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Service Code NDC 0409492834
Hospital Charge Code 0409492834
Hospital Revenue Code 258
Min. Negotiated Rate $0.65
Max. Negotiated Rate $1.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.93
Rate for Payer: Aetna Government $0.93
Rate for Payer: Brighton Health Commercial $1.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.49
Rate for Payer: Cigna LocalPlus Benefit Plan $1.27
Rate for Payer: EmblemHealth Commercial $0.93
Rate for Payer: Group Health Inc Commercial $0.93
Rate for Payer: Group Health Inc Medicare $0.65
Rate for Payer: Hamaspik Choice Inc Medicaid $0.93
Rate for Payer: Hamaspik Choice Inc Medicare $0.93
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.21
Service Code NDC 0409492834
Hospital Charge Code 0409492834
Hospital Revenue Code 258
Min. Negotiated Rate $0.93
Max. Negotiated Rate $0.93
Rate for Payer: Hamaspik Choice Inc Medicaid $0.93
Service Code HCPCS J0612
Hospital Charge Code 7583417119
Hospital Revenue Code 258
Min. Negotiated Rate $0.60
Max. Negotiated Rate $0.60
Rate for Payer: Hamaspik Choice Inc Medicaid $0.60
Service Code HCPCS J0612
Hospital Charge Code 6332336001
Hospital Revenue Code 258
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.60
Rate for Payer: Aetna Government $0.60
Rate for Payer: Brighton Health Commercial $0.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.96
Rate for Payer: Cigna LocalPlus Benefit Plan $0.82
Rate for Payer: EmblemHealth Commercial $0.60
Rate for Payer: Group Health Inc Commercial $0.60
Rate for Payer: Group Health Inc Medicare $0.42
Rate for Payer: Hamaspik Choice Inc Medicaid $0.60
Rate for Payer: Hamaspik Choice Inc Medicare $0.60
Rate for Payer: Healthfirst CHP/FHP/Medicaid $0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.78
Service Code HCPCS J0612
Hospital Charge Code 7583417119
Hospital Revenue Code 258
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.60
Rate for Payer: Aetna Government $0.60
Rate for Payer: Brighton Health Commercial $0.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.96
Rate for Payer: Cigna LocalPlus Benefit Plan $0.82
Rate for Payer: EmblemHealth Commercial $0.60
Rate for Payer: Group Health Inc Commercial $0.60
Rate for Payer: Group Health Inc Medicare $0.42
Rate for Payer: Hamaspik Choice Inc Medicaid $0.60
Rate for Payer: Hamaspik Choice Inc Medicare $0.60
Rate for Payer: Healthfirst CHP/FHP/Medicaid $0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.78
Service Code HCPCS J0612
Hospital Charge Code 6332336019
Hospital Revenue Code 258
Min. Negotiated Rate $0.60
Max. Negotiated Rate $0.60
Rate for Payer: Hamaspik Choice Inc Medicaid $0.60
Service Code HCPCS J0612
Hospital Charge Code 6332336019
Hospital Revenue Code 258
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.60
Rate for Payer: Aetna Government $0.60
Rate for Payer: Brighton Health Commercial $0.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.96
Rate for Payer: Cigna LocalPlus Benefit Plan $0.82
Rate for Payer: EmblemHealth Commercial $0.60
Rate for Payer: Group Health Inc Commercial $0.60
Rate for Payer: Group Health Inc Medicare $0.42
Rate for Payer: Hamaspik Choice Inc Medicaid $0.60
Rate for Payer: Hamaspik Choice Inc Medicare $0.60
Rate for Payer: Healthfirst CHP/FHP/Medicaid $0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.78
Service Code HCPCS J0612
Hospital Charge Code 6332336001
Hospital Revenue Code 258
Min. Negotiated Rate $0.60
Max. Negotiated Rate $0.60
Rate for Payer: Hamaspik Choice Inc Medicaid $0.60
Service Code HCPCS J0612
Hospital Charge Code 0143918025
Hospital Revenue Code 258
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.60
Rate for Payer: Aetna Government $0.60
Rate for Payer: Brighton Health Commercial $0.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.96
Rate for Payer: Cigna LocalPlus Benefit Plan $0.82
Rate for Payer: EmblemHealth Commercial $0.60
Rate for Payer: Group Health Inc Commercial $0.60
Rate for Payer: Group Health Inc Medicare $0.42
Rate for Payer: Hamaspik Choice Inc Medicaid $0.60
Rate for Payer: Hamaspik Choice Inc Medicare $0.60
Rate for Payer: Healthfirst CHP/FHP/Medicaid $0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.78
Service Code HCPCS J0612
Hospital Charge Code 0143918025
Hospital Revenue Code 258
Min. Negotiated Rate $0.60
Max. Negotiated Rate $0.60
Rate for Payer: Hamaspik Choice Inc Medicaid $0.60
Service Code HCPCS J0612
Hospital Charge Code 4456762001
Hospital Revenue Code 258
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.24
Rate for Payer: Aetna Government $0.24
Rate for Payer: Brighton Health Commercial $0.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.38
Rate for Payer: Cigna LocalPlus Benefit Plan $0.32
Rate for Payer: EmblemHealth Commercial $0.24
Rate for Payer: Group Health Inc Commercial $0.24
Rate for Payer: Group Health Inc Medicare $0.17
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Rate for Payer: Hamaspik Choice Inc Medicare $0.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid $0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.31
Service Code HCPCS J0612
Hospital Charge Code 4456762001
Hospital Revenue Code 258
Min. Negotiated Rate $0.24
Max. Negotiated Rate $0.24
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Service Code HCPCS J0612
Hospital Charge Code 6521916201
Hospital Revenue Code 258
Min. Negotiated Rate $0.24
Max. Negotiated Rate $0.24
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Service Code HCPCS J0612
Hospital Charge Code 6521916201
Hospital Revenue Code 258
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.24
Rate for Payer: Aetna Government $0.24
Rate for Payer: Brighton Health Commercial $0.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.38
