|
ANTIBODY SCREENING
|
Facility
OP
|
$149.83
|
|
|
Service Code
|
HCPCS 86850
|
| Hospital Charge Code |
40711135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$82.41 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$82.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$62.66
|
| Rate for Payer: Aetna Government |
$62.66
|
| Rate for Payer: Cash Price |
$62.66
|
| Rate for Payer: Cash Price |
$62.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$62.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18.42
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15.59
|
| Rate for Payer: Elderplan Medicare Advantage |
$62.66
|
| Rate for Payer: EmblemHealth Commercial |
$62.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.79
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$53.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$55.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$62.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$55.77
|
| Rate for Payer: Group Health Inc Commercial |
$62.66
|
| Rate for Payer: Group Health Inc Medicare |
$62.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$74.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$62.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.77
|
| Rate for Payer: Healthfirst Medicare Advantage |
$62.66
|
| Rate for Payer: Healthfirst QHP |
$62.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$62.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$62.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$50.13
|
| Rate for Payer: Wellcare Medicare |
$56.39
|
|
|
ANTIBODY STUDIES
|
Facility
OP
|
$858.38
|
|
|
Service Code
|
HCPCS 86870
|
| Hospital Charge Code |
40711150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$472.11 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$472.11
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$415.67
|
| Rate for Payer: Aetna Government |
$415.67
|
| Rate for Payer: Cash Price |
$415.67
|
| Rate for Payer: Cash Price |
$415.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$415.67
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32.62
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27.60
|
| Rate for Payer: Elderplan Medicare Advantage |
$415.67
|
| Rate for Payer: EmblemHealth Commercial |
$415.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$353.32
|
| Rate for Payer: Fidelis Essential Plan QHP |
$369.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$415.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$369.95
|
| Rate for Payer: Group Health Inc Commercial |
$415.67
|
| Rate for Payer: Group Health Inc Medicare |
$415.67
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$429.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$415.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$415.67
|
| Rate for Payer: Healthfirst QHP |
$415.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$415.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$415.67
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$332.54
|
| Rate for Payer: Wellcare Medicare |
$374.10
|
|
|
ANTIBODY TITER
|
Facility
OP
|
$434.63
|
|
|
Service Code
|
HCPCS 86886
|
| Hospital Charge Code |
40701119
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.66 |
| Max. Negotiated Rate |
$239.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$239.05
|
| 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 |
$8.23
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.96
|
| Rate for Payer: Elderplan Medicare Advantage |
$197.52
|
| Rate for Payer: EmblemHealth Commercial |
$197.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.66
|
| 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 |
$217.32
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$197.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.18
|
| 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
|
|
|
ANTICARDIOLIPIN AB, IGG/M QN
|
Facility
OP
|
$63.63
|
|
|
Service Code
|
HCPCS 86147
|
| Hospital Charge Code |
40729326
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.36 |
| Max. Negotiated Rate |
$40.43 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$35.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$25.45
|
| Rate for Payer: Aetna Government |
$25.45
|
| Rate for Payer: Cash Price |
$25.45
|
| Rate for Payer: Cash Price |
$25.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25.45
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$40.43
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$34.21
|
| Rate for Payer: Elderplan Medicare Advantage |
$25.45
|
| Rate for Payer: EmblemHealth Commercial |
$25.45
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22.90
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.63
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.45
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.65
|
| Rate for Payer: Group Health Inc Commercial |
$25.45
|
| Rate for Payer: Group Health Inc Medicare |
$25.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$31.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.45
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25.45
|
| Rate for Payer: Healthfirst QHP |
$25.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.45
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.45
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20.36
|
| Rate for Payer: Wellcare Medicare |
$22.90
|
|
|
ANTI-CENTROMERE B ANTIBODIES
|
Facility
OP
|
$44.83
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
40729334
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24.66
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.93
|
| Rate for Payer: Aetna Government |
$17.93
|
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$24.11
|
| Rate for Payer: Elderplan Medicare Advantage |
$17.93
|
| Rate for Payer: EmblemHealth Commercial |
