|
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC
|
Facility
|
IP
|
$59,440.01
|
|
|
Service Code
|
MSDRG 659
|
| Min. Negotiated Rate |
$20,101.53 |
| Max. Negotiated Rate |
$59,440.01 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$38,173.33
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$43,229.10
|
| Rate for Payer: Aetna Government |
$43,229.10
|
| Rate for Payer: Brighton Health Commercial |
$37,539.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$44,093.68
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$44,707.71
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$36,894.72
|
| Rate for Payer: Elderplan Medicare Advantage |
$41,067.64
|
| Rate for Payer: EmblemHealth Commercial |
$22,199.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$43,229.10
|
| Rate for Payer: Group Health Inc Commercial |
$43,229.10
|
| Rate for Payer: Group Health Inc Medicare |
$43,229.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$43,229.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$20,101.53
|
| Rate for Payer: Humana Medicare |
$59,440.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$43,229.10
|
| Rate for Payer: United Healthcare Commercial |
$51,485.45
|
| Rate for Payer: United Healthcare Medicare Advantage |
$43,229.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43,229.10
|
| Rate for Payer: Wellcare Medicare |
$41,067.64
|
|
|
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC
|
Facility
|
IP
|
$30,066.30
|
|
|
Service Code
|
MSDRG 661
|
| Min. Negotiated Rate |
$8,990.03 |
| Max. Negotiated Rate |
$30,066.30 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15,458.66
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21,866.40
|
| Rate for Payer: Aetna Government |
$21,866.40
|
| Rate for Payer: Brighton Health Commercial |
$15,201.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22,303.73
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18,104.82
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$14,940.87
|
| Rate for Payer: Elderplan Medicare Advantage |
$20,773.08
|
| Rate for Payer: EmblemHealth Commercial |
$8,990.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$21,866.40
|
| Rate for Payer: Group Health Inc Commercial |
$21,866.40
|
| Rate for Payer: Group Health Inc Medicare |
$21,866.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21,866.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,167.88
|
| Rate for Payer: Humana Medicare |
$30,066.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21,866.40
|
| Rate for Payer: United Healthcare Commercial |
$20,849.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,866.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21,866.40
|
| Rate for Payer: Wellcare Medicare |
$20,773.08
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS WITH MCC
|
Facility
|
IP
|
$32,468.81
|
|
|
Service Code
|
MSDRG 689
|
| Min. Negotiated Rate |
$10,070.50 |
| Max. Negotiated Rate |
$32,468.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17,316.53
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23,613.68
|
| Rate for Payer: Aetna Government |
$23,613.68
|
| Rate for Payer: Brighton Health Commercial |
$17,028.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$24,085.95
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20,280.71
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$16,736.52
|
| Rate for Payer: Elderplan Medicare Advantage |
$22,433.00
|
| Rate for Payer: EmblemHealth Commercial |
$10,070.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$23,613.68
|
| Rate for Payer: Group Health Inc Commercial |
$23,613.68
|
| Rate for Payer: Group Health Inc Medicare |
$23,613.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23,613.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,980.36
|
| Rate for Payer: Humana Medicare |
$32,468.81
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23,613.68
|
| Rate for Payer: United Healthcare Commercial |
$23,355.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,613.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23,613.68
|
| Rate for Payer: Wellcare Medicare |
$22,433.00
|
|
|
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC
|
Facility
|
IP
|
$25,461.47
|
|
|
Service Code
|
MSDRG 690
|
| Min. Negotiated Rate |
$6,919.17 |
| Max. Negotiated Rate |
$25,461.47 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11,897.74
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18,517.43
|
| Rate for Payer: Aetna Government |
$18,517.43
|
| Rate for Payer: Brighton Health Commercial |
$11,700.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18,887.78
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13,934.36
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11,499.23
|
| Rate for Payer: Elderplan Medicare Advantage |
$17,591.56
|
| Rate for Payer: EmblemHealth Commercial |
$6,919.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$18,517.43
|
| Rate for Payer: Group Health Inc Commercial |
$18,517.43
|
| Rate for Payer: Group Health Inc Medicare |
