|
CATH FOLEY 16FR DOVER
|
Facility
|
IP
|
$54.00
|
|
| Hospital Charge Code |
4471546
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.10 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Cash Price |
$40.50
|
| Rate for Payer: Galaxy Health Commercial |
$35.10
|
|
|
CATH FOLEY LATEX 5CC 14FR
|
Facility
|
OP
|
$53.00
|
|
| Hospital Charge Code |
4471448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.02 |
| Max. Negotiated Rate |
$42.66 |
| Rate for Payer: Aetna of NY Commercial |
$37.10
|
| Rate for Payer: Aetna of NY Medicare |
$24.38
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$39.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$39.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$19.61
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$26.50
|
| Rate for Payer: Cash Price |
$39.75
|
| Rate for Payer: CDPHP Commercial |
$42.66
|
| Rate for Payer: CDPHP Medicare |
$19.61
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$42.40
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$42.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$42.40
|
| Rate for Payer: EmblemHealth Medicaid |
$42.40
|
| Rate for Payer: EmblemHealth Medicare |
$18.02
|
| Rate for Payer: EmblemHealth Select Care |
$38.16
|
| Rate for Payer: Fidelis Medicare |
$20.20
|
| Rate for Payer: Galaxy Health Commercial |
$34.45
|
| Rate for Payer: Hamaspik Choice Medicare |
$19.61
|
| Rate for Payer: Humana Medicare |
$19.61
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$37.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$24.38
|
| Rate for Payer: MVP Health Care of NY Commercial |
$39.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$29.84
|
| Rate for Payer: MVP Health Care of NY Medicare |
$20.59
|
| Rate for Payer: United Healthcare Medicare |
$19.61
|
| Rate for Payer: WellCare Medicare |
$29.15
|
|
|
CATH FOLEY LATEX 5CC 14FR
|
Facility
|
IP
|
$53.00
|
|
| Hospital Charge Code |
4471448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.45 |
| Max. Negotiated Rate |
$34.45 |
| Rate for Payer: Cash Price |
$39.75
|
| Rate for Payer: Galaxy Health Commercial |
$34.45
|
|
|
CATH FOLEY LATEX 5CC 22FR
|
Facility
|
OP
|
$20.00
|
|
| Hospital Charge Code |
4471661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$16.10 |
| Rate for Payer: Aetna of NY Commercial |
$14.00
|
| Rate for Payer: Aetna of NY Medicare |
$9.20
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$15.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$15.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$7.40
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$10.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: CDPHP Commercial |
$16.10
|
| Rate for Payer: CDPHP Medicare |
$7.40
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$16.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$16.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$16.00
|
| Rate for Payer: EmblemHealth Medicaid |
$16.00
|
| Rate for Payer: EmblemHealth Medicare |
$6.80
|
| Rate for Payer: EmblemHealth Select Care |
$14.40
|
| Rate for Payer: Fidelis Medicare |
$7.62
|
| Rate for Payer: Galaxy Health Commercial |
$13.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$7.40
|
| Rate for Payer: Humana Medicare |
$7.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$14.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$9.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$15.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$11.26
|
| Rate for Payer: MVP Health Care of NY Medicare |
$7.77
|
| Rate for Payer: United Healthcare Medicare |
$7.40
|
| Rate for Payer: WellCare Medicare |
$11.00
|
|
|
CATH FOLEY LATEX 5CC 22FR
|
Facility
|
IP
|
$20.00
|
|
| Hospital Charge Code |
4471661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Galaxy Health Commercial |
$13.00
|
|
|
CATH INDW FOLEY 3 WAY
|
Facility
|
OP
|
$57.00
|
|
|
Service Code
|
HCPCS A4346
|
| Hospital Charge Code |
4600271
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$19.38 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna of NY Commercial |
$39.90
|
| Rate for Payer: Aetna of NY Medicare |
$26.22
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$42.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$42.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$21.09
