|
ANESTHESIA 120 MIN
|
Facility
|
OP
|
$413.00
|
|
| Hospital Charge Code |
4120006
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$61.95 |
| Max. Negotiated Rate |
$330.40 |
| Rate for Payer: Aetna of NY Commercial |
$289.10
|
| Rate for Payer: Aetna of NY Medicare |
$189.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$165.20
|
| Rate for Payer: Cash Price |
$309.75
|
| Rate for Payer: CDPHP Medicare |
$152.81
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$330.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$330.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$330.40
|
| Rate for Payer: EmblemHealth Medicaid |
$330.40
|
| Rate for Payer: EmblemHealth Medicare |
$140.42
|
| Rate for Payer: EmblemHealth Select Care |
$297.36
|
| Rate for Payer: Fidelis Medicare |
$165.20
|
| Rate for Payer: Galaxy Health Commercial |
$268.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$165.20
|
| Rate for Payer: Humana Medicare |
$165.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$289.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$189.98
|
| Rate for Payer: MVP Health Care of NY Commercial |
$309.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$232.52
|
| Rate for Payer: MVP Health Care of NY Medicare |
$173.46
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$61.95
|
| Rate for Payer: United Healthcare Medicare |
$165.20
|
| Rate for Payer: WellCare Medicare |
$227.15
|
|
|
ANESTHESIA 135 MINS
|
Facility
|
IP
|
$448.00
|
|
| Hospital Charge Code |
4120013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$291.20 |
| Max. Negotiated Rate |
$291.20 |
| Rate for Payer: Cash Price |
$336.00
|
| Rate for Payer: Galaxy Health Commercial |
$291.20
|
|
|
ANESTHESIA 135 MINS
|
Facility
|
OP
|
$448.00
|
|
| Hospital Charge Code |
4120013
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$67.20 |
| Max. Negotiated Rate |
$358.40 |
| Rate for Payer: Aetna of NY Commercial |
$313.60
|
| Rate for Payer: Aetna of NY Medicare |
$206.08
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$179.20
|
| Rate for Payer: Cash Price |
$336.00
|
| Rate for Payer: CDPHP Medicare |
$165.76
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$358.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$358.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$358.40
|
| Rate for Payer: EmblemHealth Medicaid |
$358.40
|
| Rate for Payer: EmblemHealth Medicare |
$152.32
|
| Rate for Payer: EmblemHealth Select Care |
$322.56
|
| Rate for Payer: Fidelis Medicare |
$179.20
|
| Rate for Payer: Galaxy Health Commercial |
$291.20
|
| Rate for Payer: Hamaspik Choice Medicare |
$179.20
|
| Rate for Payer: Humana Medicare |
$179.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$313.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$206.08
|
| Rate for Payer: MVP Health Care of NY Commercial |
$336.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$252.22
|
| Rate for Payer: MVP Health Care of NY Medicare |
$188.16
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$67.20
|
| Rate for Payer: United Healthcare Medicare |
$179.20
|
| Rate for Payer: WellCare Medicare |
$246.40
|
|
|
ANESTHESIA 150 MIN
|
Facility
|
OP
|
$483.00
|
|
| Hospital Charge Code |
4120007
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$72.45 |
| Max. Negotiated Rate |
$386.40 |
| Rate for Payer: Aetna of NY Commercial |
$338.10
|
| Rate for Payer: Aetna of NY Medicare |
$222.18
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$193.20
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: CDPHP Medicare |
$178.71
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$386.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$386.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$386.40
|
| Rate for Payer: EmblemHealth Medicaid |
$386.40
|
| Rate for Payer: EmblemHealth Medicare |
$164.22
|
| Rate for Payer: EmblemHealth Select Care |
$347.76
|
| Rate for Payer: Fidelis Medicare |
$193.20
|
| Rate for Payer: Galaxy Health Commercial |
$313.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$193.20
|
| Rate for Payer: Humana Medicare |
$193.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$338.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$222.18
|
| Rate for Payer: MVP Health Care of NY Commercial |
$362.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$271.93
|
| Rate for Payer: MVP Health Care of NY Medicare |
