Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS J3010
Hospital Charge Code 63323013099
Hospital Revenue Code 250
Min. Negotiated Rate $0.11
Max. Negotiated Rate $1.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.63
Rate for Payer: Aetna Government $0.63
Rate for Payer: Brighton Health Commercial $0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.25
Rate for Payer: Cigna LocalPlus Benefit Plan $0.21
Rate for Payer: Group Health Inc Commercial $0.16
Rate for Payer: Group Health Inc Medicare $0.11
Rate for Payer: Hamaspik Choice Inc Medicaid $0.16
Rate for Payer: Hamaspik Choice Inc Medicare $0.16
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid $0.99
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage $1.05
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) $1.05
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) $1.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.20
Service Code HCPCS 80361
Hospital Charge Code 40601237
Hospital Revenue Code 301
Min. Negotiated Rate $0.01
Max. Negotiated Rate $71.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial $49.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.01
Rate for Payer: Aetna Government $0.01
Rate for Payer: Brighton Health Commercial $67.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $71.54
Rate for Payer: Cigna LocalPlus Benefit Plan $60.81
Rate for Payer: Group Health Inc Commercial $44.71
Rate for Payer: Group Health Inc Medicare $31.30
Rate for Payer: Hamaspik Choice Inc Medicaid $44.71
Rate for Payer: Hamaspik Choice Inc Medicare $44.71
Rate for Payer: United Healthcare Commercial $31.48
Hospital Charge Code 64905492
Hospital Revenue Code 270
Min. Negotiated Rate $9.98
Max. Negotiated Rate $22.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $15.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $14.25
Rate for Payer: Aetna Government $14.25
Rate for Payer: Brighton Health Commercial $21.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $22.80
Rate for Payer: Cigna LocalPlus Benefit Plan $19.38
Rate for Payer: Group Health Inc Commercial $14.25
Rate for Payer: Group Health Inc Medicare $9.98
Rate for Payer: Hamaspik Choice Inc Medicaid $14.25
Rate for Payer: Hamaspik Choice Inc Medicare $14.25
Service Code HCPCS J1439
Hospital Charge Code 41656593
Hospital Revenue Code 636
Min. Negotiated Rate $0.80
Max. Negotiated Rate $1.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.15
Rate for Payer: Aetna Government $1.15
Rate for Payer: Affinity Essential Plan 1&2 $0.80
Rate for Payer: Affinity Essential Plan 3&4 $0.80
Rate for Payer: Affinity Medicaid/CHP/HARP $0.80
Rate for Payer: Brighton Health Commercial $1.16
Rate for Payer: Cash Price $1.15
Rate for Payer: Cash Price $1.15
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $1.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.97
Rate for Payer: Cigna LocalPlus Benefit Plan $1.12
Rate for Payer: Elderplan Medicare Advantage $1.15
Rate for Payer: EmblemHealth Commercial $1.15
Rate for Payer: Fidelis CHP/HARP/Medicaid $1.15
Rate for Payer: Fidelis Essential Plan Aliesa $1.15
Rate for Payer: Fidelis Essential Plan QHP $1.20
Rate for Payer: Fidelis Medicare Advantage $1.15
Rate for Payer: Fidelis Qualified Health Plan $1.20
Rate for Payer: Group Health Inc Commercial $1.15
Rate for Payer: Group Health Inc Medicare $1.15
Rate for Payer: Hamaspik Choice Inc Medicaid $0.97
Rate for Payer: Hamaspik Choice Inc Medicare $0.97
Rate for Payer: Healthfirst Medicare Advantage $0.97
Rate for Payer: Healthfirst QHP $1.15
Rate for Payer: Humana Medicare $1.17
Rate for Payer: Senior Whole Health Medicare Advantage $1.15
Rate for Payer: SOMOS CHP/HARP/Medicaid $1.16
Rate for Payer: SOMOS Essential $1.16
Rate for Payer: United Healthcare Commercial $1.10
Rate for Payer: United Healthcare Medicare Advantage $1.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.26
Rate for Payer: Wellcare CHP/FHP/Medicaid $0.92
Rate for Payer: Wellcare Medicare $1.09
Service Code HCPCS J1439
Hospital Charge Code 41646593
Hospital Revenue Code 636
Min. Negotiated Rate $0.80
Max. Negotiated Rate $1.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.15
Rate for Payer: Aetna Government $1.15
Rate for Payer: Affinity Essential Plan 1&2 $0.80
Rate for Payer: Affinity Essential Plan 3&4 $0.80
Rate for Payer: Affinity Medicaid/CHP/HARP $0.80
Rate for Payer: Brighton Health Commercial $1.16
Rate for Payer: Cash Price $1.15
Rate for Payer: Cash Price $1.15
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $1.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.97
