|
REMOVAL OF NAIL BED LEFT
|
Facility
|
IP
|
$1,246.00
|
|
|
Service Code
|
HCPCS 11750 LT
|
| Hospital Charge Code |
4856658
|
|
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
|
|
|
REMOVAL OF NAIL BED RIGHT
|
Facility
|
IP
|
$1,246.00
|
|
|
Service Code
|
HCPCS 11750 RT
|
| Hospital Charge Code |
4856657
|
|
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
|
|
|
REMOVAL OF NAIL BED RIGHT
|
Facility
|
OP
|
$1,246.00
|
|
|
Service Code
|
HCPCS 11750 RT
|
| Hospital Charge Code |
4856657
|
|
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
|
|
|
REMOVAL OF SPINAL NEUROSTIMULATOR ELECTRODE PERCUTANEOUS ARRAY(S), INCLUDING FLUOROSCOPY, WHEN PERFORMED
|
Facility
|
OP
|
$2,097.00
|
|
|
Service Code
|
CPT 63661
|
|
Hospital Revenue Code
|
490
|
| Min. Negotiated Rate |
$1,839.63 |
| Max. Negotiated Rate |
$2,097.00 |
| Rate for Payer: Aetna of NY Commercial |
$1,900.00
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,900.00
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$2,097.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1,839.63
|
| Rate for Payer: United Healthcare Commercial |
$2,097.00
|
|
|
REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR
|
Facility
|
OP
|
$2,170.00
|
|
|
Service Code
|
HCPCS 33286
|
| Hospital Charge Code |
4601208
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$325.50 |
| Max. Negotiated Rate |
$1,736.00 |
| Rate for Payer: Aetna of NY Commercial |
$1,000.00
|
| 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: Cash Price |
$1,627.50
|
| Rate for Payer: CDPHP Medicare |
$802.90
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,206.00
|
| 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 |
$1,085.00
|
| 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 |
$1,000.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$998.20
|
| 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 |
$911.40
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$1,009.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$325.50
|
| Rate for Payer: United Healthcare Commercial |
$1,009.00
|
| Rate for Payer: United Healthcare Medicare |
$868.00
|
| Rate for Payer: WellCare Medicare |
$1,193.50
|
|
|
REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR
|
Facility
|
IP
|
$2,170.00
|
|
|
Service Code
|
HCPCS 33286
|
| Hospital Charge Code |
4601208
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,410.50 |
| Max. Negotiated Rate |
$1,410.50 |
| Rate for Payer: Cash Price |
$1,627.50
|
| Rate for Payer: Galaxy Health Commercial |
$1,410.50
|
|
|
REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
HCPCS 15854
|
| Hospital Charge Code |
4853045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$38.35 |
| Max. Negotiated Rate |
$38.35 |
| Rate for Payer: Cash Price |
$44.25
|
| Rate for Payer: Galaxy Health Commercial |
$38.35
|
|
|
REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
HCPCS 15854
|
| Hospital Charge Code |
4602240
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$1,234.00 |
| Rate for Payer: Aetna of NY Commercial |
$1,000.00
|
| Rate for Payer: Aetna of NY Medicare |
$27.14
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$23.60
|
| Rate for Payer: Cash Price |
$44.25
|
| Rate for Payer: Cash Price |
$44.25
|
| Rate for Payer: Cash Price |
$44.25
|
| Rate for Payer: CDPHP Medicare |
$21.83
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,206.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$47.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$47.20
|
| Rate for Payer: EmblemHealth Medicaid |
$47.20
|
| Rate for Payer: EmblemHealth Medicare |
$20.06
|
| Rate for Payer: EmblemHealth Select Care |
$1,085.00
|
| Rate for Payer: Fidelis Medicare |
$23.60
|
| Rate for Payer: Galaxy Health Commercial |
$38.35
|
| Rate for Payer: Hamaspik Choice Medicare |
$23.60
|
| Rate for Payer: Humana Medicare |
$23.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,000.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$27.14
|
| 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 |
$24.78
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$1,009.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.85
|
| Rate for Payer: United Healthcare Commercial |
$1,009.00
|
| Rate for Payer: United Healthcare Medicare |
$23.60
|
| Rate for Payer: WellCare Medicare |
$32.45
|
|
|
REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
HCPCS 15854
|
| Hospital Charge Code |
4602240
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$38.35 |
| Max. Negotiated Rate |
$38.35 |
| Rate for Payer: Cash Price |
$44.25
|
| Rate for Payer: Galaxy Health Commercial |
$38.35
|
|
|
REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
HCPCS 15854
|
| Hospital Charge Code |
4853045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$47.20 |
| Rate for Payer: Aetna of NY Commercial |
$41.30
|
| Rate for Payer: Aetna of NY Medicare |
$27.14
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$23.60
|
| Rate for Payer: Cash Price |
$44.25
|
| Rate for Payer: CDPHP Medicare |
$21.83
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$47.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$47.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$47.20
|
| Rate for Payer: EmblemHealth Medicaid |
$47.20
|
| Rate for Payer: EmblemHealth Medicare |
$20.06
|
| Rate for Payer: EmblemHealth Select Care |
$42.48
|
| Rate for Payer: Fidelis Medicare |
$23.60
|
| Rate for Payer: Galaxy Health Commercial |
$38.35
|
| Rate for Payer: Hamaspik Choice Medicare |
$23.60
|
| Rate for Payer: Humana Medicare |
$23.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$41.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$27.14
|
| Rate for Payer: MVP Health Care of NY Commercial |
$44.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$33.22
|
| Rate for Payer: MVP Health Care of NY Medicare |
$24.78
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.85
|
| Rate for Payer: United Healthcare Medicare |
$23.60
|
| Rate for Payer: WellCare Medicare |
$32.45
|
|
|
REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
HCPCS 15853
|
| Hospital Charge Code |
4853044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$28.60 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Galaxy Health Commercial |
$28.60
|
|
|
REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
HCPCS 15853
|
| Hospital Charge Code |
4602239
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$28.60 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Galaxy Health Commercial |
$28.60
|
|
|
REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
HCPCS 15853
|
| Hospital Charge Code |
4602239
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$1,234.00 |
| Rate for Payer: Aetna of NY Commercial |
$1,000.00
|
| Rate for Payer: Aetna of NY Medicare |
$20.24
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$17.60
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: CDPHP Medicare |
$16.28
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,206.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$35.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$35.20
|
| Rate for Payer: EmblemHealth Medicaid |
$35.20
|
| Rate for Payer: EmblemHealth Medicare |
$14.96
|
| Rate for Payer: EmblemHealth Select Care |
$1,085.00
|
| Rate for Payer: Fidelis Medicare |
$17.60
|
| Rate for Payer: Galaxy Health Commercial |
$28.60
|
| Rate for Payer: Hamaspik Choice Medicare |
$17.60
|
| Rate for Payer: Humana Medicare |
$17.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,000.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$20.24
|
| 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 |
$18.48
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$1,009.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$6.60
|
| Rate for Payer: United Healthcare Commercial |
$1,009.00
|
| Rate for Payer: United Healthcare Medicare |
$17.60
|
| Rate for Payer: WellCare Medicare |
$24.20
|
|
|
REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
HCPCS 15853
|
| Hospital Charge Code |
4853044
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$35.20 |
| Rate for Payer: Aetna of NY Commercial |
$30.80
|
| Rate for Payer: Aetna of NY Medicare |
$20.24
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$17.60
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: CDPHP Medicare |
$16.28
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$35.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$35.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$35.20
|
| Rate for Payer: EmblemHealth Medicaid |
$35.20
|
| Rate for Payer: EmblemHealth Medicare |
$14.96
|
| Rate for Payer: EmblemHealth Select Care |
$31.68
|
| Rate for Payer: Fidelis Medicare |
$17.60
|
| Rate for Payer: Galaxy Health Commercial |
$28.60
|
| Rate for Payer: Hamaspik Choice Medicare |
$17.60
|
| Rate for Payer: Humana Medicare |
$17.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$30.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$20.24
|
| Rate for Payer: MVP Health Care of NY Commercial |
$33.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$24.77
|
| Rate for Payer: MVP Health Care of NY Medicare |
$18.48
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$6.60
|
| Rate for Payer: United Healthcare Medicare |
$17.60
|
| Rate for Payer: WellCare Medicare |