$18,517.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18,517.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,610.60
|
| Rate for Payer: Humana Medicare |
$25,461.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18,517.43
|
| Rate for Payer: United Healthcare Commercial |
$16,046.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,517.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18,517.43
|
| Rate for Payer: Wellcare Medicare |
$17,591.56
|
|
|
KIDNEY AND URINARY TRACT NEOPLASMS WITH CC
|
Facility
|
IP
|
$30,007.20
|
|
|
Service Code
|
MSDRG 687
|
| Min. Negotiated Rate |
$8,963.45 |
| Max. Negotiated Rate |
$30,007.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15,412.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21,823.42
|
| Rate for Payer: Aetna Government |
$21,823.42
|
| Rate for Payer: Brighton Health Commercial |
$15,156.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22,259.89
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18,051.29
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$14,896.70
|
| Rate for Payer: Elderplan Medicare Advantage |
$20,732.25
|
| Rate for Payer: EmblemHealth Commercial |
$8,963.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$21,823.42
|
| Rate for Payer: Group Health Inc Commercial |
$21,823.42
|
| Rate for Payer: Group Health Inc Medicare |
$21,823.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21,823.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,147.89
|
| Rate for Payer: Humana Medicare |
$30,007.20
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21,823.42
|
| Rate for Payer: United Healthcare Commercial |
$20,787.88
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,823.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21,823.42
|
| Rate for Payer: Wellcare Medicare |
$20,732.25
|
|
|
KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC
|
Facility
|
IP
|
$45,148.81
|
|
|
Service Code
|
MSDRG 686
|
| Min. Negotiated Rate |
$15,268.51 |
| Max. Negotiated Rate |
$45,148.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$27,121.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$32,835.50
|
| Rate for Payer: Aetna Government |
$32,835.50
|
| Rate for Payer: Brighton Health Commercial |
$26,671.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$33,492.21
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$31,764.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$26,213.51
|
| Rate for Payer: Elderplan Medicare Advantage |
$31,193.72
|
| Rate for Payer: EmblemHealth Commercial |
$15,772.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$32,835.50
|
| Rate for Payer: Group Health Inc Commercial |
$32,835.50
|
| Rate for Payer: Group Health Inc Medicare |
$32,835.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$32,835.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15,268.51
|
| Rate for Payer: Humana Medicare |
$45,148.81
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$32,835.50
|
| Rate for Payer: United Healthcare Commercial |
$36,580.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,835.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$32,835.50
|
| Rate for Payer: Wellcare Medicare |
$31,193.72
|
|
|
KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC
|
Facility
|
IP
|
$24,965.71
|
|
|
Service Code
|
MSDRG 688
|
| Min. Negotiated Rate |
$6,696.22 |
| Max. Negotiated Rate |
$24,965.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11,514.37
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18,156.88
|
| Rate for Payer: Aetna Government |
$18,156.88
|
| Rate for Payer: Brighton Health Commercial |
$11,323.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18,520.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13,485.36
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11,128.70
|
| Rate for Payer: Elderplan Medicare Advantage |
$17,249.04
|
| Rate for Payer: EmblemHealth Commercial |
$6,696.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$18,156.88
|
| Rate for Payer: Group Health Inc Commercial |
$18,156.88
|
| Rate for Payer: Group Health Inc Medicare |
$18,156.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18,156.88
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,442.95
|
| Rate for Payer: Humana Medicare |
$24,965.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18,156.88
|
| Rate for Payer: United Healthcare Commercial |
$15,529.76
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,156.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18,156.88
|
| Rate for Payer: Wellcare Medicare |
$17,249.04
|
|
|
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC
|
Facility
|
IP
|
$32,880.69
|
|
|
Service Code
|
MSDRG 695
|
| Min. Negotiated Rate |
$10,255.70 |
| Max. Negotiated Rate |
$32,880.69 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17,635.02
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23,913.23
|
| Rate for Payer: Aetna Government |
$23,913.23
|
| Rate for Payer: Brighton Health Commercial |
$17,342.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$24,391.49
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20,653.72