$17.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$15.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.96
|
| Rate for Payer: Group Health Inc Commercial |
$17.93
|
| Rate for Payer: Group Health Inc Medicare |
$17.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.93
|
| Rate for Payer: Healthfirst QHP |
$17.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$14.34
|
| Rate for Payer: Wellcare Medicare |
$16.14
|
|
|
ANTI-DNASE B STREP ANTIBODIES
|
Facility
OP
|
$33.13
|
|
|
Service Code
|
HCPCS 86215
|
| Hospital Charge Code |
40729329
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.60 |
| Max. Negotiated Rate |
$21.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$18.22
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13.25
|
| Rate for Payer: Aetna Government |
$13.25
|
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$13.25
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$21.06
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.82
|
| Rate for Payer: Elderplan Medicare Advantage |
$13.25
|
| Rate for Payer: EmblemHealth Commercial |
$13.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.79
|
| Rate for Payer: Fidelis Medicare Advantage |
$13.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.79
|
| Rate for Payer: Group Health Inc Commercial |
$13.25
|
| Rate for Payer: Group Health Inc Medicare |
$13.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.25
|
| Rate for Payer: Healthfirst QHP |
$13.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$13.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.25
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.60
|
| Rate for Payer: Wellcare Medicare |
$11.92
|
|
|
ANTI-DSDNA ANTIBODIES
|
Facility
OP
|
$34.35
|
|
|
Service Code
|
HCPCS 86225
|
| Hospital Charge Code |
40729330
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.99 |
| Max. Negotiated Rate |
$21.83 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$18.89
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13.74
|
| Rate for Payer: Aetna Government |
$13.74
|
| Rate for Payer: Cash Price |
$13.74
|
| Rate for Payer: Cash Price |
$13.74
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$13.74
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$21.83
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18.47
|
| Rate for Payer: Elderplan Medicare Advantage |
$13.74
|
| Rate for Payer: EmblemHealth Commercial |
$13.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$12.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$12.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$13.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$12.23
|
| Rate for Payer: Group Health Inc Commercial |
$13.74
|
| Rate for Payer: Group Health Inc Medicare |
$13.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.74
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.74
|
| Rate for Payer: Healthfirst QHP |
$13.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$13.74
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13.74
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.99
|
| Rate for Payer: Wellcare Medicare |
$12.37
|
|
|
ANTI E CADHERIN
|
Facility
OP
|
$543.70
|
|
| Hospital Charge Code |
64903634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$190.30 |
| Max. Negotiated Rate |
$434.96 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$299.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$271.85
|
| Rate for Payer: Aetna Government |
$271.85
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$434.96
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$369.72
|
| Rate for Payer: Group Health Inc Commercial |
$271.85
|
| Rate for Payer: Group Health Inc Medicare |
$190.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$271.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$271.85
|
|
|
ANTI EMETIC EACH ADDITIONAL
|
Facility
OP
|
$115.43
|
|
|
Service Code
|
HCPCS 96366
|
| Hospital Charge Code |
30103253
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$43.94 |
| Max. Negotiated Rate |
$30,767.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$694.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$54.93
|
| Rate for Payer: Aetna Government |
$54.93
|
| Rate for Payer: Amida Care Medicaid |
$307.67
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$54.93
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$54.93
|
| Rate for Payer: Cash Price |
$54.93
|
| Rate for Payer: Cash Price |
$54.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$54.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$747.30
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$635.21
|
| Rate for Payer: Elderplan Medicare Advantage |
$54.93
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30,767.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$307.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$307.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$54.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$323.05
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$307.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$54.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$307.67
|
| Rate for Payer: Healthfirst Essential Plan |
$692.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$307.67
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$54.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$54.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$307.67
|
| Rate for Payer: SOMOS Essential |
$692.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$54.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$43.94
|
| Rate for Payer: Wellcare Medicare |
$52.18
|
|
|
ANTIEXTRACTABLE NUCLEAR AG
|
Facility
OP
|
$44.83
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
40729336
