|
PARAFFIN BATH (W/ KX)
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
HCPCS 97018 GP,KX
|
| Hospital Charge Code |
4650319
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$15.60 |
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Galaxy Health Commercial |
$15.60
|
|
|
PARATHYROID HORMONE
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS 83970
|
| Hospital Charge Code |
4300608
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.28 |
| Max. Negotiated Rate |
$128.80 |
| Rate for Payer: Aetna of NY Commercial |
$104.00
|
| Rate for Payer: Aetna of NY Medicare |
$73.60
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$120.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$120.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$59.20
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$80.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: CDPHP Commercial |
$128.80
|
| Rate for Payer: CDPHP Medicare |
$59.20
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$96.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$128.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$128.00
|
| Rate for Payer: EmblemHealth Medicaid |
$128.00
|
| Rate for Payer: EmblemHealth Medicare |
$54.40
|
| Rate for Payer: EmblemHealth Select Care |
$96.00
|
| Rate for Payer: Fidelis Medicare |
$60.98
|
| Rate for Payer: Galaxy Health Commercial |
$104.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$59.20
|
| Rate for Payer: Humana Medicare |
$59.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$104.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$73.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$120.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$90.08
|
| Rate for Payer: MVP Health Care of NY Medicare |
$62.16
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$120.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$41.28
|
| Rate for Payer: United Healthcare Commercial |
$120.00
|
| Rate for Payer: United Healthcare Medicare |
$59.20
|
| Rate for Payer: WellCare Medicare |
$88.00
|
|
|
PARATHYROID HORMONE
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS 83970
|
| Hospital Charge Code |
4300608
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$104.00 |
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Galaxy Health Commercial |
$104.00
|
|
|
PARATHYROID IMAGING
|
Facility
|
OP
|
$1,180.00
|
|
|
Service Code
|
HCPCS 78070
|
| Hospital Charge Code |
4210029
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$60.60 |
| Max. Negotiated Rate |
$1,500.00 |
| Rate for Payer: Aetna of NY Commercial |
$826.00
|
| Rate for Payer: Aetna of NY Medicare |
$542.80
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$885.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$885.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$436.60
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$590.00
|
| Rate for Payer: Cash Price |
$885.00
|
| Rate for Payer: Cash Price |
$885.00
|
| Rate for Payer: CDPHP Commercial |
$949.90
|
| Rate for Payer: CDPHP Medicare |
$436.60
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$826.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$944.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$944.00
|
| Rate for Payer: EmblemHealth Medicaid |
$944.00
|
| Rate for Payer: EmblemHealth Medicare |
$401.20
|
| Rate for Payer: EmblemHealth Select Care |
$767.00
|
| Rate for Payer: Fidelis Medicare |
$449.70
|
| Rate for Payer: Galaxy Health Commercial |
$767.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$436.60
|
| Rate for Payer: Humana Medicare |
$436.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$826.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$542.80
|
| Rate for Payer: MVP Health Care of NY Commercial |
$885.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$664.34
|
| Rate for Payer: MVP Health Care of NY Medicare |
$458.43
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$1,500.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$60.60
|
| Rate for Payer: United Healthcare Commercial |
$1,500.00
|
| Rate for Payer: United Healthcare Medicare |
$436.60
|
| Rate for Payer: WellCare Medicare |
$649.00
|
|
|
PARATHYROID IMAGING
|
Facility
|
IP
|
$1,180.00
|
|
|
Service Code
|
HCPCS 78070
|
| Hospital Charge Code |
4210029
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$767.00 |
| Max. Negotiated Rate |
$767.00 |
| Rate for Payer: Cash Price |
$885.00
|
| Rate for Payer: Galaxy Health Commercial |
$767.00
|
|
|
PARE BENIGN LES; SGL
|
Facility
|
OP
|
$573.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
4855444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$190.75 |
| Max. Negotiated Rate |
$2,521.93 |
| Rate for Payer: Aetna of NY Commercial |
$401.10
|
| Rate for Payer: Aetna of NY Medicare |
$263.58
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$2,017.33
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$2,521.93
