|
ANIDULAFUNGIN 50 MG INJ
|
Facility
|
OP
|
$1.86
|
|
|
Service Code
|
HCPCS J0348
|
| Hospital Charge Code |
41645301
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.49 |
| Max. Negotiated Rate |
$1.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.02
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.57
|
| Rate for Payer: Aetna Government |
$0.57
|
| Rate for Payer: Brighton Health Commercial |
$1.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.93
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.07
|
| Rate for Payer: Group Health Inc Commercial |
$0.93
|
| Rate for Payer: Group Health Inc Medicare |
$0.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$0.49
|
| Rate for Payer: SOMOS Essential |
$0.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.21
|
|
|
ANIDULAFUNGIN 50 MG INJ
|
Facility
|
IP
|
$1.86
|
|
|
Service Code
|
HCPCS J0348
|
| Hospital Charge Code |
41655301
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$0.93 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.93
|
|
|
ANIDULAFUNGIN 50 MG INJ
|
Facility
|
IP
|
$1.86
|
|
|
Service Code
|
HCPCS J0348
|
| Hospital Charge Code |
41645301
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$0.93 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.93
|
|
|
ANIFROLUMAB-FNIA 300 MG/2ML IV SOLN [180984]
|
Facility
|
OP
|
$3,046.24
|
|
|
Service Code
|
HCPCS J3590
|
| Hospital Charge Code |
00310304000
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,066.18 |
| Max. Negotiated Rate |
$3,198.55 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,675.43
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,523.12
|
| Rate for Payer: Aetna Government |
$1,523.12
|
| Rate for Payer: Brighton Health Commercial |
$1,827.74
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,523.12
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,751.59
|
| Rate for Payer: EmblemHealth Commercial |
$1,523.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,198.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,523.12
|
| Rate for Payer: Group Health Inc Medicare |
$1,066.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,523.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,523.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,980.05
|
|
|
ANIFROLUMAB-FNIA 300 MG/2ML IV SOLN [180984]
|
Facility
|
IP
|
$3,046.24
|
|
|
Service Code
|
HCPCS J3590
|
| Hospital Charge Code |
00310304000
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,523.12 |
| Max. Negotiated Rate |
$1,523.12 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,523.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,523.12
|
|
|
ANIT-MULLERIAN HORMONE (AMH)
|
Facility
|
IP
|
$35.30
|
|
|
Service Code
|
HCPCS 82397
|
| Hospital Charge Code |
40729236
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$14.12
|
|
|
ANIT-MULLERIAN HORMONE (AMH)
|
Facility
|
OP
|
$35.30
|
|
|
Service Code
|
HCPCS 82397
|
| Hospital Charge Code |
40729236
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$26.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19.42
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.12
|
| Rate for Payer: Aetna Government |
$14.12
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.88
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.88
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.88
|
| Rate for Payer: Brighton Health Commercial |
$26.48
|
| Rate for Payer: Cash Price |
$14.12
|
| Rate for Payer: Cash Price |
$14.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$14.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22.45
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19.00
|
| Rate for Payer: Elderplan Medicare Advantage |
$14.12
|
| Rate for Payer: EmblemHealth Commercial |
$14.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$12.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$12.57
|
| Rate for Payer: Group Health Inc Commercial |
$14.12
|
| Rate for Payer: Group Health Inc Medicare |
$14.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.12
|
| Rate for Payer: Healthfirst QHP |
$14.12
|
| Rate for Payer: Humana Medicare |
$14.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.12
|
| Rate for Payer: United Healthcare Commercial |
$17.89
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$11.30
|
| Rate for Payer: Wellcare Medicare |
$12.71
|
|
|
ANKLE ORTHOSIS
|
Facility
|
OP
|
$77.94
|
|
|
Service Code
|
HCPCS L4350
|
| Hospital Charge Code |
40209320
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$27.28 |
| Max. Negotiated Rate |
$81.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$42.87
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$43.82
|
| Rate for Payer: Aetna Government |
$43.82
|
| Rate for Payer: Brighton Health Commercial |
$46.76
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$38.97
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$44.82
|
| Rate for Payer: EmblemHealth Commercial |
$38.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$81.84
|
| Rate for Payer: Group Health Inc Commercial |
$38.97
|
| Rate for Payer: Group Health Inc Medicare |
$27.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$38.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$38.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$50.66
|
|
|
ANOSCOPY, DX
|
Facility
|
OP
|
$330.23
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
30102458
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$103.40 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$147.72
|
| Rate for Payer: Aetna Government |
$147.72
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$103.40
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$103.40
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$103.40
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$147.72
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$147.72
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$147.72
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$125.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$131.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$147.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$131.47
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$165.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$147.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$147.72
|
| Rate for Payer: Humana Medicare |
$150.67
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$147.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$147.72
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$147.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$147.72
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$118.18