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24.66
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.93
|
| Rate for Payer: Aetna Government |
$17.93
|
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$24.11
|
| Rate for Payer: Elderplan Medicare Advantage |
$17.93
|
| Rate for Payer: EmblemHealth Commercial |
$17.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$15.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.96
|
| Rate for Payer: Group Health Inc Commercial |
$17.93
|
| Rate for Payer: Group Health Inc Medicare |
$17.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.93
|
| Rate for Payer: Healthfirst QHP |
$17.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$14.34
|
| Rate for Payer: Wellcare Medicare |
$16.14
|
|
|
ANTIFUNGAL SUSCEP 3 DRUGS
|
Facility
OP
|
$21.63
|
|
|
Service Code
|
HCPCS 87186
|
| Hospital Charge Code |
40619852
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$13.74 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.90
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.65
|
| Rate for Payer: Aetna Government |
$8.65
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.65
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.63
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.65
|
| Rate for Payer: EmblemHealth Commercial |
$8.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.65
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.70
|
| Rate for Payer: Group Health Inc Commercial |
$8.65
|
| Rate for Payer: Group Health Inc Medicare |
$8.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.65
|
| Rate for Payer: Healthfirst QHP |
$8.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.65
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6.92
|
| Rate for Payer: Wellcare Medicare |
$7.78
|
|
|
ANTIFUNGAL SUSCEP 8 DRUGS
|
Facility
OP
|
$21.63
|
|
|
Service Code
|
HCPCS 87186
|
| Hospital Charge Code |
40619854
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$13.74 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.90
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.65
|
| Rate for Payer: Aetna Government |
$8.65
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: Cash Price |
$8.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.65
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.63
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.65
|
| Rate for Payer: EmblemHealth Commercial |
$8.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.65
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.70
|
| Rate for Payer: Group Health Inc Commercial |
$8.65
|
| Rate for Payer: Group Health Inc Medicare |
$8.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.65
|
| Rate for Payer: Healthfirst QHP |
$8.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.65
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6.92
|
| Rate for Payer: Wellcare Medicare |
$7.78
|
|
|
ANTIGEN THERAPY SERVICES
|
Facility
OP
|
$115.43
|
|
|
Service Code
|
HCPCS 95145
|
| Hospital Charge Code |
30301419
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$63.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$54.93
|
| Rate for Payer: Aetna Government |
$54.93
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$54.93
|
| Rate for Payer: Cash Price |
$54.93
|
| Rate for Payer: Cash Price |
$54.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$54.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$204.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$173.89
|
| Rate for Payer: Elderplan Medicare Advantage |
$54.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$46.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$48.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$54.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$48.89
|
| 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 |
$57.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$54.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.75
|
| Rate for Payer: Healthfirst Medicare Advantage |
$46.69
|
| Rate for Payer: Healthfirst QHP |
$54.93
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$54.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$54.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$54.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$43.94
|
| Rate for Payer: Wellcare Medicare |
$52.18
|
|
|
ANTIGLOMERULAR BM AB
|
Facility
OP
|
$28.83
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
40729242
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$18.34 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.86
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.53
|
| Rate for Payer: Aetna Government |
$11.53
|
| Rate for Payer: Cash Price |
$11.53
|
| Rate for Payer: Cash Price |
$11.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.53
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18.34
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15.52
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.53
|
| Rate for Payer: EmblemHealth Commercial |
$11.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.26
|
| Rate for Payer: Group Health Inc Commercial |
$11.53
|
| Rate for Payer: Group Health Inc Medicare |
$11.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$11.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.53
|
| Rate for Payer: Healthfirst QHP |
$11.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.22
|
| Rate for Payer: Wellcare Medicare |
$10.38
|
|
|
ANTIHISTONE ANTIBODIES
|
Facility
OP
|
$44.83
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
40729332
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24.66
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.93
|
| Rate for Payer: Aetna Government |
$17.93
|
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$24.11
|
| Rate for Payer: Elderplan Medicare Advantage |