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$212.01
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$286.50
|
| Rate for Payer: Cash Price |
$429.75
|
| Rate for Payer: Cash Price |
$429.75
|
| Rate for Payer: Cash Price |
$429.75
|
| Rate for Payer: CDPHP Commercial |
$461.26
|
| Rate for Payer: CDPHP Medicare |
$212.01
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$458.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$458.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$458.40
|
| Rate for Payer: EmblemHealth Medicaid |
$458.40
|
| Rate for Payer: EmblemHealth Medicare |
$194.82
|
| Rate for Payer: EmblemHealth Select Care |
$412.56
|
| Rate for Payer: Fidelis Medicare |
$218.37
|
| Rate for Payer: Galaxy Health Commercial |
$372.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$212.01
|
| Rate for Payer: Humana Medicare |
$212.01
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$401.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$263.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$429.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$322.60
|
| Rate for Payer: MVP Health Care of NY Medicare |
$222.61
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$190.75
|
| Rate for Payer: United Healthcare Medicare |
$212.01
|
| Rate for Payer: WellCare Medicare |
$315.15
|
|
|
PARE BENIGN LES; SGL
|
Facility
|
IP
|
$573.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
4855444
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$372.45 |
| Max. Negotiated Rate |
$372.45 |
| Rate for Payer: Cash Price |
$429.75
|
| Rate for Payer: Galaxy Health Commercial |
$372.45
|
|
|
PARE BENIGN LES; SINGLE
|
Facility
|
IP
|
$573.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
4600990
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$372.45 |
| Max. Negotiated Rate |
$372.45 |
| Rate for Payer: Cash Price |
$429.75
|
| Rate for Payer: Galaxy Health Commercial |
$372.45
|
|
|
PARE BENIGN LES; SINGLE
|
Facility
|
OP
|
$573.00
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
4600990
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$190.75 |
| Max. Negotiated Rate |
$1,189.18 |
| Rate for Payer: Aetna of NY Commercial |
$955.00
|
| Rate for Payer: Aetna of NY Medicare |
$263.58
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$950.93
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,189.18
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$212.01
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$286.50
|
| Rate for Payer: Cash Price |
$429.75
|
| Rate for Payer: Cash Price |
$429.75
|
| Rate for Payer: Cash Price |
$429.75
|
| Rate for Payer: Cash Price |
$429.75
|
| Rate for Payer: CDPHP Commercial |
$461.26
|
| Rate for Payer: CDPHP Medicare |
$212.01
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,182.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$458.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$458.40
|
| Rate for Payer: EmblemHealth Medicaid |
$458.40
|
| Rate for Payer: EmblemHealth Medicare |
$194.82
|
| Rate for Payer: EmblemHealth Select Care |
$1,064.00
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$250.00
|
| Rate for Payer: Fidelis Medicare |
$218.37
|
| Rate for Payer: Galaxy Health Commercial |
$372.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$212.01
|
| Rate for Payer: Humana Medicare |
$212.01
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$955.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$263.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,174.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$881.00
|
| Rate for Payer: MVP Health Care of NY Medicare |
$222.61
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$980.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$190.75
|
| Rate for Payer: United Healthcare Commercial |
$980.00
|
| Rate for Payer: United Healthcare Medicare |
$212.01
|
| Rate for Payer: WellCare Medicare |
$315.15
|
|
|
PAROXETINE HCL 10MG TABS 10X10EA
|
Facility
|
OP
|
$8.24
|
|
|
Service Code
|
NDC 63739088810
|
| Hospital Charge Code |
4400608
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$6.63 |
| Rate for Payer: Aetna of NY Commercial |
$5.77
|
| Rate for Payer: Aetna of NY Medicare |
$3.79
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$6.18
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$6.18
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$3.05
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$4.12
|
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: CDPHP Commercial |
$6.63
|
| Rate for Payer: CDPHP Medicare |
$3.05
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$6.59
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$6.59
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$6.59
|
| Rate for Payer: EmblemHealth Medicaid |
$6.59
|
| Rate for Payer: EmblemHealth Medicare |
$2.80
|
| Rate for Payer: EmblemHealth Select Care |
