|
PULMONARY STRESS TESTING
|
Facility
|
IP
|
$408.00
|
|
|
Service Code
|
HCPCS 94618
|
| Hospital Charge Code |
4530014
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$265.20 |
| Max. Negotiated Rate |
$265.20 |
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Galaxy Health Commercial |
$265.20
|
|
|
PULMONARY STRESS TESTING
|
Facility
|
OP
|
$408.00
|
|
|
Service Code
|
HCPCS 94618
|
| Hospital Charge Code |
4530014
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$326.40 |
| Rate for Payer: Aetna of NY Commercial |
$285.60
|
| Rate for Payer: Aetna of NY Medicare |
$187.68
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$163.20
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: CDPHP Medicare |
$150.96
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$285.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$326.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$326.40
|
| Rate for Payer: EmblemHealth Medicaid |
$326.40
|
| Rate for Payer: EmblemHealth Medicare |
$138.72
|
| Rate for Payer: EmblemHealth Select Care |
$265.20
|
| Rate for Payer: Fidelis Medicare |
$163.20
|
| Rate for Payer: Galaxy Health Commercial |
$265.20
|
| Rate for Payer: Hamaspik Choice Medicare |
$163.20
|
| Rate for Payer: Humana Medicare |
$163.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$285.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$187.68
|
| Rate for Payer: MVP Health Care of NY Commercial |
$306.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$229.70
|
| Rate for Payer: MVP Health Care of NY Medicare |
$171.36
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$61.20
|
| Rate for Payer: United Healthcare Medicare |
$163.20
|
| Rate for Payer: WellCare Medicare |
$224.40
|
|
|
PULSE OXIMETRY
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
HCPCS 94760
|
| Hospital Charge Code |
4480088
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$8.45 |
| Rate for Payer: Cash Price |
$9.75
|
| Rate for Payer: Galaxy Health Commercial |
$8.45
|
|
|
PULSE OXIMETRY
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
HCPCS 94760
|
| Hospital Charge Code |
4480088
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$10.40 |
| Rate for Payer: Aetna of NY Commercial |
$9.10
|
| Rate for Payer: Aetna of NY Medicare |
$5.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$5.20
|
| Rate for Payer: Cash Price |
$9.75
|
| Rate for Payer: CDPHP Medicare |
$4.81
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$9.10
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$10.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$10.40
|
| Rate for Payer: EmblemHealth Medicaid |
$10.40
|
| Rate for Payer: EmblemHealth Medicare |
$4.42
|
| Rate for Payer: EmblemHealth Select Care |
$8.45
|
| Rate for Payer: Fidelis Medicare |
$5.20
|
| Rate for Payer: Galaxy Health Commercial |
$8.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$5.20
|
| Rate for Payer: Humana Medicare |
$5.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$9.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$5.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$9.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$7.32
|
| Rate for Payer: MVP Health Care of NY Medicare |
$5.46
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1.95
|
| Rate for Payer: United Healthcare Medicare |
$5.20
|
| Rate for Payer: WellCare Medicare |
$7.15
|
|
|
PULSE OXIMETRY CONT
|
Facility
|
OP
|
$469.00
|
|
|
Service Code
|
HCPCS 94762
|
| Hospital Charge Code |
4530034
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$70.35 |
| Max. Negotiated Rate |
$375.20 |
| Rate for Payer: Aetna of NY Commercial |
$328.30
|
| Rate for Payer: Aetna of NY Medicare |
$215.74
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$187.60
|
| Rate for Payer: Cash Price |
$351.75
|
| Rate for Payer: CDPHP Medicare |
$173.53
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$328.30
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$375.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$375.20
|
| Rate for Payer: EmblemHealth Medicaid |
$375.20
|
| Rate for Payer: EmblemHealth Medicare |
$159.46
|
| Rate for Payer: EmblemHealth Select Care |
$304.85
|
| Rate for Payer: Fidelis Medicare |
$187.60
|
| Rate for Payer: Galaxy Health Commercial |
$304.85
|
| Rate for Payer: Hamaspik Choice Medicare |
$187.60
|
| Rate for Payer: Humana Medicare |
$187.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$328.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$215.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$351.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$264.05
|