$17.93
|
| Rate for Payer: EmblemHealth Commercial |
$17.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$15.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.96
|
| Rate for Payer: Group Health Inc Commercial |
$17.93
|
| Rate for Payer: Group Health Inc Medicare |
$17.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.93
|
| Rate for Payer: Healthfirst QHP |
$17.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$14.34
|
| Rate for Payer: Wellcare Medicare |
$16.14
|
|
|
ANTI-HISTONE ANTIBODY
|
Facility
OP
|
$43.18
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
40617609
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.82 |
| Max. Negotiated Rate |
$23.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.27
|
| Rate for Payer: Aetna Government |
$17.27
|
| Rate for Payer: Cash Price |
$17.27
|
| Rate for Payer: Cash Price |
$17.27
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17.27
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.41
|
| Rate for Payer: Elderplan Medicare Advantage |
$17.27
|
| Rate for Payer: EmblemHealth Commercial |
$17.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$15.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$14.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.37
|
| Rate for Payer: Group Health Inc Commercial |
$17.27
|
| Rate for Payer: Group Health Inc Medicare |
$17.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.27
|
| Rate for Payer: Healthfirst QHP |
$17.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.27
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$13.82
|
| Rate for Payer: Wellcare Medicare |
$15.54
|
|
|
ANTI-HU ANTIBODIES
|
Facility
OP
|
$30.13
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
40729892
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$19.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16.57
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.05
|
| Rate for Payer: Aetna Government |
$12.05
|
| Rate for Payer: Cash Price |
$12.05
|
| Rate for Payer: Cash Price |
$12.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.05
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.20
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.05
|
| Rate for Payer: EmblemHealth Commercial |
$12.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.05
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.72
|
| Rate for Payer: Group Health Inc Commercial |
$12.05
|
| Rate for Payer: Group Health Inc Medicare |
$12.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.05
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.05
|
| Rate for Payer: Healthfirst QHP |
$12.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.05
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.64
|
| Rate for Payer: Wellcare Medicare |
$10.84
|
|
|
ANTI-JO-1
|
Facility
OP
|
$44.83
|
|
|
Service Code
|
HCPCS 86235
|
| Hospital Charge Code |
40729333
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.34 |
| Max. Negotiated Rate |
$28.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24.66
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.93
|
| Rate for Payer: Aetna Government |
$17.93
|
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Cash Price |
$17.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$24.11
|
| Rate for Payer: Elderplan Medicare Advantage |
$17.93
|
| Rate for Payer: EmblemHealth Commercial |
$17.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$15.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.96
|
| Rate for Payer: Group Health Inc Commercial |
$17.93
|
| Rate for Payer: Group Health Inc Medicare |
$17.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.93
|
| Rate for Payer: Healthfirst QHP |
$17.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$14.34
|
| Rate for Payer: Wellcare Medicare |
$16.14
|
|
|
ANTI-MPO ANTIBODIES
|
Facility
OP
|
$28.83
|
|
|
Service Code
|
HCPCS 83516
|
| Hospital Charge Code |
40729913
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.22 |
| Max. Negotiated Rate |
$18.34 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.86
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.53
|
| Rate for Payer: Aetna Government |
$11.53
|
| Rate for Payer: Cash Price |
$11.53
|
| Rate for Payer: Cash Price |
$11.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.53
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18.34
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15.52
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.53
|
| Rate for Payer: EmblemHealth Commercial |
$11.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.26
|
| Rate for Payer: Group Health Inc Commercial |
$11.53
|
| Rate for Payer: Group Health Inc Medicare |
$11.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$11.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.53
|
| Rate for Payer: Healthfirst QHP |
$11.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.22
|
| Rate for Payer: Wellcare Medicare |
$10.38
|
|
|
ANTI-MYELIN ASSOC GLYCOP IGG
|
Facility
OP
|
$30.13
|
|
|
Service Code
|
HCPCS 86255
|
| Hospital Charge Code |
40729883
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$19.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16.57
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.05
|
| Rate for Payer: Aetna Government |
$12.05
|
| Rate for Payer: Cash Price |
$12.05
|
| Rate for Payer: Cash Price |
$12.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.05
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.20
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.05
|
| Rate for Payer: EmblemHealth Commercial |
$12.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.05
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.72
|
| Rate for Payer: Group Health Inc Commercial |
$12.05
|
| Rate for Payer: Group Health Inc Medicare |