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$28.50
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: CDPHP Commercial |
$45.88
|
| Rate for Payer: CDPHP Medicare |
$21.09
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$45.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$45.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$45.60
|
| Rate for Payer: EmblemHealth Medicaid |
$45.60
|
| Rate for Payer: EmblemHealth Medicare |
$19.38
|
| Rate for Payer: EmblemHealth Select Care |
$41.04
|
| Rate for Payer: Fidelis Medicare |
$21.72
|
| Rate for Payer: Galaxy Health Commercial |
$37.05
|
| Rate for Payer: Hamaspik Choice Medicare |
$21.09
|
| Rate for Payer: Humana Medicare |
$21.09
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$39.90
|
| Rate for Payer: Local 1199SEIU Medicare |
$26.22
|
| Rate for Payer: MVP Health Care of NY Commercial |
$42.75
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$32.09
|
| Rate for Payer: MVP Health Care of NY Medicare |
$22.14
|
| Rate for Payer: United Healthcare Medicare |
$21.09
|
| Rate for Payer: WellCare Medicare |
$31.35
|
|
|
CATH INDW FOLEY 3 WAY
|
Facility
|
IP
|
$57.00
|
|
|
Service Code
|
HCPCS A4346
|
| Hospital Charge Code |
4600271
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.05 |
| Max. Negotiated Rate |
$37.05 |
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Galaxy Health Commercial |
$37.05
|
|
|
CATH TROCAR 20FR 16"L
|
Facility
|
IP
|
$1,346.00
|
|
| Hospital Charge Code |
4471343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$874.90 |
| Max. Negotiated Rate |
$874.90 |
| Rate for Payer: Cash Price |
$1,009.50
|
| Rate for Payer: Galaxy Health Commercial |
$874.90
|
|
|
CATH TROCAR 20FR 16"L
|
Facility
|
OP
|
$1,346.00
|
|
| Hospital Charge Code |
4471343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$457.64 |
| Max. Negotiated Rate |
$1,083.53 |
| Rate for Payer: Aetna of NY Commercial |
$942.20
|
| Rate for Payer: Aetna of NY Medicare |
$619.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$498.02
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$673.00
|
| Rate for Payer: Cash Price |
$1,009.50
|
| Rate for Payer: CDPHP Commercial |
$1,083.53
|
| Rate for Payer: CDPHP Medicare |
$498.02
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicaid |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicare |
$457.64
|
| Rate for Payer: EmblemHealth Select Care |
$969.12
|
| Rate for Payer: Fidelis Medicare |
$512.96
|
| Rate for Payer: Galaxy Health Commercial |
$874.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$498.02
|
| Rate for Payer: Humana Medicare |
$498.02
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$942.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$619.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,009.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$757.80
|
| Rate for Payer: MVP Health Care of NY Medicare |
$522.92
|
| Rate for Payer: United Healthcare Medicare |
$498.02
|
| Rate for Payer: WellCare Medicare |
$740.30
|
|
|
CATH TROCAR 24FR 16"L
|
Facility
|
IP
|
$1,346.00
|
|
| Hospital Charge Code |
4471345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$874.90 |
| Max. Negotiated Rate |
$874.90 |
| Rate for Payer: Cash Price |
$1,009.50
|
| Rate for Payer: Galaxy Health Commercial |
$874.90
|
|
|
CATH TROCAR 24FR 16"L
|
Facility
|
OP
|
$1,346.00
|
|
| Hospital Charge Code |
4471345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$457.64 |
| Max. Negotiated Rate |
$1,083.53 |
| Rate for Payer: Aetna of NY Commercial |
$942.20
|
| Rate for Payer: Aetna of NY Medicare |
$619.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$498.02
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$673.00
|
| Rate for Payer: Cash Price |
$1,009.50
|
| Rate for Payer: CDPHP Commercial |
$1,083.53
|
| Rate for Payer: CDPHP Medicare |
$498.02
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicaid |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicare |
$457.64
|
| Rate for Payer: EmblemHealth Select Care |
$969.12
|
| Rate for Payer: Fidelis Medicare |
$512.96
|
| Rate for Payer: Galaxy Health Commercial |
$874.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$498.02
|
| Rate for Payer: Humana Medicare |
$498.02