| Rate for Payer: MVP Health Care of NY Medicare |
$196.98
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$70.35
|
| Rate for Payer: United Healthcare Medicare |
$187.60
|
| Rate for Payer: WellCare Medicare |
$257.95
|
|
|
PULSE OXIMETRY CONT
|
Facility
|
IP
|
$469.00
|
|
|
Service Code
|
HCPCS 94762
|
| Hospital Charge Code |
4530034
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$304.85 |
| Max. Negotiated Rate |
$304.85 |
| Rate for Payer: Cash Price |
$351.75
|
| Rate for Payer: Galaxy Health Commercial |
$304.85
|
|
|
PULSE OX MULTIPLE RESPIRATORY
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
HCPCS 94761
|
| Hospital Charge Code |
4530043
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$2.10 |
| Max. Negotiated Rate |
$11.20 |
| Rate for Payer: Aetna of NY Commercial |
$9.80
|
| Rate for Payer: Aetna of NY Medicare |
$6.44
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$5.60
|
| Rate for Payer: Cash Price |
$10.50
|
| Rate for Payer: CDPHP Medicare |
$5.18
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$9.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$11.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$11.20
|
| Rate for Payer: EmblemHealth Medicaid |
$11.20
|
| Rate for Payer: EmblemHealth Medicare |
$4.76
|
| Rate for Payer: EmblemHealth Select Care |
$9.10
|
| Rate for Payer: Fidelis Medicare |
$5.60
|
| Rate for Payer: Galaxy Health Commercial |
$9.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$5.60
|
| Rate for Payer: Humana Medicare |
$5.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$9.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$6.44
|
| Rate for Payer: MVP Health Care of NY Commercial |
$10.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$7.88
|
| Rate for Payer: MVP Health Care of NY Medicare |
$5.88
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$2.10
|
| Rate for Payer: United Healthcare Medicare |
$5.60
|
| Rate for Payer: WellCare Medicare |
$7.70
|
|
|
PULSE OX MULTIPLE RESPIRATORY
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
HCPCS 94761
|
| Hospital Charge Code |
4530043
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$9.10 |
| Rate for Payer: Cash Price |
$10.50
|
| Rate for Payer: Galaxy Health Commercial |
$9.10
|
|
|
PULSE OX SINGLE RESPIRATORY
|
Facility
|
OP
|
$13.00
|
|
|
Service Code
|
HCPCS 94760
|
| Hospital Charge Code |
4530042
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$10.40 |
| Rate for Payer: Aetna of NY Commercial |
$9.10
|
| Rate for Payer: Aetna of NY Medicare |
$5.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$5.20
|
| Rate for Payer: Cash Price |
$9.75
|
| Rate for Payer: CDPHP Medicare |
$4.81
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$9.10
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$10.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$10.40
|
| Rate for Payer: EmblemHealth Medicaid |
$10.40
|
| Rate for Payer: EmblemHealth Medicare |
$4.42
|
| Rate for Payer: EmblemHealth Select Care |
$8.45
|
| Rate for Payer: Fidelis Medicare |
$5.20
|
| Rate for Payer: Galaxy Health Commercial |
$8.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$5.20
|
| Rate for Payer: Humana Medicare |
$5.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$9.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$5.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$9.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$7.32
|
| Rate for Payer: MVP Health Care of NY Medicare |
$5.46
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1.95
|
| Rate for Payer: United Healthcare Medicare |
$5.20
|
| Rate for Payer: WellCare Medicare |
$7.15
|
|
|
PULSE OX SINGLE RESPIRATORY
|
Facility
|
IP
|
$13.00
|
|
|
Service Code
|
HCPCS 94760
|
| Hospital Charge Code |
4530042
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$8.45 |
| Rate for Payer: Cash Price |
$9.75
|
| Rate for Payer: Galaxy Health Commercial |
$8.45
|
|
|
PUMP 8637-20 BATTERY PACEMAKER
|
Facility
|
OP
|
$41,731.48
|
|
| Hospital Charge Code |
4479122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,259.72 |
| Max. Negotiated Rate |
$33,385.18 |
| Rate for Payer: Aetna of NY Commercial |
$29,212.04
|
| Rate for Payer: Aetna of NY Medicare |
$19,196.48
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$16,692.59
|
| Rate for Payer: Cash Price |
$31,298.61
|
| Rate for Payer: CDPHP Medicare |
$15,440.65
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$20,865.74
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$33,385.18
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$33,385.18
|
| Rate for Payer: EmblemHealth Medicaid |
$33,385.18
