|
CATH FOLEY 16FR DOVER
|
Facility
|
OP
|
$55.62
|
|
| Hospital Charge Code |
4471546
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.34 |
| Max. Negotiated Rate |
$44.50 |
| Rate for Payer: Aetna of NY Commercial |
$38.93
|
| Rate for Payer: Aetna of NY Medicare |
$25.59
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$22.25
|
| Rate for Payer: Cash Price |
$41.72
|
| Rate for Payer: CDPHP Medicare |
$20.58
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$44.50
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$44.50
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$44.50
|
| Rate for Payer: EmblemHealth Medicaid |
$44.50
|
| Rate for Payer: EmblemHealth Medicare |
$18.91
|
| Rate for Payer: EmblemHealth Select Care |
$40.05
|
| Rate for Payer: Fidelis Medicare |
$22.25
|
| Rate for Payer: Galaxy Health Commercial |
$36.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$22.25
|
| Rate for Payer: Humana Medicare |
$22.25
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$38.93
|
| Rate for Payer: Local 1199SEIU Medicare |
$25.59
|
| Rate for Payer: MVP Health Care of NY Commercial |
$41.72
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$31.31
|
| Rate for Payer: MVP Health Care of NY Medicare |
$23.36
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.34
|
| Rate for Payer: United Healthcare Medicare |
$22.25
|
| Rate for Payer: WellCare Medicare |
$30.59
|
|
|
CATH FOLEY 16FR DOVER
|
Facility
|
IP
|
$55.62
|
|
| Hospital Charge Code |
4471546
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.15 |
| Max. Negotiated Rate |
$36.15 |
| Rate for Payer: Cash Price |
$41.72
|
| Rate for Payer: Galaxy Health Commercial |
$36.15
|
|
|
CATH FOLEY LATEX 5CC 14FR
|
Facility
|
OP
|
$54.59
|
|
| Hospital Charge Code |
4471448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$43.67 |
| Rate for Payer: Aetna of NY Commercial |
$38.21
|
| Rate for Payer: Aetna of NY Medicare |
$25.11
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$21.84
|
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: CDPHP Medicare |
$20.20
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$43.67
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$43.67
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$43.67
|
| Rate for Payer: EmblemHealth Medicaid |
$43.67
|
| Rate for Payer: EmblemHealth Medicare |
$18.56
|
| Rate for Payer: EmblemHealth Select Care |
$39.30
|
| Rate for Payer: Fidelis Medicare |
$21.84
|
| Rate for Payer: Galaxy Health Commercial |
$35.48
|
| Rate for Payer: Hamaspik Choice Medicare |
$21.84
|
| Rate for Payer: Humana Medicare |
$21.84
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$38.21
|
| Rate for Payer: Local 1199SEIU Medicare |
$25.11
|
| Rate for Payer: MVP Health Care of NY Commercial |
$40.94
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$30.73
|
| Rate for Payer: MVP Health Care of NY Medicare |
$22.93
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.19
|
| Rate for Payer: United Healthcare Medicare |
$21.84
|
| Rate for Payer: WellCare Medicare |
$30.02
|
|
|
CATH FOLEY LATEX 5CC 14FR
|
Facility
|
IP
|
$54.59
|
|
| Hospital Charge Code |
4471448
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.48 |
| Max. Negotiated Rate |
$35.48 |
| Rate for Payer: Cash Price |
$40.94
|
| Rate for Payer: Galaxy Health Commercial |
$35.48
|
|
|
CATH FOLEY LATEX 5CC 22FR
|
Facility
|
IP
|
$20.60
|
|
| Hospital Charge Code |
4471661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$13.39 |
| Rate for Payer: Cash Price |
$15.45
|
| Rate for Payer: Galaxy Health Commercial |
$13.39
|
|
|
CATH FOLEY LATEX 5CC 22FR
|
Facility
|
OP
|
$20.60
|
|
| Hospital Charge Code |
4471661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$16.48 |
| Rate for Payer: Aetna of NY Commercial |
$14.42
|
| Rate for Payer: Aetna of NY Medicare |
$9.48
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$8.24
|
| Rate for Payer: Cash Price |
$15.45
|
| Rate for Payer: CDPHP Medicare |
$7.62
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$16.48