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$942.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$619.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,009.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$757.80
|
| Rate for Payer: MVP Health Care of NY Medicare |
$522.92
|
| Rate for Payer: United Healthcare Medicare |
$498.02
|
| Rate for Payer: WellCare Medicare |
$740.30
|
|
|
CATH TROCAR 28FR 16"L
|
Facility
|
OP
|
$1,346.00
|
|
| Hospital Charge Code |
4471346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$457.64 |
| Max. Negotiated Rate |
$1,083.53 |
| Rate for Payer: Aetna of NY Commercial |
$942.20
|
| Rate for Payer: Aetna of NY Medicare |
$619.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$1,009.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$498.02
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$673.00
|
| Rate for Payer: Cash Price |
$1,009.50
|
| Rate for Payer: CDPHP Commercial |
$1,083.53
|
| Rate for Payer: CDPHP Medicare |
$498.02
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,076.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicaid |
$1,076.80
|
| Rate for Payer: EmblemHealth Medicare |
$457.64
|
| Rate for Payer: EmblemHealth Select Care |
$969.12
|
| Rate for Payer: Fidelis Medicare |
$512.96
|
| Rate for Payer: Galaxy Health Commercial |
$874.90
|
| Rate for Payer: Hamaspik Choice Medicare |
$498.02
|
| Rate for Payer: Humana Medicare |
$498.02
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$942.20
|
| Rate for Payer: Local 1199SEIU Medicare |
$619.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,009.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$757.80
|
| Rate for Payer: MVP Health Care of NY Medicare |
$522.92
|
| Rate for Payer: United Healthcare Medicare |
$498.02
|
| Rate for Payer: WellCare Medicare |
$740.30
|
|
|
CATH TROCAR 28FR 16"L
|
Facility
|
IP
|
$1,346.00
|
|
| Hospital Charge Code |
4471346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$874.90 |
| Max. Negotiated Rate |
$874.90 |
| Rate for Payer: Cash Price |
$1,009.50
|
| Rate for Payer: Galaxy Health Commercial |
$874.90
|
|
|
CATH URETHRAL TRAY
|
Facility
|
OP
|
$10.00
|
|
| Hospital Charge Code |
4471746
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of NY Commercial |
$7.00
|
| Rate for Payer: Aetna of NY Medicare |
$4.60
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$7.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$7.50
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$3.70
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$5.00
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: CDPHP Commercial |
$8.05
|
| Rate for Payer: CDPHP Medicare |
$3.70
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$8.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$8.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$8.00
|
| Rate for Payer: EmblemHealth Medicaid |
$8.00
|
| Rate for Payer: EmblemHealth Medicare |
$3.40
|
| Rate for Payer: EmblemHealth Select Care |
$7.20
|
| Rate for Payer: Fidelis Medicare |
$3.81
|
| Rate for Payer: Galaxy Health Commercial |
$6.50
|
| Rate for Payer: Hamaspik Choice Medicare |
$3.70
|
| Rate for Payer: Humana Medicare |
$3.70
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$7.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$4.60
|
| Rate for Payer: MVP Health Care of NY Commercial |
$7.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$5.63
|
| Rate for Payer: MVP Health Care of NY Medicare |
$3.88
|
| Rate for Payer: United Healthcare Medicare |
$3.70
|
| Rate for Payer: WellCare Medicare |
$5.50
|
|
|
CATH URETHRAL TRAY
|
Facility
|
IP
|
$10.00
|
|
| Hospital Charge Code |
4471746
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Galaxy Health Commercial |
$6.50
|
|
|
CAUTERY HIGH TEMP FINE TIP
|
Facility
|
OP
|
$32.00
|
|
| Hospital Charge Code |
4471284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.88 |
| Max. Negotiated Rate |
$25.76 |
| Rate for Payer: Aetna of NY Commercial |
$22.40
|
| Rate for Payer: Aetna of NY Medicare |
$14.72
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$24.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$24.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$11.84
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$16.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: CDPHP Commercial |
$25.76
|
| Rate for Payer: CDPHP Medicare |