$5.93
|
| Rate for Payer: Fidelis Medicare |
$3.14
|
| Rate for Payer: Galaxy Health Commercial |
$5.36
|
| Rate for Payer: Hamaspik Choice Medicare |
$3.05
|
| Rate for Payer: Humana Medicare |
$3.05
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$5.77
|
| Rate for Payer: Local 1199SEIU Medicare |
$3.79
|
| Rate for Payer: MVP Health Care of NY Commercial |
$6.18
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$4.64
|
| Rate for Payer: MVP Health Care of NY Medicare |
$3.20
|
| Rate for Payer: United Healthcare Medicare |
$3.05
|
| Rate for Payer: WellCare Medicare |
$4.53
|
|
|
PAROXETINE HCL 10MG TABS 10X10EA
|
Facility
|
IP
|
$8.24
|
|
|
Service Code
|
NDC 63739088810
|
| Hospital Charge Code |
4400608
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$5.36 |
| Rate for Payer: Cash Price |
$6.18
|
| Rate for Payer: Galaxy Health Commercial |
$5.36
|
| Rate for Payer: WellCare Medicare |
$4.53
|
|
|
PARTIAL REMOVAL FINGER BONE
|
Facility
|
OP
|
$4,599.00
|
|
|
Service Code
|
HCPCS 26236
|
| Hospital Charge Code |
4853009
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,531.33 |
| Max. Negotiated Rate |
$3,702.20 |
| Rate for Payer: Aetna of NY Commercial |
$3,219.30
|
| Rate for Payer: Aetna of NY Medicare |
$2,115.54
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$2,017.33
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$2,521.93
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$1,701.63
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$2,299.50
|
| Rate for Payer: Cash Price |
$3,449.25
|
| Rate for Payer: Cash Price |
$3,449.25
|
| Rate for Payer: Cash Price |
$3,449.25
|
| Rate for Payer: CDPHP Commercial |
$3,702.20
|
| Rate for Payer: CDPHP Medicare |
$1,701.63
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$3,679.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$3,679.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$3,679.20
|
| Rate for Payer: EmblemHealth Medicaid |
$3,679.20
|
| Rate for Payer: EmblemHealth Medicare |
$1,563.66
|
| Rate for Payer: EmblemHealth Select Care |
$3,311.28
|
| Rate for Payer: Fidelis Medicare |
$1,752.68
|
| Rate for Payer: Galaxy Health Commercial |
$2,989.35
|
| Rate for Payer: Hamaspik Choice Medicare |
$1,701.63
|
| Rate for Payer: Humana Medicare |
$1,701.63
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$3,219.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$2,115.54
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,449.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$2,589.24
|
| Rate for Payer: MVP Health Care of NY Medicare |
$1,786.71
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1,531.33
|
| Rate for Payer: United Healthcare Medicare |
$1,701.63
|
| Rate for Payer: WellCare Medicare |
$2,529.45
|
|
|
PARTIAL REMOVAL FINGER BONE
|
Facility
|
IP
|
$4,599.00
|
|
|
Service Code
|
HCPCS 26236
|
| Hospital Charge Code |
4853009
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,989.35 |
| Max. Negotiated Rate |
$2,989.35 |
| Rate for Payer: Cash Price |
$3,449.25
|
| Rate for Payer: Galaxy Health Commercial |
$2,989.35
|
|
|
PARTIAL REMOVAL PHALANX OF TOE
|
Facility
|
IP
|
$9,262.00
|
|
|
Service Code
|
HCPCS 28124
|
| Hospital Charge Code |
4853010
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,020.30 |
| Max. Negotiated Rate |
$6,020.30 |
| Rate for Payer: Cash Price |
$6,946.50
|
| Rate for Payer: Galaxy Health Commercial |
$6,020.30
|
|
|
PARTIAL REMOVAL PHALANX OF TOE
|
Facility
|
OP
|
$9,262.00
|
|
|
Service Code
|
HCPCS 28124
|
| Hospital Charge Code |
4853010
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,017.33 |
| Max. Negotiated Rate |
$7,455.91 |
| Rate for Payer: Aetna of NY Commercial |
$6,483.40
|
| Rate for Payer: Aetna of NY Medicare |
$4,260.52
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$2,017.33
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$2,521.93
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$3,426.94
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$4,631.00
|
| Rate for Payer: Cash Price |
$6,946.50
|
| Rate for Payer: Cash Price |
$6,946.50
|
| Rate for Payer: Cash Price |
$6,946.50
|
| Rate for Payer: CDPHP Commercial |
$7,455.91
|
| Rate for Payer: CDPHP Medicare |
$3,426.94
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$7,409.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$7,409.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$7,409.60
|
| Rate for Payer: EmblemHealth Medicaid |
$7,409.60
|
| Rate for Payer: EmblemHealth Medicare |
$3,149.08
|
| Rate for Payer: EmblemHealth Select Care |
$6,668.64
|
| Rate for Payer: Fidelis Medicare |
$3,529.75
|
| Rate for Payer: Galaxy Health Commercial |
$6,020.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$3,426.94
|
| Rate for Payer: Humana Medicare |
$3,426.94
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$6,483.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$4,260.52