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17,044.34
|
| Rate for Payer: Elderplan Medicare Advantage |
$22,717.57
|
| Rate for Payer: EmblemHealth Commercial |
$10,255.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$23,913.23
|
| Rate for Payer: Group Health Inc Commercial |
$23,913.23
|
| Rate for Payer: Group Health Inc Medicare |
$23,913.23
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23,913.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11,119.65
|
| Rate for Payer: Humana Medicare |
$32,880.69
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23,913.23
|
| Rate for Payer: United Healthcare Commercial |
$23,784.85
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,913.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23,913.23
|
| Rate for Payer: Wellcare Medicare |
$22,717.57
|
|
|
KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC
|
Facility
|
IP
|
$23,272.51
|
|
|
Service Code
|
MSDRG 696
|
| Min. Negotiated Rate |
$5,934.76 |
| Max. Negotiated Rate |
$23,272.51 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$10,205.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16,925.46
|
| Rate for Payer: Aetna Government |
$16,925.46
|
| Rate for Payer: Brighton Health Commercial |
$10,035.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17,263.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11,951.87
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9,863.20
|
| Rate for Payer: Elderplan Medicare Advantage |
$16,079.19
|
| Rate for Payer: EmblemHealth Commercial |
$5,934.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$16,925.46
|
| Rate for Payer: Group Health Inc Commercial |
$16,925.46
|
| Rate for Payer: Group Health Inc Medicare |
$16,925.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16,925.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,870.34
|
| Rate for Payer: Humana Medicare |
$23,272.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16,925.46
|
| Rate for Payer: United Healthcare Commercial |
$13,763.79
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,925.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16,925.46
|
| Rate for Payer: Wellcare Medicare |
$16,079.19
|
|
|
KIDNEY FUNCTION TEST
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS 80069
|
| Hospital Charge Code |
40609635
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$8.68
|
|
|
KIDNEY FUNCTION TEST
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS 80069
|
| Hospital Charge Code |
40609635
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$13.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.68
|
| Rate for Payer: Aetna Government |
$8.68
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.08
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.08
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.08
|
| Rate for Payer: Brighton Health Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$8.68
|
| Rate for Payer: Cash Price |
$8.68
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.68
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.68
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.68
|
| Rate for Payer: EmblemHealth Commercial |
$8.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.73
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.68
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.73
|
| Rate for Payer: Group Health Inc Commercial |
$8.68
|
| Rate for Payer: Group Health Inc Medicare |
$8.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.68
|
| Rate for Payer: Healthfirst QHP |
$8.68
|
| Rate for Payer: Humana Medicare |
$8.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.68
|
| Rate for Payer: United Healthcare Commercial |
$11.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.68
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6.94
|
| Rate for Payer: Wellcare Medicare |
$7.81
|
|
|
KIDNEY TRANSPLANT
|
Facility
|
IP
|
$59,748.50
|
|
|
Service Code
|
MSDRG 652
|
| Min. Negotiated Rate |
$22,780.82 |
| Max. Negotiated Rate |
$59,748.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$44,299.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$48,991.00
|
| Rate for Payer: Aetna Government |
$48,991.00
|
| Rate for Payer: Brighton Health Commercial |
$43,563.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$49,970.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51,882.98
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$42,816.06
|
| Rate for Payer: Elderplan Medicare Advantage |
$46,541.45
|
| Rate for Payer: EmblemHealth Commercial |
$25,762.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$48,991.00
|
| Rate for Payer: Group Health Inc Commercial |
$48,991.00
|
| Rate for Payer: Group Health Inc Medicare |
$48,991.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$48,991.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22,780.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$48,991.00
|
| Rate for Payer: United Healthcare Commercial |
$59,748.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48,991.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$48,991.00