Rate for Payer: Cigna LocalPlus Benefit Plan $1.12
Rate for Payer: Elderplan Medicare Advantage $1.15
Rate for Payer: EmblemHealth Commercial $1.15
Rate for Payer: Fidelis CHP/HARP/Medicaid $1.15
Rate for Payer: Fidelis Essential Plan Aliesa $1.15
Rate for Payer: Fidelis Essential Plan QHP $1.20
Rate for Payer: Fidelis Medicare Advantage $1.15
Rate for Payer: Fidelis Qualified Health Plan $1.20
Rate for Payer: Group Health Inc Commercial $1.15
Rate for Payer: Group Health Inc Medicare $1.15
Rate for Payer: Hamaspik Choice Inc Medicaid $0.97
Rate for Payer: Hamaspik Choice Inc Medicare $0.97
Rate for Payer: Healthfirst Medicare Advantage $0.97
Rate for Payer: Healthfirst QHP $1.15
Rate for Payer: Humana Medicare $1.17
Rate for Payer: Senior Whole Health Medicare Advantage $1.15
Rate for Payer: SOMOS CHP/HARP/Medicaid $1.16
Rate for Payer: SOMOS Essential $1.16
Rate for Payer: United Healthcare Commercial $1.10
Rate for Payer: United Healthcare Medicare Advantage $1.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.26
Rate for Payer: Wellcare CHP/FHP/Medicaid $0.92
Rate for Payer: Wellcare Medicare $1.09
Service Code HCPCS J1439
Hospital Charge Code 41656593
Hospital Revenue Code 636
Min. Negotiated Rate $0.97
Max. Negotiated Rate $0.97
Rate for Payer: Cash Price $1.15
Rate for Payer: Hamaspik Choice Inc Medicaid $0.97
Rate for Payer: Hamaspik Choice Inc Medicare $0.97
Service Code HCPCS J1439
Hospital Charge Code 41646593
Hospital Revenue Code 636
Min. Negotiated Rate $0.97
Max. Negotiated Rate $0.97
Rate for Payer: Cash Price $1.15
Rate for Payer: Hamaspik Choice Inc Medicaid $0.97
Rate for Payer: Hamaspik Choice Inc Medicare $0.97
Service Code HCPCS J1439
Hospital Charge Code 00517065001
Hospital Revenue Code 278
Min. Negotiated Rate $0.92
Max. Negotiated Rate $75.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial $63.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.15
Rate for Payer: Aetna Government $1.15
Rate for Payer: Brighton Health Commercial $69.40
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $1.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $57.84
Rate for Payer: Cigna LocalPlus Benefit Plan $66.51
Rate for Payer: Elderplan Medicare Advantage $1.15
Rate for Payer: EmblemHealth Commercial $57.84
Rate for Payer: Fidelis Medicare Advantage $1.15
Rate for Payer: Group Health Inc Commercial $1.15
Rate for Payer: Group Health Inc Medicare $1.15
Rate for Payer: Hamaspik Choice Inc Medicaid $57.84
Rate for Payer: Hamaspik Choice Inc Medicare $57.84
Rate for Payer: Healthfirst Medicare Advantage $0.97
Rate for Payer: Healthfirst QHP $1.15
Rate for Payer: Humana Medicare $1.17
Rate for Payer: Senior Whole Health Medicare Advantage $1.15
Rate for Payer: United Healthcare Medicare Advantage $1.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $75.19
Rate for Payer: Wellcare CHP/FHP/Medicaid $0.92
Service Code HCPCS J1439
Hospital Charge Code 00517065001
Hospital Revenue Code 278
Min. Negotiated Rate $57.84
Max. Negotiated Rate $57.84
Rate for Payer: Hamaspik Choice Inc Medicaid $57.84
Rate for Payer: Hamaspik Choice Inc Medicare $57.84
Service Code NDC 59365606501
Hospital Charge Code 59365606501
Hospital Revenue Code 250
Min. Negotiated Rate $0.86
Max. Negotiated Rate $1.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.23
Rate for Payer: Aetna Government $1.23
Rate for Payer: Brighton Health Commercial $1.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.96
Rate for Payer: Cigna LocalPlus Benefit Plan $1.67
Rate for Payer: Group Health Inc Commercial $1.23
Rate for Payer: Group Health Inc Medicare $0.86
Rate for Payer: Hamaspik Choice Inc Medicaid $1.23
Rate for Payer: Hamaspik Choice Inc Medicare $1.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.60
Hospital Charge Code 41654566
Hospital Revenue Code 250
Min. Negotiated Rate $8.58
Max. Negotiated Rate $19.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial $13.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $12.26
Rate for Payer: Aetna Government $12.26
Rate for Payer: Brighton Health Commercial $18.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $19.61
Rate for Payer: Cigna LocalPlus Benefit Plan $16.67
Rate for Payer: Group Health Inc Commercial $12.26
Rate for Payer: Group Health Inc Medicare $8.58
Rate for Payer: Hamaspik Choice Inc Medicaid $12.26
Rate for Payer: Hamaspik Choice Inc Medicare $12.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $15.93
Hospital Charge Code 41644566
Hospital Revenue Code 250