|
| Rate for Payer: MVP Health Care of NY Commercial |
$6,946.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$5,214.51
|
| Rate for Payer: MVP Health Care of NY Medicare |
$3,598.29
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$3,084.03
|
| Rate for Payer: United Healthcare Medicare |
$3,426.94
|
| Rate for Payer: WellCare Medicare |
$5,094.10
|
|
|
PATIENT PROGRAMMER KIT
|
Facility
|
OP
|
$4,826.00
|
|
| Hospital Charge Code |
4472063
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,640.84 |
| Max. Negotiated Rate |
$3,884.93 |
| Rate for Payer: Aetna of NY Commercial |
$3,378.20
|
| Rate for Payer: Aetna of NY Medicare |
$2,219.96
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$3,619.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$3,619.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$1,785.62
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$2,413.00
|
| Rate for Payer: Cash Price |
$3,619.50
|
| Rate for Payer: CDPHP Commercial |
$3,884.93
|
| Rate for Payer: CDPHP Medicare |
$1,785.62
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$3,860.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$3,860.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$3,860.80
|
| Rate for Payer: EmblemHealth Medicaid |
$3,860.80
|
| Rate for Payer: EmblemHealth Medicare |
$1,640.84
|
| Rate for Payer: EmblemHealth Select Care |
$3,474.72
|
| Rate for Payer: Fidelis Medicare |
$1,839.19
|
| Rate for Payer: Galaxy Health Commercial |
$3,136.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$1,785.62
|
| Rate for Payer: Humana Medicare |
$1,785.62
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$3,378.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$2,219.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,619.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$2,717.04
|
| Rate for Payer: MVP Health Care of NY Medicare |
$1,874.90
|
| Rate for Payer: United Healthcare Medicare |
$1,785.62
|
| Rate for Payer: WellCare Medicare |
$2,654.30
|
|
|
PATIENT PROGRAMMER KIT
|
Facility
|
IP
|
$4,826.00
|
|
| Hospital Charge Code |
4472063
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,136.90 |
| Max. Negotiated Rate |
$3,136.90 |
| Rate for Payer: Cash Price |
$3,619.50
|
| Rate for Payer: Galaxy Health Commercial |
$3,136.90
|
|
|
PATIENT PROGRAMMER KIT
|
Facility
|
IP
|
$4,826.00
|
|
| Hospital Charge Code |
4472064
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,136.90 |
| Max. Negotiated Rate |
$3,136.90 |
| Rate for Payer: Cash Price |
$3,619.50
|
| Rate for Payer: Galaxy Health Commercial |
$3,136.90
|
|
|
PATIENT PROGRAMMER KIT
|
Facility
|
IP
|
$4,826.00
|
|
| Hospital Charge Code |
4472065
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3,136.90 |
| Max. Negotiated Rate |
$3,136.90 |
| Rate for Payer: Cash Price |
$3,619.50
|
| Rate for Payer: Galaxy Health Commercial |
$3,136.90
|
|
|
PATIENT PROGRAMMER KIT
|
Facility
|
OP
|
$4,826.00
|
|
| Hospital Charge Code |
4472065
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,640.84 |
| Max. Negotiated Rate |
$3,884.93 |
| Rate for Payer: Aetna of NY Commercial |
$3,378.20
|
| Rate for Payer: Aetna of NY Medicare |
$2,219.96
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$3,619.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$3,619.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$1,785.62
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$2,413.00
|
| Rate for Payer: Cash Price |
$3,619.50
|
| Rate for Payer: CDPHP Commercial |
$3,884.93
|
| Rate for Payer: CDPHP Medicare |
$1,785.62
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$3,860.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$3,860.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$3,860.80
|
| Rate for Payer: EmblemHealth Medicaid |
$3,860.80
|
| Rate for Payer: EmblemHealth Medicare |
$1,640.84
|
| Rate for Payer: EmblemHealth Select Care |
$3,474.72
|
| Rate for Payer: Fidelis Medicare |
$1,839.19
|
| Rate for Payer: Galaxy Health Commercial |
$3,136.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$1,785.62
|
| Rate for Payer: Humana Medicare |
$1,785.62
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$3,378.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$2,219.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,619.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$2,717.04
|
| Rate for Payer: MVP Health Care of NY Medicare |
$1,874.90
|
| Rate for Payer: United Healthcare Medicare |
$1,785.62
|
| Rate for Payer: WellCare Medicare |
$2,654.30
|
|
|
PATIENT PROGRAMMER KIT
|
Facility
|
OP
|
$4,826.00
|
|
| Hospital Charge Code |
4472064
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,640.84 |
| Max. Negotiated Rate |
$3,884.93 |
| Rate for Payer: Aetna of NY Commercial |
$3,378.20
|
| Rate for Payer: Aetna of NY Medicare |
$2,219.96