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$16.48
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$16.48
|
| Rate for Payer: EmblemHealth Medicaid |
$16.48
|
| Rate for Payer: EmblemHealth Medicare |
$7.00
|
| Rate for Payer: EmblemHealth Select Care |
$14.83
|
| Rate for Payer: Fidelis Medicare |
$8.24
|
| Rate for Payer: Galaxy Health Commercial |
$13.39
|
| Rate for Payer: Hamaspik Choice Medicare |
$8.24
|
| Rate for Payer: Humana Medicare |
$8.24
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$14.42
|
| Rate for Payer: Local 1199SEIU Medicare |
$9.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$15.45
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$11.60
|
| Rate for Payer: MVP Health Care of NY Medicare |
$8.65
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$3.09
|
| Rate for Payer: United Healthcare Medicare |
$8.24
|
| Rate for Payer: WellCare Medicare |
$11.33
|
|
|
CATH INDW FOLEY 3 WAY
|
Facility
|
IP
|
$58.71
|
|
|
Service Code
|
HCPCS A4346
|
| Hospital Charge Code |
4600271
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.16 |
| Max. Negotiated Rate |
$38.16 |
| Rate for Payer: Cash Price |
$44.03
|
| Rate for Payer: Galaxy Health Commercial |
$38.16
|
|
|
CATH INDW FOLEY 3 WAY
|
Facility
|
OP
|
$58.71
|
|
|
Service Code
|
HCPCS A4346
|
| Hospital Charge Code |
4600271
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$46.97 |
| Rate for Payer: Aetna of NY Commercial |
$41.10
|
| Rate for Payer: Aetna of NY Medicare |
$27.01
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$23.48
|
| Rate for Payer: Cash Price |
$44.03
|
| Rate for Payer: CDPHP Medicare |
$21.72
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$46.97
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$46.97
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$46.97
|
| Rate for Payer: EmblemHealth Medicaid |
$46.97
|
| Rate for Payer: EmblemHealth Medicare |
$19.96
|
| Rate for Payer: EmblemHealth Select Care |
$42.27
|
| Rate for Payer: Fidelis Medicare |
$23.48
|
| Rate for Payer: Galaxy Health Commercial |
$38.16
|
| Rate for Payer: Hamaspik Choice Medicare |
$23.48
|
| Rate for Payer: Humana Medicare |
$23.48
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$41.10
|
| Rate for Payer: Local 1199SEIU Medicare |
$27.01
|
| Rate for Payer: MVP Health Care of NY Commercial |
$44.03
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$33.05
|
| Rate for Payer: MVP Health Care of NY Medicare |
$24.66
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$8.81
|
| Rate for Payer: United Healthcare Medicare |
$23.48
|
| Rate for Payer: WellCare Medicare |
$32.29
|
|
|
CATH TROCAR 20FR 16"L
|
Facility
|
IP
|
$1,386.38
|
|
| Hospital Charge Code |
4471343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$901.15 |
| Max. Negotiated Rate |
$901.15 |
| Rate for Payer: Cash Price |
$1,039.79
|
| Rate for Payer: Galaxy Health Commercial |
$901.15
|
|
|
CATH TROCAR 20FR 16"L
|
Facility
|
OP
|
$1,386.38
|
|
| Hospital Charge Code |
4471343
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$207.96 |
| Max. Negotiated Rate |
$1,109.10 |
| Rate for Payer: Aetna of NY Commercial |
$970.47
|
| Rate for Payer: Aetna of NY Medicare |
$637.73
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$554.55
|
| Rate for Payer: Cash Price |
$1,039.79
|
| Rate for Payer: CDPHP Medicare |
$512.96
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,109.10
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,109.10
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,109.10
|
| Rate for Payer: EmblemHealth Medicaid |
$1,109.10
|
| Rate for Payer: EmblemHealth Medicare |
$471.37
|
| Rate for Payer: EmblemHealth Select Care |
$998.19
|
| Rate for Payer: Fidelis Medicare |
$554.55
|
| Rate for Payer: Galaxy Health Commercial |
$901.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$554.55
|
| Rate for Payer: Humana Medicare |
$554.55
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$970.47
|
| Rate for Payer: Local 1199SEIU Medicare |
$637.73