|
| Rate for Payer: Wellcare Medicare |
$140.33
|
|
|
ANOSCOPY, DX
|
Facility
|
IP
|
$330.23
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
40019718
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$147.72
|
|
|
ANOSCOPY, DX
|
Facility
|
OP
|
$330.23
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
30308126
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$103.40 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$147.72
|
| Rate for Payer: Aetna Government |
$147.72
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$103.40
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$103.40
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$103.40
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$147.72
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$147.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$125.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$131.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$147.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$131.47
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$165.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$147.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$125.56
|
| Rate for Payer: Healthfirst QHP |
$147.72
|
| Rate for Payer: Humana Medicare |
$150.67
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$147.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$147.72
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$147.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$147.72
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$118.18
|
| Rate for Payer: Wellcare Medicare |
$140.33
|
|
|
ANOSCOPY, DX
|
Facility
|
OP
|
$330.23
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
40019718
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$103.40 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$147.72
|
| Rate for Payer: Aetna Government |
$147.72
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$103.40
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$103.40
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$103.40
|
| Rate for Payer: Brighton Health Commercial |
$247.67
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$147.72
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$147.72
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$125.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$131.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$147.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$131.47
|
| Rate for Payer: Group Health Inc Commercial |
$147.72
|
| Rate for Payer: Group Health Inc Medicare |
$147.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$165.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$147.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$125.56
|
| Rate for Payer: Healthfirst QHP |
$147.72
|
| Rate for Payer: Humana Medicare |
$150.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$147.72
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$147.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$147.72
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$118.18
|
| Rate for Payer: Wellcare Medicare |
$140.33
|
|
|
ANOSCOPY, DX
|
Facility
|
IP
|
$330.23
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
30308126
|
|
Hospital Revenue Code
|
510
|
| Rate for Payer: Cash Price |
$147.72
|
|
|
ANOSCOPY, DX
|
Facility
|
IP
|
$330.23
|
|
|
Service Code
|
HCPCS 46600
|
| Hospital Charge Code |
30102458
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$147.72
|
|
|
ANOSCOPY REMOVE FOR BODY
|
Facility
|
OP
|
$2,313.60
|
|
|
Service Code
|
HCPCS 46608
|
| Hospital Charge Code |
30105550
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,056.92
|
| Rate for Payer: Aetna Government |
$1,056.92
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$739.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$739.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$739.84
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$1,056.92
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,056.92
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,056.92
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$898.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$940.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,056.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$940.66
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,156.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,056.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$1,056.92
|
| Rate for Payer: Humana Medicare |
$1,078.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,056.92
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,056.92
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,056.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,056.92
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$845.54
|
| Rate for Payer: Wellcare Medicare |
$1,004.07
|
|
|
ANOSCOPY REMOVE FOR BODY
|
Facility
|
IP
|
$2,313.60
|
|
|
Service Code
|
HCPCS 46608
|
| Hospital Charge Code |
30105550
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,056.92
|
|
|
ANOSCOPY REMOVE FOREIGN BODY
|
Facility
|
OP
|
$2,313.60
|
|
|
Service Code
|
HCPCS 46608
|
| Hospital Charge Code |
40014082
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$739.84 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,056.92
|
| Rate for Payer: Aetna Government |
$1,056.92
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$739.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$739.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$739.84
|
| Rate for Payer: Brighton Health Commercial |
$1,735.20
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Cash Price |
$1,056.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,056.92
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,056.92
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$898.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$940.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,056.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$940.66
|
| Rate for Payer: Group Health Inc Commercial |
$1,056.92
|
| Rate for Payer: Group Health Inc Medicare |
$1,056.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,156.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,056.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$898.38
|
| Rate for Payer: Healthfirst QHP |
$1,056.92
|
| Rate for Payer: Humana Medicare |
$1,078.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,056.92
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,056.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,056.92