$202.86
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$72.45
|
| Rate for Payer: United Healthcare Medicare |
$193.20
|
| Rate for Payer: WellCare Medicare |
$265.65
|
|
|
ANESTHESIA 150 MIN
|
Facility
|
IP
|
$483.00
|
|
| Hospital Charge Code |
4120007
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$313.95 |
| Max. Negotiated Rate |
$313.95 |
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Galaxy Health Commercial |
$313.95
|
|
|
ANESTHESIA 15 MINS
|
Facility
|
IP
|
$88.00
|
|
| Hospital Charge Code |
4120002
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$57.20 |
| Max. Negotiated Rate |
$57.20 |
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Galaxy Health Commercial |
$57.20
|
|
|
ANESTHESIA 15 MINS
|
Facility
|
OP
|
$88.00
|
|
| Hospital Charge Code |
4120002
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$70.40 |
| Rate for Payer: Aetna of NY Commercial |
$61.60
|
| Rate for Payer: Aetna of NY Medicare |
$40.48
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$35.20
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: CDPHP Medicare |
$32.56
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$70.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$70.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$70.40
|
| Rate for Payer: EmblemHealth Medicaid |
$70.40
|
| Rate for Payer: EmblemHealth Medicare |
$29.92
|
| Rate for Payer: EmblemHealth Select Care |
$63.36
|
| Rate for Payer: Fidelis Medicare |
$35.20
|
| Rate for Payer: Galaxy Health Commercial |
$57.20
|
| Rate for Payer: Hamaspik Choice Medicare |
$35.20
|
| Rate for Payer: Humana Medicare |
$35.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$61.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$40.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$66.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$49.54
|
| Rate for Payer: MVP Health Care of NY Medicare |
$36.96
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$13.20
|
| Rate for Payer: United Healthcare Medicare |
$35.20
|
| Rate for Payer: WellCare Medicare |
$48.40
|
|
|
ANESTHESIA 165 MINS
|
Facility
|
IP
|
$518.00
|
|
| Hospital Charge Code |
4120014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$336.70 |
| Max. Negotiated Rate |
$336.70 |
| Rate for Payer: Cash Price |
$388.50
|
| Rate for Payer: Galaxy Health Commercial |
$336.70
|
|
|
ANESTHESIA 165 MINS
|
Facility
|
OP
|
$518.00
|
|
| Hospital Charge Code |
4120014
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$77.70 |
| Max. Negotiated Rate |
$414.40 |
| Rate for Payer: Aetna of NY Commercial |
$362.60
|
| Rate for Payer: Aetna of NY Medicare |
$238.28
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$207.20
|
| Rate for Payer: Cash Price |
$388.50
|
| Rate for Payer: CDPHP Medicare |
$191.66
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$414.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$414.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$414.40
|
| Rate for Payer: EmblemHealth Medicaid |
$414.40
|
| Rate for Payer: EmblemHealth Medicare |
$176.12
|
| Rate for Payer: EmblemHealth Select Care |
$372.96
|
| Rate for Payer: Fidelis Medicare |
$207.20
|
| Rate for Payer: Galaxy Health Commercial |
$336.70
|
| Rate for Payer: Hamaspik Choice Medicare |
$207.20
|
| Rate for Payer: Humana Medicare |
$207.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$362.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$238.28
|
| Rate for Payer: MVP Health Care of NY Commercial |
$388.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$291.63
|
| Rate for Payer: MVP Health Care of NY Medicare |
$217.56
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$77.70
|
| Rate for Payer: United Healthcare Medicare |
$207.20
|
| Rate for Payer: WellCare Medicare |
$284.90
|
|
|
ANESTHESIA 180 MIN
|
Facility
|
OP
|
$554.00
|
|
| Hospital Charge Code |
4120008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$83.10 |
| Max. Negotiated Rate |
$443.20 |
| Rate for Payer: Aetna of NY Commercial |
$387.80
|
| Rate for Payer: Aetna of NY Medicare |
$254.84
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$221.60
|
| Rate for Payer: Cash Price |
$415.50
|
| Rate for Payer: CDPHP Medicare |
$204.98
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$443.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$443.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$443.20