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,039.79
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$780.53
|
| Rate for Payer: MVP Health Care of NY Medicare |
$582.28
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$207.96
|
| Rate for Payer: United Healthcare Medicare |
$554.55
|
| Rate for Payer: WellCare Medicare |
$762.51
|
|
|
CATH TROCAR 24FR 16"L
|
Facility
|
IP
|
$1,386.38
|
|
| Hospital Charge Code |
4471345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$901.15 |
| Max. Negotiated Rate |
$901.15 |
| Rate for Payer: Cash Price |
$1,039.79
|
| Rate for Payer: Galaxy Health Commercial |
$901.15
|
|
|
CATH TROCAR 24FR 16"L
|
Facility
|
OP
|
$1,386.38
|
|
| Hospital Charge Code |
4471345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$207.96 |
| Max. Negotiated Rate |
$1,109.10 |
| Rate for Payer: Aetna of NY Commercial |
$970.47
|
| Rate for Payer: Aetna of NY Medicare |
$637.73
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$554.55
|
| Rate for Payer: Cash Price |
$1,039.79
|
| Rate for Payer: CDPHP Medicare |
$512.96
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,109.10
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,109.10
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,109.10
|
| Rate for Payer: EmblemHealth Medicaid |
$1,109.10
|
| Rate for Payer: EmblemHealth Medicare |
$471.37
|
| Rate for Payer: EmblemHealth Select Care |
$998.19
|
| Rate for Payer: Fidelis Medicare |
$554.55
|
| Rate for Payer: Galaxy Health Commercial |
$901.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$554.55
|
| Rate for Payer: Humana Medicare |
$554.55
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$970.47
|
| Rate for Payer: Local 1199SEIU Medicare |
$637.73
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,039.79
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$780.53
|
| Rate for Payer: MVP Health Care of NY Medicare |
$582.28
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$207.96
|
| Rate for Payer: United Healthcare Medicare |
$554.55
|
| Rate for Payer: WellCare Medicare |
$762.51
|
|
|
CATH TROCAR 28FR 16"L
|
Facility
|
IP
|
$1,386.38
|
|
| Hospital Charge Code |
4471346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$901.15 |
| Max. Negotiated Rate |
$901.15 |
| Rate for Payer: Cash Price |
$1,039.79
|
| Rate for Payer: Galaxy Health Commercial |
$901.15
|
|
|
CATH TROCAR 28FR 16"L
|
Facility
|
OP
|
$1,386.38
|
|
| Hospital Charge Code |
4471346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$207.96 |
| Max. Negotiated Rate |
$1,109.10 |
| Rate for Payer: Aetna of NY Commercial |
$970.47
|
| Rate for Payer: Aetna of NY Medicare |
$637.73
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$554.55
|
| Rate for Payer: Cash Price |
$1,039.79
|
| Rate for Payer: CDPHP Medicare |
$512.96
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$1,109.10
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$1,109.10
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$1,109.10
|
| Rate for Payer: EmblemHealth Medicaid |
$1,109.10
|
| Rate for Payer: EmblemHealth Medicare |
$471.37
|
| Rate for Payer: EmblemHealth Select Care |
$998.19
|
| Rate for Payer: Fidelis Medicare |
$554.55
|
| Rate for Payer: Galaxy Health Commercial |
$901.15
|
| Rate for Payer: Hamaspik Choice Medicare |
$554.55
|
| Rate for Payer: Humana Medicare |
$554.55
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$970.47
|
| Rate for Payer: Local 1199SEIU Medicare |
$637.73
|
| Rate for Payer: MVP Health Care of NY Commercial |
$1,039.79
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$780.53
|
| Rate for Payer: MVP Health Care of NY Medicare |
$582.28
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$207.96
|
| Rate for Payer: United Healthcare Medicare |
$554.55
|
| Rate for Payer: WellCare Medicare |
$762.51
|
|
|
CATH URETHRAL TRAY
|
Facility
|
IP
|
$10.30
|
|
| Hospital Charge Code |
4471746
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$6.70 |
| Rate for Payer: Cash Price |
$7.72
|
| Rate for Payer: Galaxy Health Commercial |