Min. Negotiated Rate $8.58
Max. Negotiated Rate $19.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial $13.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $12.26
Rate for Payer: Aetna Government $12.26
Rate for Payer: Brighton Health Commercial $18.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $19.61
Rate for Payer: Cigna LocalPlus Benefit Plan $16.67
Rate for Payer: Group Health Inc Commercial $12.26
Rate for Payer: Group Health Inc Medicare $8.58
Rate for Payer: Hamaspik Choice Inc Medicaid $12.26
Rate for Payer: Hamaspik Choice Inc Medicare $12.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $15.93
Service Code HCPCS 82728
Hospital Charge Code 40602375
Hospital Revenue Code 301
Rate for Payer: Cash Price $13.63
Service Code HCPCS 82728
Hospital Charge Code 40602375
Hospital Revenue Code 301
Min. Negotiated Rate $9.54
Max. Negotiated Rate $25.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial $18.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $13.63
Rate for Payer: Aetna Government $13.63
Rate for Payer: Affinity Essential Plan 1&2 $9.54
Rate for Payer: Affinity Essential Plan 3&4 $9.54
Rate for Payer: Affinity Medicaid/CHP/HARP $9.54
Rate for Payer: Brighton Health Commercial $25.56
Rate for Payer: Cash Price $13.63
Rate for Payer: Cash Price $13.63
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $13.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $21.64
Rate for Payer: Cigna LocalPlus Benefit Plan $18.32
Rate for Payer: Elderplan Medicare Advantage $13.63
Rate for Payer: EmblemHealth Commercial $13.63
Rate for Payer: Fidelis Essential Plan Aliesa $11.59
Rate for Payer: Fidelis Essential Plan QHP $12.13
Rate for Payer: Fidelis Medicare Advantage $13.63
Rate for Payer: Fidelis Qualified Health Plan $12.13
Rate for Payer: Group Health Inc Commercial $13.63
Rate for Payer: Group Health Inc Medicare $13.63
Rate for Payer: Hamaspik Choice Inc Medicaid $17.04
Rate for Payer: Hamaspik Choice Inc Medicare $13.63
Rate for Payer: Healthfirst Medicare Advantage $13.63
Rate for Payer: Healthfirst QHP $13.63
Rate for Payer: Humana Medicare $13.90
Rate for Payer: Senior Whole Health Medicare Advantage $13.63
Rate for Payer: United Healthcare Commercial $17.25
Rate for Payer: United Healthcare Medicare Advantage $13.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $13.63
Rate for Payer: Wellcare CHP/FHP/Medicaid $10.90
Rate for Payer: Wellcare Medicare $12.27
Hospital Charge Code 41651190
Hospital Revenue Code 250
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.03
Rate for Payer: Aetna Government $0.03
Rate for Payer: Brighton Health Commercial $0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.04
Rate for Payer: Cigna LocalPlus Benefit Plan $0.03
Rate for Payer: Group Health Inc Commercial $0.03
Rate for Payer: Group Health Inc Medicare $0.02
Rate for Payer: Hamaspik Choice Inc Medicaid $0.03
Rate for Payer: Hamaspik Choice Inc Medicare $0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.03
Hospital Charge Code 41641190
Hospital Revenue Code 250
Min. Negotiated Rate $0.02
Max. Negotiated Rate $0.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.03
Rate for Payer: Aetna Government $0.03
Rate for Payer: Brighton Health Commercial $0.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.04
Rate for Payer: Cigna LocalPlus Benefit Plan $0.03
Rate for Payer: Group Health Inc Commercial $0.03
Rate for Payer: Group Health Inc Medicare $0.02
Rate for Payer: Hamaspik Choice Inc Medicaid $0.03
Rate for Payer: Hamaspik Choice Inc Medicare $0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.03
Service Code NDC 00904213761
Hospital Charge Code 00904213761
Hospital Revenue Code 250
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.04
Rate for Payer: Aetna Government $0.04
Rate for Payer: Brighton Health Commercial $0.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.06
Rate for Payer: Cigna LocalPlus Benefit Plan $0.05
Rate for Payer: Group Health Inc Commercial $0.04
Rate for Payer: Group Health Inc Medicare $0.03
Rate for Payer: Hamaspik Choice Inc Medicaid $0.04
Rate for Payer: Hamaspik Choice Inc Medicare $0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.05
Hospital Charge Code 41657031
Hospital Revenue Code 250
Max. Negotiated Rate $0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.01
Rate for Payer: Aetna Government $0.01
Rate for Payer: Brighton Health Commercial $0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.01
Rate for Payer: Cigna LocalPlus Benefit Plan $0.01