|
| Rate for Payer: EmblemHealth Medicare |
$14,188.70
|
| Rate for Payer: EmblemHealth Select Care |
$20,865.74
|
| Rate for Payer: Fidelis Medicare |
$16,692.59
|
| Rate for Payer: Galaxy Health Commercial |
$27,125.46
|
| Rate for Payer: Hamaspik Choice Medicare |
$16,692.59
|
| Rate for Payer: Humana Medicare |
$16,692.59
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$29,212.04
|
| Rate for Payer: Local 1199SEIU Medicare |
$19,196.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$27,125.46
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$27,125.46
|
| Rate for Payer: MVP Health Care of NY Medicare |
$17,527.22
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$6,259.72
|
| Rate for Payer: United Healthcare Medicare |
$16,692.59
|
| Rate for Payer: WellCare Medicare |
$22,952.31
|
|
|
PUMP 8637-20 BATTERY PACEMAKER
|
Facility
|
IP
|
$41,731.48
|
|
| Hospital Charge Code |
4479122
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$18,779.17 |
| Max. Negotiated Rate |
$29,212.04 |
| Rate for Payer: Aetna of NY Commercial |
$29,212.04
|
| Rate for Payer: Cash Price |
$31,298.61
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$20,865.74
|
| Rate for Payer: EmblemHealth Select Care |
$20,865.74
|
| Rate for Payer: Galaxy Health Commercial |
$27,125.46
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$29,212.04
|
| Rate for Payer: Multiplan Commercial |
$18,779.17
|
| Rate for Payer: MVP Health Care of NY Commercial |
$27,125.46
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$27,125.46
|
| Rate for Payer: WellCare Medicare |
$22,952.31
|
|
|
PUMP RENTAL FEE
|
Facility
|
OP
|
$15.45
|
|
| Hospital Charge Code |
1050104
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.32 |
| Max. Negotiated Rate |
$12.36 |
| Rate for Payer: Aetna of NY Commercial |
$10.81
|
| Rate for Payer: Aetna of NY Medicare |
$7.11
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$6.18
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: CDPHP Medicare |
$5.72
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$12.36
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$12.36
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$12.36
|
| Rate for Payer: EmblemHealth Medicaid |
$12.36
|
| Rate for Payer: EmblemHealth Medicare |
$5.25
|
| Rate for Payer: EmblemHealth Select Care |
$11.12
|
| Rate for Payer: Fidelis Medicare |
$6.18
|
| Rate for Payer: Galaxy Health Commercial |
$10.04
|
| Rate for Payer: Hamaspik Choice Medicare |
$6.18
|
| Rate for Payer: Humana Medicare |
$6.18
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$10.81
|
| Rate for Payer: Local 1199SEIU Medicare |
$7.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$11.59
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$8.70
|
| Rate for Payer: MVP Health Care of NY Medicare |
$6.49
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$2.32
|
| Rate for Payer: United Healthcare Medicare |
$6.18
|
| Rate for Payer: WellCare Medicare |
$8.50
|
|
|
PUMP RENTAL FEE
|
Facility
|
IP
|
$15.45
|
|
| Hospital Charge Code |
1050104
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.04 |
| Max. Negotiated Rate |
$10.04 |
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Galaxy Health Commercial |
$10.04
|
|
|
PUNCH BX SKIN EA SEP/ADDL
|
Facility
|
OP
|
$198.00
|
|
|
Service Code
|
HCPCS 11105
|
| Hospital Charge Code |
4853028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.70 |
| Max. Negotiated Rate |
$158.40 |
| Rate for Payer: Aetna of NY Commercial |
$138.60
|
| Rate for Payer: Aetna of NY Medicare |
$91.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$79.20
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: CDPHP Medicare |
$73.26
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$158.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$158.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$158.40
|
| Rate for Payer: EmblemHealth Medicaid |
$158.40
|
| Rate for Payer: EmblemHealth Medicare |
$67.32
|
| Rate for Payer: EmblemHealth Select Care |
$142.56
|
| Rate for Payer: Fidelis Medicare |
$79.20
|
| Rate for Payer: Galaxy Health Commercial |
$128.70
|
| Rate for Payer: Hamaspik Choice Medicare |
$79.20
|
| Rate for Payer: Humana Medicare |
$79.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$138.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$91.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$148.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$111.47
|
| Rate for Payer: MVP Health Care of NY Medicare |
$83.16
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$29.70
|
| Rate for Payer: United Healthcare Medicare |
$79.20