$6.70
|
|
|
CATH URETHRAL TRAY
|
Facility
|
OP
|
$10.30
|
|
| Hospital Charge Code |
4471746
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.54 |
| Max. Negotiated Rate |
$8.24 |
| Rate for Payer: Aetna of NY Commercial |
$7.21
|
| Rate for Payer: Aetna of NY Medicare |
$4.74
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$4.12
|
| Rate for Payer: Cash Price |
$7.72
|
| Rate for Payer: CDPHP Medicare |
$3.81
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$8.24
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$8.24
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$8.24
|
| Rate for Payer: EmblemHealth Medicaid |
$8.24
|
| Rate for Payer: EmblemHealth Medicare |
$3.50
|
| Rate for Payer: EmblemHealth Select Care |
$7.42
|
| Rate for Payer: Fidelis Medicare |
$4.12
|
| Rate for Payer: Galaxy Health Commercial |
$6.70
|
| Rate for Payer: Hamaspik Choice Medicare |
$4.12
|
| Rate for Payer: Humana Medicare |
$4.12
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$7.21
|
| Rate for Payer: Local 1199SEIU Medicare |
$4.74
|
| Rate for Payer: MVP Health Care of NY Commercial |
$7.72
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$5.80
|
| Rate for Payer: MVP Health Care of NY Medicare |
$4.33
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1.54
|
| Rate for Payer: United Healthcare Medicare |
$4.12
|
| Rate for Payer: WellCare Medicare |
$5.67
|
|
|
CAUTERY HIGH TEMP FINE TIP
|
Facility
|
OP
|
$32.96
|
|
| Hospital Charge Code |
4471284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$26.37 |
| Rate for Payer: Aetna of NY Commercial |
$23.07
|
| Rate for Payer: Aetna of NY Medicare |
$15.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$13.18
|
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: CDPHP Medicare |
$12.20
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$26.37
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$26.37
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$26.37
|
| Rate for Payer: EmblemHealth Medicaid |
$26.37
|
| Rate for Payer: EmblemHealth Medicare |
$11.21
|
| Rate for Payer: EmblemHealth Select Care |
$23.73
|
| Rate for Payer: Fidelis Medicare |
$13.18
|
| Rate for Payer: Galaxy Health Commercial |
$21.42
|
| Rate for Payer: Hamaspik Choice Medicare |
$13.18
|
| Rate for Payer: Humana Medicare |
$13.18
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$23.07
|
| Rate for Payer: Local 1199SEIU Medicare |
$15.16
|
| Rate for Payer: MVP Health Care of NY Commercial |
$24.72
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$18.56
|
| Rate for Payer: MVP Health Care of NY Medicare |
$13.84
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$4.94
|
| Rate for Payer: United Healthcare Medicare |
$13.18
|
| Rate for Payer: WellCare Medicare |
$18.13
|
|
|
CAUTERY HIGH TEMP FINE TIP
|
Facility
|
IP
|
$32.96
|
|
| Hospital Charge Code |
4471284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$21.42 |
| Rate for Payer: Cash Price |
$24.72
|
| Rate for Payer: Galaxy Health Commercial |
$21.42
|
|
|
CAUTERY LOW TEMP FINE TIP
|
Facility
|
OP
|
$24.72
|
|
| Hospital Charge Code |
4471274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.71 |
| Max. Negotiated Rate |
$19.78 |
| Rate for Payer: Aetna of NY Commercial |
$17.30
|
| Rate for Payer: Aetna of NY Medicare |
$11.37
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$9.89
|
| Rate for Payer: Cash Price |
$18.54
|
| Rate for Payer: CDPHP Medicare |
$9.15
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$19.78
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$19.78
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$19.78
|
| Rate for Payer: EmblemHealth Medicaid |
$19.78
|
| Rate for Payer: EmblemHealth Medicare |
$8.40
|
| Rate for Payer: EmblemHealth Select Care |
$17.80
|
| Rate for Payer: Fidelis Medicare |
$9.89
|
| Rate for Payer: Galaxy Health Commercial |
$16.07
|
| Rate for Payer: Hamaspik Choice Medicare |
$9.89
|
| Rate for Payer: Humana Medicare |
$9.89
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$17.30