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$3,619.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$3,619.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$1,785.62
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$2,413.00
|
| Rate for Payer: Cash Price |
$3,619.50
|
| Rate for Payer: CDPHP Commercial |
$3,884.93
|
| Rate for Payer: CDPHP Medicare |
$1,785.62
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$3,860.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$3,860.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$3,860.80
|
| Rate for Payer: EmblemHealth Medicaid |
$3,860.80
|
| Rate for Payer: EmblemHealth Medicare |
$1,640.84
|
| Rate for Payer: EmblemHealth Select Care |
$3,474.72
|
| Rate for Payer: Fidelis Medicare |
$1,839.19
|
| Rate for Payer: Galaxy Health Commercial |
$3,136.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$1,785.62
|
| Rate for Payer: Humana Medicare |
$1,785.62
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$3,378.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$2,219.96
|
| Rate for Payer: MVP Health Care of NY Commercial |
$3,619.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$2,717.04
|
| Rate for Payer: MVP Health Care of NY Medicare |
$1,874.90
|
| Rate for Payer: United Healthcare Medicare |
$1,785.62
|
| Rate for Payer: WellCare Medicare |
$2,654.30
|
|
|
PATRIOT COLLAR
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
4478141
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$20.12 |
| Rate for Payer: Aetna of NY Commercial |
$17.50
|
| Rate for Payer: Aetna of NY Medicare |
$11.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$18.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$18.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$9.25
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$12.50
|
| Rate for Payer: Cash Price |
$18.75
|
| Rate for Payer: CDPHP Commercial |
$20.12
|
| Rate for Payer: CDPHP Medicare |
$9.25
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$20.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$20.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$20.00
|
| Rate for Payer: EmblemHealth Medicaid |
$20.00
|
| Rate for Payer: EmblemHealth Medicare |
$8.50
|
| Rate for Payer: EmblemHealth Select Care |
$18.00
|
| Rate for Payer: Fidelis Medicare |
$9.53
|
| Rate for Payer: Galaxy Health Commercial |
$16.25
|
| Rate for Payer: Hamaspik Choice Medicare |
$9.25
|
| Rate for Payer: Humana Medicare |
$9.25
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$17.50
|
| Rate for Payer: Local 1199SEIU Medicare |
$11.50
|
| Rate for Payer: MVP Health Care of NY Commercial |
$18.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$14.08
|
| Rate for Payer: MVP Health Care of NY Medicare |
$9.71
|
| Rate for Payer: United Healthcare Medicare |
$9.25
|
| Rate for Payer: WellCare Medicare |
$13.75
|
|
|
PATRIOT COLLAR
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
4478141
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.25 |
| Max. Negotiated Rate |
$16.25 |
| Rate for Payer: Cash Price |
$18.75
|
| Rate for Payer: Galaxy Health Commercial |
$16.25
|
|
|
PCA TUBING
|
Facility
|
IP
|
$41.00
|
|
| Hospital Charge Code |
4471922
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.65 |
| Max. Negotiated Rate |
$26.65 |
| Rate for Payer: Cash Price |
$30.75
|
| Rate for Payer: Galaxy Health Commercial |
$26.65
|
|
|
PCA TUBING
|
Facility
|
OP
|
$41.00
|
|
| Hospital Charge Code |
4471922
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.94 |
| Max. Negotiated Rate |
$33.00 |
| Rate for Payer: Aetna of NY Commercial |
$28.70
|
| Rate for Payer: Aetna of NY Medicare |
$18.86
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$30.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$30.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$15.17
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$20.50
|
| Rate for Payer: Cash Price |
$30.75
|
| Rate for Payer: CDPHP Commercial |
$33.00
|
| Rate for Payer: CDPHP Medicare |
$15.17
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$32.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$32.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$32.80
|
| Rate for Payer: EmblemHealth Medicaid |
$32.80
|
| Rate for Payer: EmblemHealth Medicare |
$13.94
|
| Rate for Payer: EmblemHealth Select Care |
$29.52
|
| Rate for Payer: Fidelis Medicare |
$15.63
|
| Rate for Payer: Galaxy Health Commercial |
$26.65
|
| Rate for Payer: Hamaspik Choice Medicare |
$15.17
|
| Rate for Payer: Humana Medicare |
$15.17
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$28.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$18.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$30.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$23.08
|
| Rate for Payer: MVP Health Care of NY Medicare |
$15.93
|
| Rate for Payer: United Healthcare Medicare |
$15.17
|
| Rate for Payer: WellCare Medicare |
$22.55
|
|