|
| Rate for Payer: EmblemHealth Medicaid |
$443.20
|
| Rate for Payer: EmblemHealth Medicare |
$188.36
|
| Rate for Payer: EmblemHealth Select Care |
$398.88
|
| Rate for Payer: Fidelis Medicare |
$221.60
|
| Rate for Payer: Galaxy Health Commercial |
$360.10
|
| Rate for Payer: Hamaspik Choice Medicare |
$221.60
|
| Rate for Payer: Humana Medicare |
$221.60
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$387.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$254.84
|
| Rate for Payer: MVP Health Care of NY Commercial |
$415.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$311.90
|
| Rate for Payer: MVP Health Care of NY Medicare |
$232.68
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$83.10
|
| Rate for Payer: United Healthcare Medicare |
$221.60
|
| Rate for Payer: WellCare Medicare |
$304.70
|
|
|
ANESTHESIA 180 MIN
|
Facility
|
IP
|
$554.00
|
|
| Hospital Charge Code |
4120008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$360.10 |
| Max. Negotiated Rate |
$360.10 |
| Rate for Payer: Cash Price |
$415.50
|
| Rate for Payer: Galaxy Health Commercial |
$360.10
|
|
|
ANESTHESIA 195 MINS
|
Facility
|
OP
|
$588.00
|
|
| Hospital Charge Code |
4120015
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$88.20 |
| Max. Negotiated Rate |
$470.40 |
| Rate for Payer: Aetna of NY Commercial |
$411.60
|
| Rate for Payer: Aetna of NY Medicare |
$270.48
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$235.20
|
| Rate for Payer: Cash Price |
$441.00
|
| Rate for Payer: CDPHP Medicare |
$217.56
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$470.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$470.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$470.40
|
| Rate for Payer: EmblemHealth Medicaid |
$470.40
|
| Rate for Payer: EmblemHealth Medicare |
$199.92
|
| Rate for Payer: EmblemHealth Select Care |
$423.36
|
| Rate for Payer: Fidelis Medicare |
$235.20
|
| Rate for Payer: Galaxy Health Commercial |
$382.20
|
| Rate for Payer: Hamaspik Choice Medicare |
$235.20
|
| Rate for Payer: Humana Medicare |
$235.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$411.60
|
| Rate for Payer: Local 1199SEIU Medicare |
$270.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$441.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$331.04
|
| Rate for Payer: MVP Health Care of NY Medicare |
$246.96
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$88.20
|
| Rate for Payer: United Healthcare Medicare |
$235.20
|
| Rate for Payer: WellCare Medicare |
$323.40
|
|
|
ANESTHESIA 195 MINS
|
Facility
|
IP
|
$588.00
|
|
| Hospital Charge Code |
4120015
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$382.20 |
| Max. Negotiated Rate |
$382.20 |
| Rate for Payer: Cash Price |
$441.00
|
| Rate for Payer: Galaxy Health Commercial |
$382.20
|
|
|
ANESTHESIA 210 MIN
|
Facility
|
OP
|
$622.00
|
|
| Hospital Charge Code |
4120009
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$93.30 |
| Max. Negotiated Rate |
$497.60 |
| Rate for Payer: Aetna of NY Commercial |
$435.40
|
| Rate for Payer: Aetna of NY Medicare |
$286.12
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$248.80
|
| Rate for Payer: Cash Price |
$466.50
|
| Rate for Payer: CDPHP Medicare |
$230.14
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$497.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$497.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$497.60
|
| Rate for Payer: EmblemHealth Medicaid |
$497.60
|
| Rate for Payer: EmblemHealth Medicare |
$211.48
|
| Rate for Payer: EmblemHealth Select Care |
$447.84
|
| Rate for Payer: Fidelis Medicare |
$248.80
|
| Rate for Payer: Galaxy Health Commercial |
$404.30
|
| Rate for Payer: Hamaspik Choice Medicare |
$248.80
|
| Rate for Payer: Humana Medicare |
$248.80
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$435.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$286.12
|
| Rate for Payer: MVP Health Care of NY Commercial |
$466.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$350.19
|
| Rate for Payer: MVP Health Care of NY Medicare |
$261.24
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$93.30
|
| Rate for Payer: United Healthcare Medicare |
$248.80
|
| Rate for Payer: WellCare Medicare |
$342.10
|
|
|
ANESTHESIA 210 MIN
|
Facility
|
IP
|
$622.00
|
|
| Hospital Charge Code |