|
| Rate for Payer: Local 1199SEIU Medicare |
$11.37
|
| Rate for Payer: MVP Health Care of NY Commercial |
$18.54
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$13.92
|
| Rate for Payer: MVP Health Care of NY Medicare |
$10.38
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$3.71
|
| Rate for Payer: United Healthcare Medicare |
$9.89
|
| Rate for Payer: WellCare Medicare |
$13.60
|
|
|
CAUTERY LOW TEMP FINE TIP
|
Facility
|
IP
|
$24.72
|
|
| Hospital Charge Code |
4471274
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.07 |
| Max. Negotiated Rate |
$16.07 |
| Rate for Payer: Cash Price |
$18.54
|
| Rate for Payer: Galaxy Health Commercial |
$16.07
|
|
|
CAUTERY PAD
|
Facility
|
IP
|
$11.33
|
|
| Hospital Charge Code |
4479188
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$7.36 |
| Rate for Payer: Cash Price |
$8.50
|
| Rate for Payer: Galaxy Health Commercial |
$7.36
|
|
|
CAUTERY PAD
|
Facility
|
OP
|
$11.33
|
|
| Hospital Charge Code |
4479188
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$9.06 |
| Rate for Payer: Aetna of NY Commercial |
$7.93
|
| Rate for Payer: Aetna of NY Medicare |
$5.21
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$4.53
|
| Rate for Payer: Cash Price |
$8.50
|
| Rate for Payer: CDPHP Medicare |
$4.19
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$9.06
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$9.06
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$9.06
|
| Rate for Payer: EmblemHealth Medicaid |
$9.06
|
| Rate for Payer: EmblemHealth Medicare |
$3.85
|
| Rate for Payer: EmblemHealth Select Care |
$8.16
|
| Rate for Payer: Fidelis Medicare |
$4.53
|
| Rate for Payer: Galaxy Health Commercial |
$7.36
|
| Rate for Payer: Hamaspik Choice Medicare |
$4.53
|
| Rate for Payer: Humana Medicare |
$4.53
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$7.93
|
| Rate for Payer: Local 1199SEIU Medicare |
$5.21
|
| Rate for Payer: MVP Health Care of NY Commercial |
$8.50
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$6.38
|
| Rate for Payer: MVP Health Care of NY Medicare |
$4.76
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$1.70
|
| Rate for Payer: United Healthcare Medicare |
$4.53
|
| Rate for Payer: WellCare Medicare |
$6.23
|
|
|
CAUTERY PENCIL
|
Facility
|
OP
|
$20.60
|
|
| Hospital Charge Code |
4479186
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.09 |
| Max. Negotiated Rate |
$16.48 |
| Rate for Payer: Aetna of NY Commercial |
$14.42
|
| Rate for Payer: Aetna of NY Medicare |
$9.48
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicare |
$8.24
|
| Rate for Payer: Cash Price |
$15.45
|
| Rate for Payer: CDPHP Medicare |
$7.62
|
| Rate for Payer: EmblemHealth CBP/EPO/PPO/HMO/Network Access |
$16.48
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$16.48
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$16.48
|
| Rate for Payer: EmblemHealth Medicaid |
$16.48
|
| Rate for Payer: EmblemHealth Medicare |
$7.00
|
| Rate for Payer: EmblemHealth Select Care |
$14.83
|
| Rate for Payer: Fidelis Medicare |
$8.24
|
| Rate for Payer: Galaxy Health Commercial |
$13.39
|
| Rate for Payer: Hamaspik Choice Medicare |
$8.24
|
| Rate for Payer: Humana Medicare |
$8.24
|
| Rate for Payer: Local 1199SEIU Aetna Signature Administrators |
$14.42
|
| Rate for Payer: Local 1199SEIU Medicare |
$9.48
|
| Rate for Payer: MVP Health Care of NY Commercial |
$15.45
|
| Rate for Payer: MVP Health Care of NY Individual Exchange/Student Health Plan |
$11.60
|
| Rate for Payer: MVP Health Care of NY Medicare |
$8.65
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$3.09
|
| Rate for Payer: United Healthcare Medicare |
$8.24
|
| Rate for Payer: WellCare Medicare |
$11.33
|
|
|
CAUTERY PENCIL
|
Facility
|
IP
|
$20.60
|
|
| Hospital Charge Code |
4479186
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$13.39 |
| Rate for Payer: Cash Price |
$15.45
|
| Rate for Payer: Galaxy Health Commercial |
$13.39
|
|
|
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
|
|