|
| Rate for Payer: WellCare Medicare |
$108.90
|
|
|
PUNCH BX SKIN EA SEP/ADDL
|
Facility
|
IP
|
$198.00
|
|
|
Service Code
|
HCPCS 11105
|
| Hospital Charge Code |
4853028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.70 |
| Max. Negotiated Rate |
$128.70 |
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Galaxy Health Commercial |
$128.70
|
|
|
PUNCH BX SKIN SINGLE LESION
|
Facility
|
OP
|
$1,246.00
|
|
|
Service Code
|
HCPCS 11104
|
| Hospital Charge Code |
4853027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$186.90 |
| Max. Negotiated Rate |
$996.80 |
| Rate for Payer: Aetna of NY Commercial |
$872.20
|
| Rate for Payer: Aetna of NY Medicare |
$573.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$498.40
|
| Rate for Payer: Cash Price |
$934.50
|
| Rate for Payer: CDPHP Medicare |
$461.02
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$996.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$996.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$996.80
|
| Rate for Payer: EmblemHealth Medicaid |
$996.80
|
| Rate for Payer: EmblemHealth Medicare |
$423.64
|
| Rate for Payer: EmblemHealth Select Care |
$897.12
|
| Rate for Payer: Fidelis Medicare |
$498.40
|
| Rate for Payer: Galaxy Health Commercial |
$809.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$498.40
|
| Rate for Payer: Humana Medicare |
$498.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$872.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$573.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$934.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$701.50
|
| Rate for Payer: MVP Health Care of NY Medicare |
$523.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$186.90
|
| Rate for Payer: United Healthcare Medicare |
$498.40
|
| Rate for Payer: WellCare Medicare |
$685.30
|
|
|
PUNCH BX SKIN SINGLE LESION
|
Facility
|
IP
|
$1,246.00
|
|
|
Service Code
|
HCPCS 11104
|
| Hospital Charge Code |
4853027
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$809.90 |
| Max. Negotiated Rate |
$809.90 |
| Rate for Payer: Cash Price |
$934.50
|
| Rate for Payer: Galaxy Health Commercial |
$809.90
|
|
|
PUNCT ASP - ABSC HEMAT CYST
|
Facility
|
IP
|
$1,246.00
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
4856673
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$809.90 |
| Max. Negotiated Rate |
$809.90 |
| Rate for Payer: Cash Price |
$934.50
|
| Rate for Payer: Galaxy Health Commercial |
$809.90
|
|
|
PUNCT ASP - ABSC HEMAT CYST
|
Facility
|
OP
|
$1,246.00
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
4856673
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$186.90 |
| Max. Negotiated Rate |
$996.80 |
| Rate for Payer: Aetna of NY Commercial |
$872.20
|
| Rate for Payer: Aetna of NY Medicare |
$573.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$498.40
|
| Rate for Payer: Cash Price |
$934.50
|
| Rate for Payer: CDPHP Medicare |
$461.02
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$996.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$996.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$996.80
|
| Rate for Payer: EmblemHealth Medicaid |
$996.80
|
| Rate for Payer: EmblemHealth Medicare |
$423.64
|
| Rate for Payer: EmblemHealth Select Care |
$897.12
|
| Rate for Payer: Fidelis Medicare |
$498.40
|
| Rate for Payer: Galaxy Health Commercial |
$809.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$498.40
|
| Rate for Payer: Humana Medicare |
$498.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$872.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$573.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$934.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$701.50
|
| Rate for Payer: MVP Health Care of NY Medicare |
$523.32
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$186.90
|
| Rate for Payer: United Healthcare Medicare |
$498.40
|
| Rate for Payer: WellCare Medicare |
$685.30
|
|
|
PUNCTURE ASP ABCESS HEMA CYST
|
Facility
|
IP
|
$1,246.00
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
4600138
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$809.90 |
| Max. Negotiated Rate |
$809.90 |
| Rate for Payer: Cash Price |
$934.50
|
| Rate for Payer: Galaxy Health Commercial |
$809.90
|
|
|
PUNCTURE ASP ABCESS HEMA CYST
|
Facility
|
OP
|
$1,246.00
|
|
|
Service Code
|
HCPCS 10160
|
| Hospital Charge Code |
4600138
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$186.90 |
| Max. Negotiated Rate |
$1,234.00 |
| Rate for Payer: Aetna of NY Commercial |
$1,000.00
|
| Rate for Payer: Aetna of NY Medicare |
$573.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$498.40
|
