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Service Code HCPCS J1817
Hospital Charge Code 41648195
Hospital Revenue Code 636
Min. Negotiated Rate $3.86
Max. Negotiated Rate $3.86
Rate for Payer: Hamaspik Choice Inc Medicaid $3.86
Rate for Payer: Hamaspik Choice Inc Medicare $3.86
Service Code HCPCS J1817
Hospital Charge Code 41658197
Hospital Revenue Code 636
Min. Negotiated Rate $2.19
Max. Negotiated Rate $11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial $3.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $11.14
Rate for Payer: Aetna Government $11.14
Rate for Payer: Brighton Health Commercial $3.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $3.12
Rate for Payer: Cigna LocalPlus Benefit Plan $3.59
Rate for Payer: Group Health Inc Commercial $3.12
Rate for Payer: Group Health Inc Medicare $2.19
Rate for Payer: Hamaspik Choice Inc Medicaid $3.12
Rate for Payer: Hamaspik Choice Inc Medicare $3.12
Rate for Payer: SOMOS CHP/HARP/Medicaid $8.01
Rate for Payer: SOMOS Essential $8.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $4.06
Service Code HCPCS J1817
Hospital Charge Code 41658197
Hospital Revenue Code 636
Min. Negotiated Rate $3.12
Max. Negotiated Rate $3.12
Rate for Payer: Hamaspik Choice Inc Medicaid $3.12
Rate for Payer: Hamaspik Choice Inc Medicare $3.12
Service Code HCPCS J1817
Hospital Charge Code 41648197
Hospital Revenue Code 636
Min. Negotiated Rate $3.12
Max. Negotiated Rate $3.12
Rate for Payer: Hamaspik Choice Inc Medicaid $3.12
Rate for Payer: Hamaspik Choice Inc Medicare $3.12
Service Code HCPCS J1817
Hospital Charge Code 41648197
Hospital Revenue Code 636
Min. Negotiated Rate $2.19
Max. Negotiated Rate $11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial $3.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $11.14
Rate for Payer: Aetna Government $11.14
Rate for Payer: Brighton Health Commercial $3.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $3.12
Rate for Payer: Cigna LocalPlus Benefit Plan $3.59
Rate for Payer: Group Health Inc Commercial $3.12
Rate for Payer: Group Health Inc Medicare $2.19
Rate for Payer: Hamaspik Choice Inc Medicaid $3.12
Rate for Payer: Hamaspik Choice Inc Medicare $3.12
Rate for Payer: SOMOS CHP/HARP/Medicaid $8.01
Rate for Payer: SOMOS Essential $8.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $4.06
Service Code HCPCS J1817
Hospital Charge Code 41648199
Hospital Revenue Code 636
Min. Negotiated Rate $0.43
Max. Negotiated Rate $11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $11.14
Rate for Payer: Aetna Government $11.14
Rate for Payer: Brighton Health Commercial $0.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.62
Rate for Payer: Cigna LocalPlus Benefit Plan $0.71
Rate for Payer: Group Health Inc Commercial $0.62
Rate for Payer: Group Health Inc Medicare $0.43
Rate for Payer: Hamaspik Choice Inc Medicaid $0.62
Rate for Payer: Hamaspik Choice Inc Medicare $0.62
Rate for Payer: SOMOS CHP/HARP/Medicaid $8.01
Rate for Payer: SOMOS Essential $8.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.80
Service Code HCPCS J1817
Hospital Charge Code 41648199
Hospital Revenue Code 636
Min. Negotiated Rate $0.62
Max. Negotiated Rate $0.62
Rate for Payer: Hamaspik Choice Inc Medicaid $0.62
Rate for Payer: Hamaspik Choice Inc Medicare $0.62
Service Code HCPCS J1817
Hospital Charge Code 41658199
Hospital Revenue Code 636
Min. Negotiated Rate $0.62
Max. Negotiated Rate $0.62
Rate for Payer: Hamaspik Choice Inc Medicaid $0.62
Rate for Payer: Hamaspik Choice Inc Medicare $0.62
Service Code HCPCS J1817
Hospital Charge Code 41658199
Hospital Revenue Code 636
Min. Negotiated Rate $0.43
Max. Negotiated Rate $11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $11.14
Rate for Payer: Aetna Government $11.14
Rate for Payer: Brighton Health Commercial $0.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.62
Rate for Payer: Cigna LocalPlus Benefit Plan $0.71
Rate for Payer: Group Health Inc Commercial $0.62
Rate for Payer: Group Health Inc Medicare $0.43
Rate for Payer: Hamaspik Choice Inc Medicaid $0.62