$12.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.05
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.05
|
| Rate for Payer: Healthfirst QHP |
$12.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.05
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.64
|
| Rate for Payer: Wellcare Medicare |
$10.84
|
|
|
ANTI-MYELIN ASSOC. GLY. IGM
|
Facility
OP
|
$30.13
|
|
|
Service Code
|
HCPCS 86256
|
| Hospital Charge Code |
40729891
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$19.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16.57
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.05
|
| Rate for Payer: Aetna Government |
$12.05
|
| Rate for Payer: Cash Price |
$12.05
|
| Rate for Payer: Cash Price |
$12.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.05
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.20
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.05
|
| Rate for Payer: EmblemHealth Commercial |
$12.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.05
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.72
|
| Rate for Payer: Group Health Inc Commercial |
$12.05
|
| Rate for Payer: Group Health Inc Medicare |
$12.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.05
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.05
|
| Rate for Payer: Healthfirst QHP |
$12.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.05
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.64
|
| Rate for Payer: Wellcare Medicare |
$10.84
|
|
|
ANTIMYELOPEROXIDASE (MPO) ABS
|
Facility
OP
|
$43.18
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
40609754
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.82 |
| Max. Negotiated Rate |
$23.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.27
|
| Rate for Payer: Aetna Government |
$17.27
|
| Rate for Payer: Cash Price |
$17.27
|
| Rate for Payer: Cash Price |
$17.27
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17.27
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.41
|
| Rate for Payer: Elderplan Medicare Advantage |
$17.27
|
| Rate for Payer: EmblemHealth Commercial |
$17.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$15.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$14.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.37
|
| Rate for Payer: Group Health Inc Commercial |
$17.27
|
| Rate for Payer: Group Health Inc Medicare |
$17.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.27
|
| Rate for Payer: Healthfirst QHP |
$17.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.27
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$13.82
|
| Rate for Payer: Wellcare Medicare |
$15.54
|
|
|
ANTINUCLEAR ANTIBODIES - NEG
|
Facility
OP
|
$30.23
|
|
|
Service Code
|
HCPCS 86038
|
| Hospital Charge Code |
40614105
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.67 |
| Max. Negotiated Rate |
$19.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16.63
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.09
|
| Rate for Payer: Aetna Government |
$12.09
|
| Rate for Payer: Cash Price |
$12.09
|
| Rate for Payer: Cash Price |
$12.09
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.09
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.21
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.26
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.09
|
| Rate for Payer: EmblemHealth Commercial |
$12.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.76
|
| Rate for Payer: Group Health Inc Commercial |
$12.09
|
| Rate for Payer: Group Health Inc Medicare |
$12.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.09
|
| Rate for Payer: Healthfirst QHP |
$12.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.09
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.67
|
| Rate for Payer: Wellcare Medicare |
$10.88
|
|
|
ANTIOXIDANT INFUSED 28 X 42MM
|
Facility
OP
|
$6,130.00
|
|
| Hospital Charge Code |
64905978
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,145.50 |
| Max. Negotiated Rate |
$4,904.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,371.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,065.00
|
| Rate for Payer: Aetna Government |
$3,065.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4,904.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,168.40
|
| Rate for Payer: Group Health Inc Commercial |
$3,065.00
|
| Rate for Payer: Group Health Inc Medicare |
$2,145.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,065.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,065.00
|
|
|
ANTIPANCREATIC ISLET CELLS
|
Facility
OP
|
$58.93
|
|
|
Service Code
|
HCPCS 86341
|
| Hospital Charge Code |
40609148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.86 |
| Max. Negotiated Rate |
$32.41 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$32.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23.57
|
| Rate for Payer: Aetna Government |
$23.57
|
| Rate for Payer: Cash Price |
$23.57
|
| Rate for Payer: Cash Price |
$23.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$23.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$31.45
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$26.61
|
| Rate for Payer: Elderplan Medicare Advantage |
$23.57
|
| Rate for Payer: EmblemHealth Commercial |
$23.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$20.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$20.98
|
| Rate for Payer: Fidelis Medicare Advantage |
$23.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$20.98
|
| Rate for Payer: Group Health Inc Commercial |
$23.57
|
| Rate for Payer: Group Health Inc Medicare |
$23.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$23.57
|
| Rate for Payer: Healthfirst QHP |
$23.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18.86
|
| Rate for Payer: Wellcare Medicare |
$21.21
|
|