4120009
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$404.30 |
| Max. Negotiated Rate |
$404.30 |
| Rate for Payer: Cash Price |
$466.50
|
| Rate for Payer: Galaxy Health Commercial |
$404.30
|
|
|
ANESTHESIA 225 MINS
|
Facility
|
OP
|
$657.00
|
|
| Hospital Charge Code |
4120020
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$98.55 |
| Max. Negotiated Rate |
$525.60 |
| Rate for Payer: Aetna of NY Commercial |
$459.90
|
| Rate for Payer: Aetna of NY Medicare |
$302.22
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$262.80
|
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: CDPHP Medicare |
$243.09
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$525.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$525.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$525.60
|
| Rate for Payer: EmblemHealth Medicaid |
$525.60
|
| Rate for Payer: EmblemHealth Medicare |
$223.38
|
| Rate for Payer: EmblemHealth Select Care |
$473.04
|
| Rate for Payer: Fidelis Medicare |
$262.80
|
| Rate for Payer: Galaxy Health Commercial |
$427.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$262.80
|
| Rate for Payer: Humana Medicare |
$262.80
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$459.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$302.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$492.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$369.89
|
| Rate for Payer: MVP Health Care of NY Medicare |
$275.94
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$98.55
|
| Rate for Payer: United Healthcare Medicare |
$262.80
|
| Rate for Payer: WellCare Medicare |
$361.35
|
|
|
ANESTHESIA 225 MINS
|
Facility
|
IP
|
$657.00
|
|
| Hospital Charge Code |
4120020
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$427.05 |
| Max. Negotiated Rate |
$427.05 |
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Galaxy Health Commercial |
$427.05
|
|
|
ANESTHESIA 240 MIN
|
Facility
|
IP
|
$691.00
|
|
| Hospital Charge Code |
4120017
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$449.15 |
| Max. Negotiated Rate |
$449.15 |
| Rate for Payer: Cash Price |
$518.25
|
| Rate for Payer: Galaxy Health Commercial |
$449.15
|
|
|
ANESTHESIA 240 MIN
|
Facility
|
OP
|
$691.00
|
|
| Hospital Charge Code |
4120017
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$103.65 |
| Max. Negotiated Rate |
$552.80 |
| Rate for Payer: Aetna of NY Commercial |
$483.70
|
| Rate for Payer: Aetna of NY Medicare |
$317.86
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$276.40
|
| Rate for Payer: Cash Price |
$518.25
|
| Rate for Payer: CDPHP Medicare |
$255.67
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$552.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$552.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$552.80
|
| Rate for Payer: EmblemHealth Medicaid |
$552.80
|
| Rate for Payer: EmblemHealth Medicare |
$234.94
|
| Rate for Payer: EmblemHealth Select Care |
$497.52
|
| Rate for Payer: Fidelis Medicare |
$276.40
|
| Rate for Payer: Galaxy Health Commercial |
$449.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$276.40
|
| Rate for Payer: Humana Medicare |
$276.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$483.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$317.86
|
| Rate for Payer: MVP Health Care of NY Commercial |
$518.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$389.03
|
| Rate for Payer: MVP Health Care of NY Medicare |
$290.22
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$103.65
|
| Rate for Payer: United Healthcare Medicare |
$276.40
|
| Rate for Payer: WellCare Medicare |
$380.05
|
|
|
ANESTHESIA 255 MINS
|
Facility
|
IP
|
$733.00
|
|
| Hospital Charge Code |
4120021
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$476.45 |
| Max. Negotiated Rate |
$476.45 |
| Rate for Payer: Cash Price |
$549.75
|
| Rate for Payer: Galaxy Health Commercial |
$476.45
|
|
|
ANESTHESIA 255 MINS
|
Facility
|
OP
|
$733.00
|
|
| Hospital Charge Code |
4120021
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$109.95 |
| Max. Negotiated Rate |
$586.40 |
| Rate for Payer: Aetna of NY Commercial |
$513.10
|
| Rate for Payer: Aetna of NY Medicare |
$337.18
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$293.20
|
| Rate for Payer: Cash Price |
$549.75
|
| Rate for Payer: CDPHP Medicare |
$271.21