Rate for Payer: Hamaspik Choice Inc Medicare $0.62
Rate for Payer: SOMOS CHP/HARP/Medicaid $8.01
Rate for Payer: SOMOS Essential $8.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.80
Service Code HCPCS J1817
Hospital Charge Code 41648201
Hospital Revenue Code 636
Min. Negotiated Rate $2.30
Max. Negotiated Rate $2.30
Rate for Payer: Hamaspik Choice Inc Medicaid $2.30
Rate for Payer: Hamaspik Choice Inc Medicare $2.30
Service Code HCPCS J1817
Hospital Charge Code 41648201
Hospital Revenue Code 636
Min. Negotiated Rate $1.61
Max. Negotiated Rate $11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $11.14
Rate for Payer: Aetna Government $11.14
Rate for Payer: Brighton Health Commercial $2.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2.30
Rate for Payer: Cigna LocalPlus Benefit Plan $2.65
Rate for Payer: Group Health Inc Commercial $2.30
Rate for Payer: Group Health Inc Medicare $1.61
Rate for Payer: Hamaspik Choice Inc Medicaid $2.30
Rate for Payer: Hamaspik Choice Inc Medicare $2.30
Rate for Payer: SOMOS CHP/HARP/Medicaid $8.01
Rate for Payer: SOMOS Essential $8.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $3.00
Service Code HCPCS J1817
Hospital Charge Code 41658201
Hospital Revenue Code 636
Min. Negotiated Rate $1.61
Max. Negotiated Rate $11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $11.14
Rate for Payer: Aetna Government $11.14
Rate for Payer: Brighton Health Commercial $2.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2.30
Rate for Payer: Cigna LocalPlus Benefit Plan $2.65
Rate for Payer: Group Health Inc Commercial $2.30
Rate for Payer: Group Health Inc Medicare $1.61
Rate for Payer: Hamaspik Choice Inc Medicaid $2.30
Rate for Payer: Hamaspik Choice Inc Medicare $2.30
Rate for Payer: SOMOS CHP/HARP/Medicaid $8.01
Rate for Payer: SOMOS Essential $8.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $3.00
Service Code HCPCS J1817
Hospital Charge Code 41658201
Hospital Revenue Code 636
Min. Negotiated Rate $2.30
Max. Negotiated Rate $2.30
Rate for Payer: Hamaspik Choice Inc Medicaid $2.30
Rate for Payer: Hamaspik Choice Inc Medicare $2.30
Service Code HCPCS J1817
Hospital Charge Code 41648203
Hospital Revenue Code 636
Min. Negotiated Rate $1.18
Max. Negotiated Rate $1.18
Rate for Payer: Hamaspik Choice Inc Medicaid $1.18
Rate for Payer: Hamaspik Choice Inc Medicare $1.18
Service Code HCPCS J1817
Hospital Charge Code 41648203
Hospital Revenue Code 636
Min. Negotiated Rate $0.83
Max. Negotiated Rate $11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $11.14
Rate for Payer: Aetna Government $11.14
Rate for Payer: Brighton Health Commercial $1.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.18
Rate for Payer: Cigna LocalPlus Benefit Plan $1.36
Rate for Payer: Group Health Inc Commercial $1.18
Rate for Payer: Group Health Inc Medicare $0.83
Rate for Payer: Hamaspik Choice Inc Medicaid $1.18
Rate for Payer: Hamaspik Choice Inc Medicare $1.18
Rate for Payer: SOMOS CHP/HARP/Medicaid $8.01
Rate for Payer: SOMOS Essential $8.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.53
Service Code HCPCS J1817
Hospital Charge Code 41658203
Hospital Revenue Code 636
Min. Negotiated Rate $1.18
Max. Negotiated Rate $1.18
Rate for Payer: Hamaspik Choice Inc Medicaid $1.18
Rate for Payer: Hamaspik Choice Inc Medicare $1.18
Service Code HCPCS J1817
Hospital Charge Code 41658203
Hospital Revenue Code 636
Min. Negotiated Rate $0.83
Max. Negotiated Rate $11.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $11.14
Rate for Payer: Aetna Government $11.14
Rate for Payer: Brighton Health Commercial $1.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1.18
Rate for Payer: Cigna LocalPlus Benefit Plan $1.36
Rate for Payer: Group Health Inc Commercial $1.18
Rate for Payer: Group Health Inc Medicare $0.83
Rate for Payer: Hamaspik Choice Inc Medicaid $1.18
Rate for Payer: Hamaspik Choice Inc Medicare $1.18
Rate for Payer: SOMOS CHP/HARP/Medicaid $8.01
Rate for Payer: SOMOS Essential $8.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.53