$24.20
|
|
|
REMOVE FULL ARM OR LEG CAST
|
Facility
|
IP
|
$857.00
|
|
|
Service Code
|
HCPCS 29705
|
| Hospital Charge Code |
4850161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$557.05 |
| Max. Negotiated Rate |
$557.05 |
| Rate for Payer: Cash Price |
$642.75
|
| Rate for Payer: Galaxy Health Commercial |
$557.05
|
|
|
REMOVE FULL ARM OR LEG CAST
|
Facility
|
OP
|
$857.00
|
|
|
Service Code
|
HCPCS 29705
|
| Hospital Charge Code |
4850161
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.55 |
| Max. Negotiated Rate |
$685.60 |
| Rate for Payer: Aetna of NY Commercial |
$599.90
|
| Rate for Payer: Aetna of NY Medicare |
$394.22
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$342.80
|
| Rate for Payer: Cash Price |
$642.75
|
| Rate for Payer: CDPHP Medicare |
$317.09
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$685.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$685.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$685.60
|
| Rate for Payer: EmblemHealth Medicaid |
$685.60
|
| Rate for Payer: EmblemHealth Medicare |
$291.38
|
| Rate for Payer: EmblemHealth Select Care |
$617.04
|
| Rate for Payer: Fidelis Medicare |
$342.80
|
| Rate for Payer: Galaxy Health Commercial |
$557.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$342.80
|
| Rate for Payer: Humana Medicare |
$342.80
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$599.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$394.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$642.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$482.49
|
| Rate for Payer: MVP Health Care of NY Medicare |
$359.94
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$128.55
|
| Rate for Payer: United Healthcare Medicare |
$342.80
|
| Rate for Payer: WellCare Medicare |
$471.35
|
|
|
REMOVE SKIN TAGS ADD-ON =<10 LESIONS
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS 11201
|
| Hospital Charge Code |
4856690
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9.00 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Aetna of NY Commercial |
$42.00
|
| Rate for Payer: Aetna of NY Medicare |
$27.60
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$24.00
|
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: CDPHP Medicare |
$22.20
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$48.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$48.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$48.00
|
| Rate for Payer: EmblemHealth Medicaid |
$48.00
|
| Rate for Payer: EmblemHealth Medicare |
$20.40
|
| Rate for Payer: EmblemHealth Select Care |
$43.20
|
| Rate for Payer: Fidelis Medicare |
$24.00
|
| Rate for Payer: Galaxy Health Commercial |
$39.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$24.00
|
| Rate for Payer: Humana Medicare |
$24.00
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$42.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$27.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$45.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$33.78
|
| Rate for Payer: MVP Health Care of NY Medicare |
$25.20
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$9.00
|
| Rate for Payer: United Healthcare Medicare |
$24.00
|
| Rate for Payer: WellCare Medicare |
$33.00
|
|
|
REMOVE SKIN TAGS ADD-ON =<10 LESIONS
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS 11201
|
| Hospital Charge Code |
4856690
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: Cash Price |
$45.00
|
| Rate for Payer: Galaxy Health Commercial |
$39.00
|
|
|
REMOVE TNL CV CATH
|
Facility
|
IP
|
$1,923.00
|
|
|
Service Code
|
HCPCS 36589
|
| Hospital Charge Code |
4450114
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,249.95 |
| Max. Negotiated Rate |
$1,249.95 |
| Rate for Payer: Cash Price |
$1,442.25
|
| Rate for Payer: Galaxy Health Commercial |
$1,249.95
|
|
|
REMOVE TNL CV CATH
|
Facility
|
OP
|
$1,923.00
|
|
|
Service Code
|
HCPCS 36589
|
| Hospital Charge Code |
4450114
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$288.45 |
| Max. Negotiated Rate |
$1,538.40 |
| Rate for Payer: Aetna of NY Commercial |
$1,346.10
|
| Rate for Payer: Aetna of NY Medicare |
$884.58
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$769.20
|
| Rate for Payer: Cash Price |
$1,442.25
|
| Rate for Payer: CDPHP Medicare |
$711.51
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,538.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,538.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,538.40
|
| Rate for Payer: EmblemHealth Medicaid |
$1,538.40
|
| Rate for Payer: EmblemHealth Medicare |
$653.82
|
| Rate for Payer: EmblemHealth Select Care |
