC
|
| Hospital Charge Code |
9209208307
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$174.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$174.00
|
|
|
HC VISUAL FIELD EXAM,EXTENDED - MATRIX VISUAL FIELD - OU - BOTH EYES
|
Facility
|
OP
|
$348.00
|
|
|
Service Code
|
CPT 92083 TC
|
| Hospital Charge Code |
9209208308
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$32.58 |
| Max. Negotiated Rate |
$278.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$191.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$32.58
|
| Rate for Payer: Aetna Government |
$32.58
|
| Rate for Payer: Brighton Health Commercial |
$261.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$278.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$236.64
|
| Rate for Payer: EmblemHealth Commercial |
$174.00
|
| Rate for Payer: Group Health Inc Commercial |
$174.00
|
| Rate for Payer: Group Health Inc Medicare |
$121.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$174.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$174.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$42.93
|
| Rate for Payer: United Healthcare Commercial |
$94.00
|
|
|
HC VISUAL FIELD EXAM,EXTENDED - MATRIX VISUAL FIELD - OU - BOTH EYES
|
Facility
|
IP
|
$348.00
|
|
|
Service Code
|
CPT 92083 TC
|
| Hospital Charge Code |
9209208308
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$174.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$174.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD BOTH
|
Facility
|
IP
|
$166.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
5109208203
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$83.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD BOTH
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
9209208203
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$23.68 |
| Max. Negotiated Rate |
$137.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$94.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23.68
|
| Rate for Payer: Aetna Government |
$23.68
|
| Rate for Payer: Brighton Health Commercial |
$129.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$137.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$116.96
|
| Rate for Payer: EmblemHealth Commercial |
$86.00
|
| Rate for Payer: Group Health Inc Commercial |
$86.00
|
| Rate for Payer: Group Health Inc Medicare |
$60.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$86.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$86.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.89
|
| Rate for Payer: United Healthcare Commercial |
$94.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD BOTH
|
Facility
|
OP
|
$166.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
5109208203
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.68 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$91.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23.68
|
| Rate for Payer: Aetna Government |
$23.68
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$217.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.48
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| 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 |
$83.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$83.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.89
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD BOTH
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
9209208203
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$86.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$86.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD LT EYE
|
Facility
|
OP
|
$166.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
5109208202
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.68 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$91.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23.68
|
| Rate for Payer: Aetna Government |
$23.68
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$217.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.48
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| 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 |
$83.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$83.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.89
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD LT EYE
|
Facility
|
IP
|
$166.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
5109208202
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$83.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD LT EYE
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
9209208202
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$86.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$86.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD LT EYE
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
9209208202
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$23.68 |
| Max. Negotiated Rate |
$137.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$94.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23.68
|
| Rate for Payer: Aetna Government |
$23.68
|
| Rate for Payer: Brighton Health Commercial |
$129.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$137.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$116.96
|
| Rate for Payer: EmblemHealth Commercial |
$86.00
|
| Rate for Payer: Group Health Inc Commercial |
$86.00
|
| Rate for Payer: Group Health Inc Medicare |
$60.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$86.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$86.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.89
|
| Rate for Payer: United Healthcare Commercial |
$94.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD RT EYE
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
9209208201
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$86.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$86.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD RT EYE
|
Facility
|
IP
|
$166.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
5109208201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$83.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD RT EYE
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
9209208201
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$23.68 |