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$845.54
|
| Rate for Payer: Wellcare Medicare |
$1,004.07
|
|
|
ANOSCOPY REMOVE FOREIGN BODY
|
Facility
|
IP
|
$2,313.60
|
|
|
Service Code
|
HCPCS 46608
|
| Hospital Charge Code |
40014082
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,056.92
|
|
|
ANOSCOPY, W BX, SINGLE/MULTI
|
Facility
|
IP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 46606
|
| Hospital Charge Code |
30308125
|
|
Hospital Revenue Code
|
510
|
| Rate for Payer: Cash Price |
$1,364.66
|
|
|
ANOSCOPY, W BX, SINGLE/MULTI
|
Facility
|
OP
|
$3,041.53
|
|
|
Service Code
|
HCPCS 46606
|
| Hospital Charge Code |
30308125
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$222.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Cash Price |
$1,364.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,520.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,364.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
|
Facility
|
OP
|
$3,311.93
|
|
|
Service Code
|
CPT 46615
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$3,311.93 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,246.99
|
| Rate for Payer: Aetna Government |
$3,246.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,272.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,272.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,272.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,246.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$3,246.99
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,759.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,889.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,246.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,889.82
|
| Rate for Payer: Group Health Inc Commercial |
$3,246.99
|
| Rate for Payer: Group Health Inc Medicare |
$3,246.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,246.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,759.94
|
| Rate for Payer: Healthfirst QHP |
$3,246.99
|
| Rate for Payer: Humana Medicare |
$3,311.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,246.99
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,246.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,246.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,597.59
|
| Rate for Payer: Wellcare Medicare |
$3,084.64
|
|
|
Anoscopy; with high-resolution magnification (HRA) (eg, colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 46607
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,364.66
|
| Rate for Payer: Aetna Government |
$1,364.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$955.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$955.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$955.26
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,364.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,364.66
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,364.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,364.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,364.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,364.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.96
|
| Rate for Payer: Healthfirst QHP |
$1,364.66
|
| Rate for Payer: Humana Medicare |
$1,391.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,364.66
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,364.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,364.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,091.73
|
| Rate for Payer: Wellcare Medicare |
$1,296.43
|
|
|
ANTENNA FOR PT PROGRAMER
|
Facility
|
OP
|
$194.00
|
|
| Hospital Charge Code |
64904938
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$67.90 |
| Max. Negotiated Rate |
$155.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$106.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$97.00
|
| Rate for Payer: Aetna Government |
$97.00
|
| Rate for Payer: Brighton Health Commercial |
$145.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$155.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$131.92
|
| Rate for Payer: Group Health Inc Commercial |
$97.00
|
| Rate for Payer: Group Health Inc Medicare |
$67.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$97.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$97.00
|
|
|
ANTER CHAMBER INRAOCULAR LENS
|
Facility
|
OP
|
$315.00
|
|
|
Service Code
|
HCPCS V2630
|
| Hospital Charge Code |
40079909
|
|
Hospital Revenue Code
|
276
|
| Min. Negotiated Rate |
$73.48 |
| Max. Negotiated Rate |
$330.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$173.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$73.48
|
| Rate for Payer: Aetna Government |
$73.48
|
| Rate for Payer: Brighton Health Commercial |
$189.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$252.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$214.20
|
| Rate for Payer: EmblemHealth Commercial |
$157.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$330.75
|
| Rate for Payer: Group Health Inc Commercial |
$157.50
|
| Rate for Payer: Group Health Inc Medicare |
$110.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$157.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$157.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$204.75
|
|
|
ANTERIOR DISCECTOMY
|
Facility
|
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 63075
|
| Hospital Charge Code |
40000080
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$13,588.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,065.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$8,273.12
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,791.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,791.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,791.18
|
| Rate for Payer: Brighton Health Commercial |
$13,588.37
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8,273.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$8,273.12
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,032.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7,363.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$8,273.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7,363.08
|
| Rate for Payer: Group Health Inc Commercial |
$8,273.12
|
| Rate for Payer: Group Health Inc Medicare |
$8,273.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,058.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Humana Medicare |
$8,438.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8,273.12
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,273.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,273.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,618.50
|
| Rate for Payer: Wellcare Medicare |
$7,859.46
|
|
