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Hospital Charge Code 41654689
Hospital Revenue Code 636
Min. Negotiated Rate $508.00
Max. Negotiated Rate $508.00
Rate for Payer: Hamaspik Choice Inc Medicaid $508.00
Rate for Payer: Hamaspik Choice Inc Medicare $508.00
Hospital Charge Code 41644689
Hospital Revenue Code 636
Min. Negotiated Rate $355.60
Max. Negotiated Rate $660.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial $558.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $508.00
Rate for Payer: Aetna Government $508.00
Rate for Payer: Brighton Health Commercial $609.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $508.00
Rate for Payer: Cigna LocalPlus Benefit Plan $584.20
Rate for Payer: Group Health Inc Commercial $508.00
Rate for Payer: Group Health Inc Medicare $355.60
Rate for Payer: Hamaspik Choice Inc Medicaid $508.00
Rate for Payer: Hamaspik Choice Inc Medicare $508.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $660.40
Hospital Charge Code 41644689
Hospital Revenue Code 636
Min. Negotiated Rate $508.00
Max. Negotiated Rate $508.00
Rate for Payer: Hamaspik Choice Inc Medicaid $508.00
Rate for Payer: Hamaspik Choice Inc Medicare $508.00
Hospital Charge Code 41654689
Hospital Revenue Code 636
Min. Negotiated Rate $355.60
Max. Negotiated Rate $660.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial $558.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $508.00
Rate for Payer: Aetna Government $508.00
Rate for Payer: Brighton Health Commercial $609.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $508.00
Rate for Payer: Cigna LocalPlus Benefit Plan $584.20
Rate for Payer: Group Health Inc Commercial $508.00
Rate for Payer: Group Health Inc Medicare $355.60
Rate for Payer: Hamaspik Choice Inc Medicaid $508.00
Rate for Payer: Hamaspik Choice Inc Medicare $508.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $660.40
Service Code NDC 00904585361
Hospital Charge Code 00904585361
Hospital Revenue Code 250
Min. Negotiated Rate $0.08
Max. Negotiated Rate $0.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.11
Rate for Payer: Aetna Government $0.11
Rate for Payer: Brighton Health Commercial $0.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.17
Rate for Payer: Cigna LocalPlus Benefit Plan $0.15
Rate for Payer: Group Health Inc Commercial $0.11
Rate for Payer: Group Health Inc Medicare $0.08
Rate for Payer: Hamaspik Choice Inc Medicaid $0.11
Rate for Payer: Hamaspik Choice Inc Medicare $0.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.14
Service Code NDC 67877031901
Hospital Charge Code 67877031901
Hospital Revenue Code 250
Min. Negotiated Rate $0.13
Max. Negotiated Rate $0.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.18
Rate for Payer: Aetna Government $0.18
Rate for Payer: Brighton Health Commercial $0.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.29
Rate for Payer: Cigna LocalPlus Benefit Plan $0.25
Rate for Payer: Group Health Inc Commercial $0.18
Rate for Payer: Group Health Inc Medicare $0.13
Rate for Payer: Hamaspik Choice Inc Medicaid $0.18
Rate for Payer: Hamaspik Choice Inc Medicare $0.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.24
Service Code NDC 60687044611
Hospital Charge Code 60687044611
Hospital Revenue Code 250
Min. Negotiated Rate $0.09
Max. Negotiated Rate $0.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.13
Rate for Payer: Aetna Government $0.13
Rate for Payer: Brighton Health Commercial $0.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.21
Rate for Payer: Cigna LocalPlus Benefit Plan $0.18
Rate for Payer: Group Health Inc Commercial $0.13
Rate for Payer: Group Health Inc Medicare $0.09
Rate for Payer: Hamaspik Choice Inc Medicaid $0.13
Rate for Payer: Hamaspik Choice Inc Medicare $0.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.17
Service Code NDC 67877031905
Hospital Charge Code 67877031905
Hospital Revenue Code 250
Min. Negotiated Rate $0.12
Max. Negotiated Rate $0.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.17
Rate for Payer: Aetna Government $0.17
Rate for Payer: Brighton Health Commercial $0.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.27
Rate for Payer: Cigna LocalPlus Benefit Plan $0.23
Rate for Payer: Group Health Inc Commercial $0.17
Rate for Payer: Group Health Inc Medicare $0.12
Rate for Payer: Hamaspik Choice Inc Medicaid $0.17
Rate for Payer: Hamaspik Choice Inc Medicare $0.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.22
Service Code NDC 60687044601
Hospital Charge Code 60687044601
Hospital Revenue Code 250
Min. Negotiated Rate $0.09
Max. Negotiated Rate $0.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.13
Rate for Payer: Aetna Government $0.13
Rate for Payer: Brighton Health Commercial $0.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.21
Rate for Payer: Cigna LocalPlus Benefit Plan $0.18
Rate for Payer: Group Health Inc Commercial $0.13
Rate for Payer: Group Health Inc Medicare $0.09
Rate for Payer: Hamaspik Choice Inc Medicaid $0.13
Rate for Payer: Hamaspik Choice Inc Medicare $0.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.17
Hospital Charge Code 41653279
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Brighton Health Commercial $0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Hospital Charge Code 41643279
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Brighton Health Commercial $0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Service Code NDC 64380080807
Hospital Charge Code 64380080807
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 $0.40
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 00904585461
Hospital Charge Code 00904585461
Hospital Revenue Code 250
Min. Negotiated Rate $0.11
Max. Negotiated Rate $0.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.15
Rate for Payer: Aetna Government $0.15