Service Code HCPCS J1815
Hospital Charge Code 00002753301
Hospital Revenue Code 250
Min. Negotiated Rate $0.95
Max. Negotiated Rate $6.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial $4.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.95
Rate for Payer: Aetna Government $0.95
Rate for Payer: Brighton Health Commercial $5.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $6.37
Rate for Payer: Cigna LocalPlus Benefit Plan $5.42
Rate for Payer: Group Health Inc Commercial $3.98
Rate for Payer: Group Health Inc Medicare $2.79
Rate for Payer: Hamaspik Choice Inc Medicaid $3.98
Rate for Payer: Hamaspik Choice Inc Medicare $3.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $5.18
Service Code HCPCS J1815
Hospital Charge Code 00002773701
Hospital Revenue Code 250
Min. Negotiated Rate $0.95
Max. Negotiated Rate $2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.95
Rate for Payer: Aetna Government $0.95
Rate for Payer: Brighton Health Commercial $2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2.40
Rate for Payer: Cigna LocalPlus Benefit Plan $2.04
Rate for Payer: Group Health Inc Commercial $1.50
Rate for Payer: Group Health Inc Medicare $1.05
Rate for Payer: Hamaspik Choice Inc Medicaid $1.50
Rate for Payer: Hamaspik Choice Inc Medicare $1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.95
Service Code HCPCS J1815
Hospital Charge Code 00002751001
Hospital Revenue Code 250
Min. Negotiated Rate $0.95
Max. Negotiated Rate $6.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial $4.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.95
Rate for Payer: Aetna Government $0.95
Rate for Payer: Brighton Health Commercial $5.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $6.37
Rate for Payer: Cigna LocalPlus Benefit Plan $5.42
Rate for Payer: Group Health Inc Commercial $3.98
Rate for Payer: Group Health Inc Medicare $2.79
Rate for Payer: Hamaspik Choice Inc Medicaid $3.98
Rate for Payer: Hamaspik Choice Inc Medicare $3.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $5.18
Service Code HCPCS J1815
Hospital Charge Code 41642189
Hospital Revenue Code 636
Min. Negotiated Rate $0.31
Max. Negotiated Rate $0.31
Rate for Payer: Hamaspik Choice Inc Medicaid $0.31
Rate for Payer: Hamaspik Choice Inc Medicare $0.31
Service Code HCPCS J1815
Hospital Charge Code 41642189
Hospital Revenue Code 636
Min. Negotiated Rate $0.21
Max. Negotiated Rate $0.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.95
Rate for Payer: Aetna Government $0.95
Rate for Payer: Brighton Health Commercial $0.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.31
Rate for Payer: Cigna LocalPlus Benefit Plan $0.35
Rate for Payer: Group Health Inc Commercial $0.31
Rate for Payer: Group Health Inc Medicare $0.21
Rate for Payer: Hamaspik Choice Inc Medicaid $0.31
Rate for Payer: Hamaspik Choice Inc Medicare $0.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.40
Service Code HCPCS J1815
Hospital Charge Code 41652189
Hospital Revenue Code 636
Min. Negotiated Rate $0.21
Max. Negotiated Rate $0.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial $0.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $0.95
Rate for Payer: Aetna Government $0.95
Rate for Payer: Brighton Health Commercial $0.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $0.31
Rate for Payer: Cigna LocalPlus Benefit Plan $0.35
Rate for Payer: Group Health Inc Commercial $0.31
Rate for Payer: Group Health Inc Medicare $0.21
Rate for Payer: Hamaspik Choice Inc Medicaid $0.31
Rate for Payer: Hamaspik Choice Inc Medicare $0.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $0.40
Service Code HCPCS J1815
Hospital Charge Code 41652189
Hospital Revenue Code 636
Min. Negotiated Rate $0.31
Max. Negotiated Rate $0.31
Rate for Payer: Hamaspik Choice Inc Medicaid $0.31
Rate for Payer: Hamaspik Choice Inc Medicare $0.31
Hospital Charge Code 41657026
Hospital Revenue Code 636
Min. Negotiated Rate $0.22
Max. Negotiated Rate $0.22
Rate for Payer: Hamaspik Choice Inc Medicaid $0.22
Rate for Payer: Hamaspik Choice Inc Medicare $0.22