Rate for Payer: Group Health Inc Commercial $0.01
Rate for Payer: Group Health Inc Medicare $0.00
Rate for Payer: Hamaspik Choice Inc Medicaid $0.01
Rate for Payer: Hamaspik Choice Inc Medicare $0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.01
Hospital Charge Code 41647031
Hospital Revenue Code 250
Max. Negotiated Rate $0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.01
Rate for Payer: Aetna Government $0.01
Rate for Payer: Brighton Health Commercial $0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.01
Rate for Payer: Cigna LocalPlus Benefit Plan $0.01
Rate for Payer: Group Health Inc Commercial $0.01
Rate for Payer: Group Health Inc Medicare $0.00
Rate for Payer: Hamaspik Choice Inc Medicaid $0.01
Rate for Payer: Hamaspik Choice Inc Medicare $0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.01
Hospital Charge Code 41641423
Hospital Revenue Code 250
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.05
Rate for Payer: Aetna Government $0.05
Rate for Payer: Brighton Health Commercial $0.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.07
Rate for Payer: Cigna LocalPlus Benefit Plan $0.06
Rate for Payer: Group Health Inc Commercial $0.05
Rate for Payer: Group Health Inc Medicare $0.03
Rate for Payer: Hamaspik Choice Inc Medicaid $0.05
Rate for Payer: Hamaspik Choice Inc Medicare $0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.06
Hospital Charge Code 41651423
Hospital Revenue Code 250
Min. Negotiated Rate $0.03
Max. Negotiated Rate $0.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.05
Rate for Payer: Aetna Government $0.05
Rate for Payer: Brighton Health Commercial $0.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.07
Rate for Payer: Cigna LocalPlus Benefit Plan $0.06
Rate for Payer: Group Health Inc Commercial $0.05
Rate for Payer: Group Health Inc Medicare $0.03
Rate for Payer: Hamaspik Choice Inc Medicaid $0.05
Rate for Payer: Hamaspik Choice Inc Medicare $0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.06
Service Code NDC 00121053005
Hospital Charge Code 00121053005
Hospital Revenue Code 250
Min. Negotiated Rate $0.28
Max. Negotiated Rate $0.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.41
Rate for Payer: Aetna Government $0.41
Rate for Payer: Brighton Health Commercial $0.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.65
Rate for Payer: Cigna LocalPlus Benefit Plan $0.55
Rate for Payer: Group Health Inc Commercial $0.41
Rate for Payer: Group Health Inc Medicare $0.28
Rate for Payer: Hamaspik Choice Inc Medicaid $0.41
Rate for Payer: Hamaspik Choice Inc Medicare $0.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.53
Service Code NDC 00904727741
Hospital Charge Code 00904727741
Hospital Revenue Code 250
Min. Negotiated Rate $0.18
Max. Negotiated Rate $0.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.26
Rate for Payer: Aetna Government $0.26
Rate for Payer: Brighton Health Commercial $0.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.42
Rate for Payer: Cigna LocalPlus Benefit Plan $0.36
Rate for Payer: Group Health Inc Commercial $0.26
Rate for Payer: Group Health Inc Medicare $0.18
Rate for Payer: Hamaspik Choice Inc Medicaid $0.26
Rate for Payer: Hamaspik Choice Inc Medicare $0.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.34
Service Code NDC 39328015705
Hospital Charge Code 39328015705
Hospital Revenue Code 250
Min. Negotiated Rate $0.26
Max. Negotiated Rate $0.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.37
Rate for Payer: Aetna Government $0.37
Rate for Payer: Brighton Health Commercial $0.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.59
Rate for Payer: Cigna LocalPlus Benefit Plan $0.50
Rate for Payer: Group Health Inc Commercial $0.37
Rate for Payer: Group Health Inc Medicare $0.26
Rate for Payer: Hamaspik Choice Inc Medicaid $0.37
Rate for Payer: Hamaspik Choice Inc Medicare $0.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.48
Service Code NDC 00904727770
Hospital Charge Code 00904727770
Hospital Revenue Code 250
Min. Negotiated Rate $0.18
Max. Negotiated Rate $0.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.26
Rate for Payer: Aetna Government $0.26
Rate for Payer: Brighton Health Commercial $0.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.42
Rate for Payer: Cigna LocalPlus Benefit Plan $0.36
Rate for Payer: Group Health Inc Commercial $0.26
Rate for Payer: Group Health Inc Medicare $0.18
Rate for Payer: Hamaspik Choice Inc Medicaid $0.26
Rate for Payer: Hamaspik Choice Inc Medicare $0.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.34