$11.84
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$25.60
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$25.60
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$25.60
|
| Rate for Payer: EmblemHealth Medicaid |
$25.60
|
| Rate for Payer: EmblemHealth Medicare |
$10.88
|
| Rate for Payer: EmblemHealth Select Care |
$23.04
|
| Rate for Payer: Fidelis Medicare |
$12.20
|
| Rate for Payer: Galaxy Health Commercial |
$20.80
|
| Rate for Payer: Hamaspik Choice Medicare |
$11.84
|
| Rate for Payer: Humana Medicare |
$11.84
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$22.40
|
| Rate for Payer: Local 1199SEIU Medicare |
$14.72
|
| Rate for Payer: MVP Health Care of NY Commercial |
$24.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$18.02
|
| Rate for Payer: MVP Health Care of NY Medicare |
$12.43
|
| Rate for Payer: United Healthcare Medicare |
$11.84
|
| Rate for Payer: WellCare Medicare |
$17.60
|
|
|
CAUTERY HIGH TEMP FINE TIP
|
Facility
|
IP
|
$32.00
|
|
| Hospital Charge Code |
4471284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.80 |
| Max. Negotiated Rate |
$20.80 |
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Galaxy Health Commercial |
$20.80
|
|
|
CAUTERY LOW TEMP FINE TIP
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
4471274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.16 |
| Max. Negotiated Rate |
$19.32 |
| Rate for Payer: Aetna of NY Commercial |
$16.80
|
| Rate for Payer: Aetna of NY Medicare |
$11.04
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$18.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$8.88
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$12.00
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: CDPHP Commercial |
$19.32
|
| Rate for Payer: CDPHP Medicare |
$8.88
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$19.20
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$19.20
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$19.20
|
| Rate for Payer: EmblemHealth Medicaid |
$19.20
|
| Rate for Payer: EmblemHealth Medicare |
$8.16
|
| Rate for Payer: EmblemHealth Select Care |
$17.28
|
| Rate for Payer: Fidelis Medicare |
$9.15
|
| Rate for Payer: Galaxy Health Commercial |
$15.60
|
| Rate for Payer: Hamaspik Choice Medicare |
$8.88
|
| Rate for Payer: Humana Medicare |
$8.88
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$16.80
|
| Rate for Payer: Local 1199SEIU Medicare |
$11.04
|
| Rate for Payer: MVP Health Care of NY Commercial |
$18.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$13.51
|
| Rate for Payer: MVP Health Care of NY Medicare |
$9.32
|
| Rate for Payer: United Healthcare Medicare |
$8.88
|
| Rate for Payer: WellCare Medicare |
$13.20
|
|
|
CAUTERY LOW TEMP FINE TIP
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
4471274
|
|
Hospital Revenue Code
|
272
|
| 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
|
|
|
CAUTERY PAD
|
Facility
|
OP
|
$11.00
|
|
| Hospital Charge Code |
4479188
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$8.86 |
| Rate for Payer: Aetna of NY Commercial |
$7.70
|
| Rate for Payer: Aetna of NY Medicare |
$5.06
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$8.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$8.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$4.07
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$5.50
|
| Rate for Payer: Cash Price |
$8.25
|
| Rate for Payer: CDPHP Commercial |
$8.86
|
| Rate for Payer: CDPHP Medicare |
$4.07
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$8.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$8.80
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$8.80
|
| Rate for Payer: EmblemHealth Medicaid |
$8.80
|
| Rate for Payer: EmblemHealth Medicare |
$3.74
|
| Rate for Payer: EmblemHealth Select Care |
$7.92
|
| Rate for Payer: Fidelis Medicare |
$4.19
|
| Rate for Payer: Galaxy Health Commercial |
$7.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$4.07
|
| Rate for Payer: Humana Medicare |
$4.07
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$7.70
|
| Rate for Payer: Local 1199SEIU Medicare |
$5.06
|
| Rate for Payer: MVP Health Care of NY Commercial |
$8.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$6.19
|
| Rate for Payer: MVP Health Care of NY Medicare |
$4.27
|