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$586.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$586.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$586.40
|
| Rate for Payer: EmblemHealth Medicaid |
$586.40
|
| Rate for Payer: EmblemHealth Medicare |
$249.22
|
| Rate for Payer: EmblemHealth Select Care |
$527.76
|
| Rate for Payer: Fidelis Medicare |
$293.20
|
| Rate for Payer: Galaxy Health Commercial |
$476.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$293.20
|
| Rate for Payer: Humana Medicare |
$293.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$513.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$337.18
|
| Rate for Payer: MVP Health Care of NY Commercial |
$549.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$412.68
|
| Rate for Payer: MVP Health Care of NY Medicare |
$307.86
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$109.95
|
| Rate for Payer: United Healthcare Medicare |
$293.20
|
| Rate for Payer: WellCare Medicare |
$403.15
|
|
|
ANESTHESIA 270 MIN
|
Facility
|
IP
|
$773.00
|
|
| Hospital Charge Code |
4120018
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$502.45 |
| Max. Negotiated Rate |
$502.45 |
| Rate for Payer: Cash Price |
$579.75
|
| Rate for Payer: Galaxy Health Commercial |
$502.45
|
|
|
ANESTHESIA 270 MIN
|
Facility
|
OP
|
$773.00
|
|
| Hospital Charge Code |
4120018
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$115.95 |
| Max. Negotiated Rate |
$618.40 |
| Rate for Payer: Aetna of NY Commercial |
$541.10
|
| Rate for Payer: Aetna of NY Medicare |
$355.58
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$309.20
|
| Rate for Payer: Cash Price |
$579.75
|
| Rate for Payer: CDPHP Medicare |
$286.01
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$618.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$618.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$618.40
|
| Rate for Payer: EmblemHealth Medicaid |
$618.40
|
| Rate for Payer: EmblemHealth Medicare |
$262.82
|
| Rate for Payer: EmblemHealth Select Care |
$556.56
|
| Rate for Payer: Fidelis Medicare |
$309.20
|
| Rate for Payer: Galaxy Health Commercial |
$502.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$309.20
|
| Rate for Payer: Humana Medicare |
$309.20
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$541.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$355.58
|
| Rate for Payer: MVP Health Care of NY Commercial |
$579.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$435.20
|
| Rate for Payer: MVP Health Care of NY Medicare |
$324.66
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$115.95
|
| Rate for Payer: United Healthcare Medicare |
$309.20
|
| Rate for Payer: WellCare Medicare |
$425.15
|
|
|
ANESTHESIA 285 MINS
|
Facility
|
IP
|
$816.00
|
|
| Hospital Charge Code |
4120022
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$530.40 |
| Max. Negotiated Rate |
$530.40 |
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: Galaxy Health Commercial |
$530.40
|
|
|
ANESTHESIA 285 MINS
|
Facility
|
OP
|
$816.00
|
|
| Hospital Charge Code |
4120022
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$652.80 |
| Rate for Payer: Aetna of NY Commercial |
$571.20
|
| Rate for Payer: Aetna of NY Medicare |
$375.36
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$326.40
|
| Rate for Payer: Cash Price |
$612.00
|
| Rate for Payer: CDPHP Medicare |
$301.92
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$652.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$652.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$652.80
|
| Rate for Payer: EmblemHealth Medicaid |
$652.80
|
| Rate for Payer: EmblemHealth Medicare |
$277.44
|
| Rate for Payer: EmblemHealth Select Care |
$587.52
|
| Rate for Payer: Fidelis Medicare |
$326.40
|
| Rate for Payer: Galaxy Health Commercial |
$530.40
|
| Rate for Payer: Hamaspik Choice Medicare |
$326.40
|
| Rate for Payer: Humana Medicare |
$326.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$571.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$375.36
|
| Rate for Payer: MVP Health Care of NY Commercial |
$612.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$459.41
|
| Rate for Payer: MVP Health Care of NY Medicare |
$342.72
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$122.40
|
| Rate for Payer: United Healthcare Medicare |
$326.40
|
| Rate for Payer: WellCare Medicare |
$448.80
|
|