|
| Rate for Payer: Wellcare Medicare |
$46,541.45
|
|
|
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC
|
Facility
|
IP
|
$95,832.56
|
|
|
Service Code
|
MSDRG 650
|
| Min. Negotiated Rate |
$32,408.83 |
| Max. Negotiated Rate |
$95,832.56 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$66,315.64
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69,696.41
|
| Rate for Payer: Aetna Government |
$69,696.41
|
| Rate for Payer: Brighton Health Commercial |
$65,213.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$71,090.34
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$77,667.33
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$64,094.41
|
| Rate for Payer: Elderplan Medicare Advantage |
$66,211.59
|
| Rate for Payer: EmblemHealth Commercial |
$38,566.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$69,696.41
|
| Rate for Payer: Group Health Inc Commercial |
$69,696.41
|
| Rate for Payer: Group Health Inc Medicare |
$69,696.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$69,696.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$32,408.83
|
| Rate for Payer: Humana Medicare |
$95,832.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$69,696.41
|
| Rate for Payer: United Healthcare Commercial |
$89,441.78
|
| Rate for Payer: United Healthcare Medicare Advantage |
$69,696.41
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$69,696.41
|
| Rate for Payer: Wellcare Medicare |
$66,211.59
|
|
|
KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC
|
Facility
|
IP
|
$76,019.38
|
|
|
Service Code
|
MSDRG 651
|
| Min. Negotiated Rate |
$25,708.37 |
| Max. Negotiated Rate |
$76,019.38 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$50,994.11
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$55,286.82
|
| Rate for Payer: Aetna Government |
$55,286.82
|
| Rate for Payer: Brighton Health Commercial |
$50,146.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$56,392.56
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$59,723.11
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$49,286.07
|
| Rate for Payer: Elderplan Medicare Advantage |
$52,522.48
|
| Rate for Payer: EmblemHealth Commercial |
$29,655.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$55,286.82
|
| Rate for Payer: Group Health Inc Commercial |
$55,286.82
|
| Rate for Payer: Group Health Inc Medicare |
$55,286.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$55,286.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25,708.37
|
| Rate for Payer: Humana Medicare |
$76,019.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$55,286.82
|
| Rate for Payer: United Healthcare Commercial |
$68,777.20
|
| Rate for Payer: United Healthcare Medicare Advantage |
$55,286.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$55,286.82
|
| Rate for Payer: Wellcare Medicare |
$52,522.48
|
|
|
KINAIR III WITHOUT SCALES BED
|
Facility
|
OP
|
$200.00
|
|
| Hospital Charge Code |
40209301
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$110.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$100.00
|
| Rate for Payer: Aetna Government |
$100.00
|
| Rate for Payer: Brighton Health Commercial |
$150.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$160.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$136.00
|
| Rate for Payer: Group Health Inc Commercial |
$100.00
|
| Rate for Payer: Group Health Inc Medicare |
$70.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$100.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$100.00
|
|
|
KINAIR III WITH SCALE BED
|
Facility
|
OP
|
$200.00
|
|
| Hospital Charge Code |
40209307
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$110.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$100.00
|
| Rate for Payer: Aetna Government |
$100.00
|
| Rate for Payer: Brighton Health Commercial |
$150.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$160.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$136.00
|
| Rate for Payer: Group Health Inc Commercial |
$100.00
|
| Rate for Payer: Group Health Inc Medicare |
$70.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$100.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$100.00
|
|
|
KIRSCHNER HIP SYSTEM
|
Facility
|
OP
|
$2,893.47
|
|
| Hospital Charge Code |
40207030
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,012.71 |
| Max. Negotiated Rate |
$2,314.78 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,591.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,446.74
|
| Rate for Payer: Aetna Government |
$1,446.74
|
| Rate for Payer: Brighton Health Commercial |
$2,170.10
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,314.78
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,967.56
|
| Rate for Payer: Group Health Inc Commercial |
$1,446.74
|
| Rate for Payer: Group Health Inc Medicare |
$1,012.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,446.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,446.74
|
|
|
KIT, 1 X 40-42 B-D MAS WH
|
Facility
|
OP
|
$74.88
|
|
| Hospital Charge Code |
64905847