| Rate for Payer: United Healthcare Medicare |
$4.07
|
| Rate for Payer: WellCare Medicare |
$6.05
|
|
|
CAUTERY PAD
|
Facility
|
IP
|
$11.00
|
|
| Hospital Charge Code |
4479188
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.15 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Cash Price |
$8.25
|
| Rate for Payer: Galaxy Health Commercial |
$7.15
|
|
|
CAUTERY PENCIL
|
Facility
|
OP
|
$20.00
|
|
| Hospital Charge Code |
4479186
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$16.10 |
| Rate for Payer: Aetna of NY Commercial |
$14.00
|
| Rate for Payer: Aetna of NY Medicare |
$9.20
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$15.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$15.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$7.40
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$10.00
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: CDPHP Commercial |
$16.10
|
| Rate for Payer: CDPHP Medicare |
$7.40
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$16.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$16.00
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$16.00
|
| Rate for Payer: EmblemHealth Medicaid |
$16.00
|
| Rate for Payer: EmblemHealth Medicare |
$6.80
|
| Rate for Payer: EmblemHealth Select Care |
$14.40
|
| Rate for Payer: Fidelis Medicare |
$7.62
|
| Rate for Payer: Galaxy Health Commercial |
$13.00
|
| Rate for Payer: Hamaspik Choice Medicare |
$7.40
|
| Rate for Payer: Humana Medicare |
$7.40
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$14.00
|
| Rate for Payer: Local 1199SEIU Medicare |
$9.20
|
| Rate for Payer: MVP Health Care of NY Commercial |
$15.00
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$11.26
|
| Rate for Payer: MVP Health Care of NY Medicare |
$7.77
|
| Rate for Payer: United Healthcare Medicare |
$7.40
|
| Rate for Payer: WellCare Medicare |
$11.00
|
|
|
CAUTERY PENCIL
|
Facility
|
IP
|
$20.00
|
|
| Hospital Charge Code |
4479186
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$13.00 |
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Galaxy Health Commercial |
$13.00
|
|
|
CBC WITH DIFF (AUTO)
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
HCPCS 85025
|
| Hospital Charge Code |
4300161
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$27.95 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Cash Price |
$32.25
|
| Rate for Payer: Galaxy Health Commercial |
$27.95
|
|
|
CBC WITH DIFF (AUTO)
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
HCPCS 85025
|
| Hospital Charge Code |
4300161
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$34.62 |
| Rate for Payer: Aetna of NY Commercial |
$27.95
|
| Rate for Payer: Aetna of NY Medicare |
$19.78
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Blue Access/Small Group |
$32.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) EPO/HMO/Indemnity/PPO |
$32.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$15.91
|
| Rate for Payer: Brighton Health (Magnacare) Direct Plus/No Fault/PIP/PPO/Workers Comp |
$21.50
|
| Rate for Payer: Cash Price |
$32.25
|
| Rate for Payer: Cash Price |
$32.25
|
| Rate for Payer: CDPHP Commercial |
$34.62
|
| Rate for Payer: CDPHP Medicare |
$15.91
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$25.80
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$34.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$34.40
|
| Rate for Payer: EmblemHealth Medicaid |
$34.40
|
| Rate for Payer: EmblemHealth Medicare |
$14.62
|
| Rate for Payer: EmblemHealth Select Care |
$25.80
|
| Rate for Payer: Fidelis Medicare |
$16.39
|
| Rate for Payer: Galaxy Health Commercial |
$27.95
|
| Rate for Payer: Hamaspik Choice Medicare |
$15.91
|
| Rate for Payer: Humana Medicare |
$15.91
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$27.95
|
| Rate for Payer: Local 1199SEIU Medicare |
$19.78
|
| Rate for Payer: MVP Health Care of NY Commercial |
$32.25
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$24.21
|
| Rate for Payer: MVP Health Care of NY Medicare |
$16.71
|
| Rate for Payer: Oxford Health Plans Freedom/Liberty/Metro |
$32.25
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$3.20
|
| Rate for Payer: United Healthcare Commercial |
$32.25
|
| Rate for Payer: United Healthcare Medicare |
$15.91
|
| Rate for Payer: WellCare Medicare |
$23.65
|
|