$1,384.56
|
| Rate for Payer: Fidelis Medicare |
$769.20
|
| Rate for Payer: Galaxy Health Commercial |
$1,249.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$769.20
|
| Rate for Payer: Humana Medicare |
$769.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,346.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$884.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,442.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$1,082.65
|
| Rate for Payer: MVP Health Care of NY Medicare |
$807.66
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$288.45
|
| Rate for Payer: United Healthcare Medicare |
$769.20
|
| Rate for Payer: WellCare Medicare |
$1,057.65
|
|
|
REM SKIN TAGS; <=15 LESIONS
|
Facility
|
IP
|
$615.00
|
|
|
Service Code
|
HCPCS 11200
|
| Hospital Charge Code |
4856689
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$399.75 |
| Max. Negotiated Rate |
$399.75 |
| Rate for Payer: Cash Price |
$461.25
|
| Rate for Payer: Galaxy Health Commercial |
$399.75
|
|
|
REM SKIN TAGS; <=15 LESIONS
|
Facility
|
IP
|
$615.00
|
|
|
Service Code
|
HCPCS 11200
|
| Hospital Charge Code |
4602226
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$399.75 |
| Max. Negotiated Rate |
$399.75 |
| Rate for Payer: Cash Price |
$461.25
|
| Rate for Payer: Galaxy Health Commercial |
$399.75
|
|
|
REM SKIN TAGS; <=15 LESIONS
|
Facility
|
OP
|
$615.00
|
|
|
Service Code
|
HCPCS 11200
|
| Hospital Charge Code |
4602226
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$92.25 |
| Max. Negotiated Rate |
$1,234.00 |
| Rate for Payer: Aetna of NY Commercial |
$1,000.00
|
| Rate for Payer: Aetna of NY Medicare |
$282.90
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$246.00
|
| Rate for Payer: Cash Price |
$461.25
|
| Rate for Payer: Cash Price |
$461.25
|
| Rate for Payer: Cash Price |
$461.25
|
| Rate for Payer: CDPHP Medicare |
$227.55
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,206.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$492.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$492.00
|
| Rate for Payer: EmblemHealth Medicaid |
$492.00
|
| Rate for Payer: EmblemHealth Medicare |
$209.10
|
| Rate for Payer: EmblemHealth Select Care |
$1,085.00
|
| Rate for Payer: Fidelis Medicare |
$246.00
|
| Rate for Payer: Galaxy Health Commercial |
$399.75
|
| Rate for Payer: Hamaspik Choice Medicare |
$246.00
|
| Rate for Payer: Humana Medicare |
$246.00
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$1,000.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$282.90
|
| 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 |
$258.30
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$1,009.00
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$92.25
|
| Rate for Payer: United Healthcare Commercial |
$1,009.00
|
| Rate for Payer: United Healthcare Medicare |
$246.00
|
| Rate for Payer: WellCare Medicare |
$338.25
|
|
|
REM SKIN TAGS; <=15 LESIONS
|
Facility
|
OP
|
$615.00
|
|
|
Service Code
|
HCPCS 11200
|
| Hospital Charge Code |
4856689
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$92.25 |
| Max. Negotiated Rate |
$492.00 |
| Rate for Payer: Aetna of NY Commercial |
$430.50
|
| Rate for Payer: Aetna of NY Medicare |
$282.90
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$246.00
|
| Rate for Payer: Cash Price |
$461.25
|
| Rate for Payer: CDPHP Medicare |
$227.55
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$492.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$492.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$492.00
|
| Rate for Payer: EmblemHealth Medicaid |
$492.00
|
| Rate for Payer: EmblemHealth Medicare |
$209.10
|
| Rate for Payer: EmblemHealth Select Care |
$442.80
|
| Rate for Payer: Fidelis Medicare |
$246.00
|
| Rate for Payer: Galaxy Health Commercial |
$399.75
|
| Rate for Payer: Hamaspik Choice Medicare |
$246.00
|
| Rate for Payer: Humana Medicare |
$246.00
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$430.50
|
| Rate for Payer: Local 1199SEIU Medicare |
$282.90
|
| Rate for Payer: MVP Health Care of NY Commercial |
$461.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$346.25
|
| Rate for Payer: MVP Health Care of NY Medicare |
$258.30
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$92.25
|
| Rate for Payer: United Healthcare Medicare |
$246.00
|
| Rate for Payer: WellCare Medicare |
$338.25
|
|
|
REM SUTURES BY MD, DIFF THAN ORIG MD
|
Facility
|
IP
|
$57.68
|
|
|
Service Code
|
HCPCS S0630
|
| Hospital Charge Code |
4850302
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$37.49 |
| Rate for Payer: Cash Price |
$43.26
|
| Rate for Payer: Galaxy Health Commercial |
$37.49
|
|