| Rate for Payer: Cash Price |
$934.50
|
| Rate for Payer: Cash Price |
$934.50
|
| Rate for Payer: Cash Price |
$934.50
|
| Rate for Payer: CDPHP Medicare |
$461.02
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,206.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$996.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$996.80
|
| Rate for Payer: EmblemHealth Medicaid |
$996.80
|
| Rate for Payer: EmblemHealth Medicare |
$423.64
|
| Rate for Payer: EmblemHealth Select Care |
$1,085.00
|
| Rate for Payer: Fidelis Medicare |
$498.40
|
| Rate for Payer: Galaxy Health Commercial |
$809.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$498.40
|
| Rate for Payer: Humana Medicare |
$498.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,000.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$573.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,234.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$925.00
|
| Rate for Payer: MVP Health Care of NY Medicare |
$523.32
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$1,009.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$186.90
|
| Rate for Payer: United Healthcare Commercial |
$1,009.00
|
| Rate for Payer: United Healthcare Medicare |
$498.40
|
| Rate for Payer: WellCare Medicare |
$685.30
|
|
|
PUNCTURE ASPIRATION CYST BREAST
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
HCPCS 19000 26
|
| Hospital Charge Code |
5201076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$20.10 |
| Max. Negotiated Rate |
$107.20 |
| Rate for Payer: Aetna of NY Commercial |
$93.80
|
| Rate for Payer: Aetna of NY Medicare |
$61.64
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$53.60
|
| Rate for Payer: Cash Price |
$100.50
|
| Rate for Payer: CDPHP Medicare |
$49.58
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$107.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$107.20
|
| Rate for Payer: EmblemHealth Medicaid |
$107.20
|
| Rate for Payer: EmblemHealth Medicare |
$45.56
|
| Rate for Payer: Fidelis Medicare |
$53.60
|
| Rate for Payer: Galaxy Health Commercial |
$87.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$53.60
|
| Rate for Payer: Humana Medicare |
$53.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$93.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$61.64
|
| Rate for Payer: MVP Health Care of NY Commercial |
$100.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$75.44
|
| Rate for Payer: MVP Health Care of NY Medicare |
$56.28
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$20.10
|
| Rate for Payer: United Healthcare Medicare |
$53.60
|
| Rate for Payer: WellCare Medicare |
$73.70
|
|
|
PUNCTURE ASPIRATION CYST BREAST
|
Facility
|
OP
|
$2,170.00
|
|
|
Service Code
|
HCPCS 19000
|
| Hospital Charge Code |
4201076
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$325.50 |
| Max. Negotiated Rate |
$1,736.00 |
| Rate for Payer: Aetna of NY Commercial |
$1,519.00
|
| Rate for Payer: Aetna of NY Medicare |
$998.20
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$868.00
|
| Rate for Payer: Cash Price |
$1,627.50
|
| Rate for Payer: Cash Price |
$1,627.50
|
| Rate for Payer: CDPHP Medicare |
$802.90
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,519.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,736.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,736.00
|
| Rate for Payer: EmblemHealth Medicaid |
$1,736.00
|
| Rate for Payer: EmblemHealth Medicare |
$737.80
|
| Rate for Payer: EmblemHealth Select Care |
$1,410.50
|
| Rate for Payer: Fidelis Medicare |
$868.00
|
| Rate for Payer: Galaxy Health Commercial |
$1,410.50
|
| Rate for Payer: Hamaspik Choice Medicare |
$868.00
|
| Rate for Payer: Humana Medicare |
$868.00
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,519.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$998.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,627.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$1,221.71
|
| Rate for Payer: MVP Health Care of NY Medicare |
$911.40
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$489.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$325.50
|
| Rate for Payer: United Healthcare Commercial |
$489.00
|
| Rate for Payer: United Healthcare Medicare |
$868.00
|
| Rate for Payer: WellCare Medicare |
$1,193.50
|
|
|
PUNCTURE ASPIRATION CYST BREAST
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
HCPCS 19000 26
|
| Hospital Charge Code |
5201076
|
|
Hospital Revenue Code
|
960
|
| Min. Negotiated Rate |
$87.10 |
| Max. Negotiated Rate |
$87.10 |
| Rate for Payer: Cash Price |
$100.50
|
| Rate for Payer: Galaxy Health Commercial |
$87.10
|
|