| Max. Negotiated Rate |
$137.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$94.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23.68
|
| Rate for Payer: Aetna Government |
$23.68
|
| Rate for Payer: Brighton Health Commercial |
$129.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$137.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$116.96
|
| Rate for Payer: EmblemHealth Commercial |
$86.00
|
| Rate for Payer: Group Health Inc Commercial |
$86.00
|
| Rate for Payer: Group Health Inc Medicare |
$60.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$86.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$86.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.89
|
| Rate for Payer: United Healthcare Commercial |
$94.00
|
|
|
HC VISUAL FIELD EXAM,INTRMD - AUTO VISUAL FIELD, INTERMEDIATE OD RT EYE
|
Facility
|
OP
|
$166.00
|
|
|
Service Code
|
CPT 92082 TC
|
| Hospital Charge Code |
5109208201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$23.68 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$91.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23.68
|
| Rate for Payer: Aetna Government |
$23.68
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$217.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.48
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| 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 |
$83.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$83.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.89
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
|
|
HC VISUAL FIELD EXAM,LMTD - AUTO VISUAL FIELD, SINGLE ISOPTER OD BOTH
|
Facility
|
IP
|
$166.00
|
|
|
Service Code
|
CPT 92081 TC
|
| Hospital Charge Code |
5109208103
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$83.00
|
|
|
HC VISUAL FIELD EXAM,LMTD - AUTO VISUAL FIELD, SINGLE ISOPTER OD BOTH
|
Facility
|
OP
|
$166.00
|
|
|
Service Code
|
CPT 92081 TC
|
| Hospital Charge Code |
5109208103
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.74 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$91.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.74
|
| Rate for Payer: Aetna Government |
$15.74
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$217.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.48
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| 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 |
$83.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$83.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20.80
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
|
|
HC VISUAL FIELD EXAM,LMTD - AUTO VISUAL FIELD, SINGLE ISOPTER OD BOTH
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 92081 TC
|
| Hospital Charge Code |
9209208103
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$86.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$86.00
|
|
|
HC VISUAL FIELD EXAM,LMTD - AUTO VISUAL FIELD, SINGLE ISOPTER OD BOTH
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
CPT 92081 TC
|
| Hospital Charge Code |
9209208103
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$15.74 |
| Max. Negotiated Rate |
$137.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$94.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.74
|
| Rate for Payer: Aetna Government |
$15.74
|
| Rate for Payer: Brighton Health Commercial |
$129.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$137.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$116.96
|
| Rate for Payer: EmblemHealth Commercial |
$86.00
|
| Rate for Payer: Group Health Inc Commercial |
$86.00
|
| Rate for Payer: Group Health Inc Medicare |
$60.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$86.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$86.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20.80
|
| Rate for Payer: United Healthcare Commercial |
$94.00
|
|
|
HC VISUAL FIELD EXAM,LMTD - AUTO VISUAL FIELD, SINGLE ISOPTER OD LT EYE
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 92081 TC
|
| Hospital Charge Code |
9209208102
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$86.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$86.00
|
|
|
HC VISUAL FIELD EXAM,LMTD - AUTO VISUAL FIELD, SINGLE ISOPTER OD LT EYE
|
Facility
|
OP
|
$172.00
|
|
|
Service Code
|
CPT 92081 TC
|
| Hospital Charge Code |
9209208102
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$15.74 |
| Max. Negotiated Rate |
$137.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$94.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.74
|
| Rate for Payer: Aetna Government |
$15.74
|
| Rate for Payer: Brighton Health Commercial |
$129.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$137.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$116.96
|
| Rate for Payer: EmblemHealth Commercial |
$86.00
|
| Rate for Payer: Group Health Inc Commercial |
$86.00
|
| Rate for Payer: Group Health Inc Medicare |
$60.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$86.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$86.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20.80
|
| Rate for Payer: United Healthcare Commercial |
$94.00
|
|
|
HC VISUAL FIELD EXAM,LMTD - AUTO VISUAL FIELD, SINGLE ISOPTER OD LT EYE
|
Facility
|
IP
|
$166.00
|
|
|
Service Code
|
CPT 92081 TC
|
| Hospital Charge Code |
5109208102
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$83.00 |
| Max. Negotiated Rate |
$83.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$83.00
|
|
|
HC VISUAL FIELD EXAM,LMTD - AUTO VISUAL FIELD, SINGLE ISOPTER OD LT EYE
|
Facility
|
OP
|
$166.00
|
|
|
Service Code
|
CPT 92081 TC
|
| Hospital Charge Code |
5109208102
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$15.74 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$91.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.74
|
| Rate for Payer: Aetna Government |
$15.74
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$217.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.48
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| 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 |
$83.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$83.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20.80
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
|