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.21 |
| Max. Negotiated Rate |
$59.90 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$41.18
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$37.44
|
| Rate for Payer: Aetna Government |
$37.44
|
| Rate for Payer: Brighton Health Commercial |
$56.16
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$59.90
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$50.92
|
| Rate for Payer: Group Health Inc Commercial |
$37.44
|
| Rate for Payer: Group Health Inc Medicare |
$26.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$37.44
|
|
|
KIT ACCESS
|
Facility
|
OP
|
$166.25
|
|
| Hospital Charge Code |
64901814
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$58.19 |
| Max. Negotiated Rate |
$133.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$91.44
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$83.12
|
| Rate for Payer: Aetna Government |
$83.12
|
| Rate for Payer: Brighton Health Commercial |
$124.69
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$133.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$113.05
|
| Rate for Payer: Group Health Inc Commercial |
$83.12
|
| Rate for Payer: Group Health Inc Medicare |
$58.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$83.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$83.12
|
|
|
KIT, ACCESSORY, AMS700
|
Facility
|
OP
|
$1,869.80
|
|
| Hospital Charge Code |
64905117
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$654.43 |
| Max. Negotiated Rate |
$1,495.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,028.39
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$934.90
|
| Rate for Payer: Aetna Government |
$934.90
|
| Rate for Payer: Brighton Health Commercial |
$1,402.35
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,495.84
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,271.46
|
| Rate for Payer: Group Health Inc Commercial |
$934.90
|
| Rate for Payer: Group Health Inc Medicare |
$654.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$934.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$934.90
|
|
|
KIT, ACCESSORY, AMS800
|
Facility
|
OP
|
$2,740.00
|
|
| Hospital Charge Code |
64905121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$959.00 |
| Max. Negotiated Rate |
$2,192.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,507.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,370.00
|
| Rate for Payer: Aetna Government |
$1,370.00
|
| Rate for Payer: Brighton Health Commercial |
$2,055.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,192.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,863.20
|
| Rate for Payer: Group Health Inc Commercial |
$1,370.00
|
| Rate for Payer: Group Health Inc Medicare |
$959.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,370.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,370.00
|
|
|
KIT ACCESSORY PENILE PROSTHES
|
Facility
|
OP
|
$900.00
|
|
| Hospital Charge Code |
40200889
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$315.00 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$495.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$450.00
|
| Rate for Payer: Aetna Government |
$450.00
|
| Rate for Payer: Brighton Health Commercial |
$675.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$720.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$612.00
|
| Rate for Payer: Group Health Inc Commercial |
$450.00
|
| Rate for Payer: Group Health Inc Medicare |
$315.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$450.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$450.00
|
|
|
KIT ACHILLES MIDSUBSTANCE BRIDGE
|
Facility
|
IP
|
$1,950.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64906667
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$975.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$975.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$975.00
|
|
|
KIT ACHILLES MIDSUBSTANCE BRIDGE
|
Facility
|
OP
|
$1,950.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64906667
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$2,047.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,072.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Brighton Health Commercial |
$1,170.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$975.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,121.25
|
| Rate for Payer: EmblemHealth Commercial |
$975.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,047.50
|
| Rate for Payer: Group Health Inc Commercial |
$975.00
|
| Rate for Payer: Group Health Inc Medicare |
$682.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$975.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$975.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,267.50
|
|
|
KIT, ACHILLES SPEEDBRIDGE
|
Facility
|
IP
|
$4,350.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64905475
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,175.00 |
| Max. Negotiated Rate |
$2,175.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,175.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,175.00
|
|