Rate for Payer: Cigna LocalPlus Benefit Plan $0.32
Rate for Payer: EmblemHealth Commercial $0.24
Rate for Payer: Group Health Inc Commercial $0.24
Rate for Payer: Group Health Inc Medicare $0.17
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Rate for Payer: Hamaspik Choice Inc Medicare $0.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid $0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.31
Service Code HCPCS J0612
Hospital Charge Code 4456762024
Hospital Revenue Code 258
Min. Negotiated Rate $0.24
Max. Negotiated Rate $0.24
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Service Code HCPCS J0612
Hospital Charge Code 4456762024
Hospital Revenue Code 258
Min. Negotiated Rate $0.04
Max. Negotiated Rate $0.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.24
Rate for Payer: Aetna Government $0.24
Rate for Payer: Brighton Health Commercial $0.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.38
Rate for Payer: Cigna LocalPlus Benefit Plan $0.32
Rate for Payer: EmblemHealth Commercial $0.24
Rate for Payer: Group Health Inc Commercial $0.24
Rate for Payer: Group Health Inc Medicare $0.17
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Rate for Payer: Hamaspik Choice Inc Medicare $0.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid $0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.31
Service Code HCPCS J0613
Hospital Charge Code 4456762124
Hospital Revenue Code 258
Min. Negotiated Rate $0.24
Max. Negotiated Rate $0.24
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Service Code HCPCS J0613
Hospital Charge Code 4456762101
Hospital Revenue Code 258
Min. Negotiated Rate $0.09
Max. Negotiated Rate $0.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.24
Rate for Payer: Aetna Government $0.24
Rate for Payer: Brighton Health Commercial $0.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.38
Rate for Payer: Cigna LocalPlus Benefit Plan $0.32
Rate for Payer: EmblemHealth Commercial $0.24
Rate for Payer: Group Health Inc Commercial $0.24
Rate for Payer: Group Health Inc Medicare $0.17
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Rate for Payer: Hamaspik Choice Inc Medicare $0.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid $0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.31
Service Code HCPCS J0613
Hospital Charge Code 8083023631
Hospital Revenue Code 258
Min. Negotiated Rate $0.09
Max. Negotiated Rate $0.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.24
Rate for Payer: Aetna Government $0.24
Rate for Payer: Brighton Health Commercial $0.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.38
Rate for Payer: Cigna LocalPlus Benefit Plan $0.32
Rate for Payer: EmblemHealth Commercial $0.24
Rate for Payer: Group Health Inc Commercial $0.24
Rate for Payer: Group Health Inc Medicare $0.17
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Rate for Payer: Hamaspik Choice Inc Medicare $0.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid $0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.31
Service Code HCPCS J0613
Hospital Charge Code 4456762101
Hospital Revenue Code 258
Min. Negotiated Rate $0.24
Max. Negotiated Rate $0.24
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Service Code HCPCS J0613
Hospital Charge Code 4456762124
Hospital Revenue Code 258
Min. Negotiated Rate $0.09
Max. Negotiated Rate $0.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.24
Rate for Payer: Aetna Government $0.24
Rate for Payer: Brighton Health Commercial $0.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.38
Rate for Payer: Cigna LocalPlus Benefit Plan $0.32
Rate for Payer: EmblemHealth Commercial $0.24
Rate for Payer: Group Health Inc Commercial $0.24
Rate for Payer: Group Health Inc Medicare $0.17
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Rate for Payer: Hamaspik Choice Inc Medicare $0.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid $0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.31
Service Code HCPCS J0613
Hospital Charge Code 8083023631
Hospital Revenue Code 258
Min. Negotiated Rate $0.24
Max. Negotiated Rate $0.24
Rate for Payer: Hamaspik Choice Inc Medicaid $0.24
Service Code NDC 6068724125
Hospital Charge Code 6068724125
Hospital Revenue Code 250
Min. Negotiated Rate $2.69
Max. Negotiated Rate $2.69
Rate for Payer: Hamaspik Choice Inc Medicaid $2.69
Service Code NDC 3334211607
Hospital Charge Code 3334211607
Hospital Revenue Code 250
Min. Negotiated Rate $1.07
Max. Negotiated Rate $2.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.53
Rate for Payer: Aetna Government $1.53
Rate for Payer: Brighton Health Commercial $2.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2.44
Rate for Payer: Cigna LocalPlus Benefit Plan $2.08
Rate for Payer: EmblemHealth Commercial $1.53
Rate for Payer: Group Health Inc Commercial $1.53
Rate for Payer: Group Health Inc Medicare $1.07
Rate for Payer: Hamaspik Choice Inc Medicaid $1.53
Rate for Payer: Hamaspik Choice Inc Medicare $1.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.99
Service Code NDC 6068724195
Hospital Charge Code 6068724195
Hospital Revenue Code 250
Min. Negotiated Rate $1.89
Max. Negotiated Rate $4.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $2.69
Rate for Payer: Aetna Government $2.69
Rate for Payer: Brighton Health Commercial $4.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $4.31
Rate for Payer: Cigna LocalPlus Benefit Plan $3.67
Rate for Payer: EmblemHealth Commercial $2.69
Rate for Payer: Group Health Inc Commercial $2.69
Rate for Payer: Group Health Inc Medicare $1.89
Rate for Payer: Hamaspik Choice Inc Medicaid $2.69
Rate for Payer: Hamaspik Choice Inc Medicare $2.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $3.50