Rate for Payer: Brighton Health Commercial $0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.24
Rate for Payer: Cigna LocalPlus Benefit Plan $0.21
Rate for Payer: Group Health Inc Commercial $0.15
Rate for Payer: Group Health Inc Medicare $0.11
Rate for Payer: Hamaspik Choice Inc Medicaid $0.15
Rate for Payer: Hamaspik Choice Inc Medicare $0.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.20
Service Code NDC 59651036105
Hospital Charge Code 59651036105
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 $0.40
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 67877032001
Hospital Charge Code 67877032001
Hospital Revenue Code 250
Min. Negotiated Rate $0.18
Max. Negotiated Rate $0.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.28
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 $0.41
Rate for Payer: Cigna LocalPlus Benefit Plan $0.35
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 $0.33
Service Code NDC 67877032005
Hospital Charge Code 67877032005
Hospital Revenue Code 250
Min. Negotiated Rate $0.18
Max. Negotiated Rate $0.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.28
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 $0.41
Rate for Payer: Cigna LocalPlus Benefit Plan $0.35
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 $0.33
Service Code NDC 65162046550
Hospital Charge Code 65162046550
Hospital Revenue Code 250
Min. Negotiated Rate $0.19
Max. Negotiated Rate $0.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.27
Rate for Payer: Aetna Government $0.27
Rate for Payer: Brighton Health Commercial $0.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.44
Rate for Payer: Cigna LocalPlus Benefit Plan $0.37
Rate for Payer: Group Health Inc Commercial $0.27
Rate for Payer: Group Health Inc Medicare $0.19
Rate for Payer: Hamaspik Choice Inc Medicaid $0.27
Rate for Payer: Hamaspik Choice Inc Medicare $0.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.36
Service Code NDC 00904585460
Hospital Charge Code 00904585460
Hospital Revenue Code 250
Min. Negotiated Rate $0.10
Max. Negotiated Rate $0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.14
Rate for Payer: Aetna Government $0.14
Rate for Payer: Brighton Health Commercial $0.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.22
Rate for Payer: Cigna LocalPlus Benefit Plan $0.19
Rate for Payer: Group Health Inc Commercial $0.14
Rate for Payer: Group Health Inc Medicare $0.10
Rate for Payer: Hamaspik Choice Inc Medicaid $0.14
Rate for Payer: Hamaspik Choice Inc Medicare $0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.18
Service Code NDC 60687045701
Hospital Charge Code 60687045701
Hospital Revenue Code 250
Min. Negotiated Rate $0.13
Max. Negotiated Rate $0.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.18
Rate for Payer: Aetna Government $0.18
Rate for Payer: Brighton Health Commercial $0.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.29
Rate for Payer: Cigna LocalPlus Benefit Plan $0.25
Rate for Payer: Group Health Inc Commercial $0.18
Rate for Payer: Group Health Inc Medicare $0.13
Rate for Payer: Hamaspik Choice Inc Medicaid $0.18
Rate for Payer: Hamaspik Choice Inc Medicare $0.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.24
Hospital Charge Code 41640276
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Brighton Health Commercial $0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Hospital Charge Code 41650276
Hospital Revenue Code 250
Min. Negotiated Rate $0.35
Max. Negotiated Rate $0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.50
Rate for Payer: Aetna Government $0.50
Rate for Payer: Brighton Health Commercial $0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.80
Rate for Payer: Cigna LocalPlus Benefit Plan $0.68
Rate for Payer: Group Health Inc Commercial $0.50
Rate for Payer: Group Health Inc Medicare $0.35
Rate for Payer: Hamaspik Choice Inc Medicaid $0.50
Rate for Payer: Hamaspik Choice Inc Medicare $0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.65
Service Code HCPCS J1741
Hospital Charge Code 41657818
Hospital Revenue Code 636
Min. Negotiated Rate $4.07
Max. Negotiated Rate $4.07
Rate for Payer: Hamaspik Choice Inc Medicaid $4.07
Rate for Payer: Hamaspik Choice Inc Medicare $4.07
Service Code HCPCS J1741
Hospital Charge Code 41657818
Hospital Revenue Code 636
Min. Negotiated Rate $1.98
Max. Negotiated Rate $5.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial $4.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.98
Rate for Payer: Aetna Government $1.98
Rate for Payer: Brighton Health Commercial $4.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $4.07
Rate for Payer: Cigna LocalPlus Benefit Plan $4.68
Rate for Payer: Group Health Inc Commercial $4.07
Rate for Payer: Group Health Inc Medicare $2.85
Rate for Payer: Hamaspik Choice Inc Medicaid $4.07
Rate for Payer: Hamaspik Choice Inc Medicare $4.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $5.29
Service Code NDC 66220028708
Hospital Charge Code 66220028708
Hospital Revenue Code 278
Min. Negotiated Rate $1.30
Max. Negotiated Rate $3.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.85
Rate for Payer: Aetna Government $1.85
Rate for Payer: Brighton Health Commercial $2.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.85
Rate for Payer: Cigna LocalPlus Benefit Plan $2.13
Rate for Payer: EmblemHealth Commercial $1.85
Rate for Payer: Fidelis Medicare Advantage $3.89
Rate for Payer: Group Health Inc Commercial $1.85
Rate for Payer: Group Health Inc Medicare $1.30
Rate for Payer: Hamaspik Choice Inc Medicaid $1.85
Rate for Payer: Hamaspik Choice Inc Medicare $1.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2.41
Service Code NDC 66220028708
Hospital Charge Code 66220028708
Hospital Revenue Code 278
Min. Negotiated Rate $1.85
Max. Negotiated Rate $1.85
Rate for Payer: Hamaspik Choice Inc Medicaid $1.85
Rate for Payer: Hamaspik Choice Inc Medicare $1.85