|
LAPARO PROC ABDM/PER/OMENTUM
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 49329
|
| Hospital Charge Code |
40014368
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
LAPARO PROC ABDM/PER/OMENTUM
|
Facility
|
IP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 49329
|
| Hospital Charge Code |
40014368
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,672.53
|
|
|
LAPARO PROC HERNIA REPAIR
|
Facility
|
IP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 49659
|
| Hospital Charge Code |
40014369
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,672.53
|
|
|
LAPARO PROC HERNIA REPAIR
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 49659
|
| Hospital Charge Code |
40014369
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
LAPARO RADICAL PROSTATECTOMY
|
Facility
|
IP
|
$25,481.21
|
|
|
Service Code
|
HCPCS 55866
|
| Hospital Charge Code |
40002234
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$11,903.87
|
|
|
LAPARO RADICAL PROSTATECTOMY
|
Facility
|
OP
|
$25,481.21
|
|
|
Service Code
|
HCPCS 55866
|
| Hospital Charge Code |
40002234
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$44,507.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$44,507.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11,903.87
|
| Rate for Payer: Aetna Government |
$11,903.87
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8,332.71
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8,332.71
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8,332.71
|
| Rate for Payer: Brighton Health Commercial |
$19,110.91
|
| Rate for Payer: Cash Price |
$11,903.87
|
| Rate for Payer: Cash Price |
$11,903.87
|
| Rate for Payer: Cash Price |
$11,903.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11,903.87
|
| 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 |
$11,903.87
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10,118.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10,594.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$11,903.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10,594.44
|
| Rate for Payer: Group Health Inc Commercial |
$11,903.87
|
| Rate for Payer: Group Health Inc Medicare |
$11,903.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12,740.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11,903.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,118.29
|
| Rate for Payer: Healthfirst QHP |
$11,903.87
|
| Rate for Payer: Humana Medicare |
$12,141.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11,903.87
|
| Rate for Payer: United Healthcare Commercial |
$3,190.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11,903.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11,903.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9,523.10
|
| Rate for Payer: Wellcare Medicare |
$11,308.68
|
|
|
LAPAROROSCO CHOLECYSTECT/CHOLANGI
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 47563
|
| Hospital Charge Code |
40019838
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,065.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
LAPAROROSCO CHOLECYSTECT/CHOLANGI
|
Facility
|
IP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 47563
|
| Hospital Charge Code |
40019838
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,672.53
|
|
|
LAPAROSCOPIC CHOLECYSTECTOMY
|
Facility
|
IP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 47562
|
| Hospital Charge Code |
40011205
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,672.53
|
|
|
LAPAROSCOPIC CHOLECYSTECTOMY
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 47562
|
| Hospital Charge Code |
40011205
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,065.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$41,245.66
|
|
|
Service Code
|
MSDRG 418
|
| Min. Negotiated Rate |
$13,948.53 |
| Max. Negotiated Rate |
$41,245.66 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24,103.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$29,996.84
|
| Rate for Payer: Aetna Government |
$29,996.84
|
| Rate for Payer: Brighton Health Commercial |
$23,703.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$30,596.78
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28,229.63
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$23,296.31
|
| Rate for Payer: Elderplan Medicare Advantage |
$28,497.00
|
| Rate for Payer: EmblemHealth Commercial |
$14,017.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$29,996.84
|
| Rate for Payer: Group Health Inc Commercial |
$29,996.84
|
| Rate for Payer: Group Health Inc Medicare |
$29,996.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29,996.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13,948.53
|
| Rate for Payer: Humana Medicare |
$41,245.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$29,996.84
|
| Rate for Payer: United Healthcare Commercial |
$32,509.28
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,996.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$29,996.84
|
| Rate for Payer: Wellcare Medicare |
$28,497.00
|
|
|
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$54,270.77
|
|
|
Service Code
|
MSDRG 417
|
| Min. Negotiated Rate |
$18,353.39 |
| Max. Negotiated Rate |
$54,270.77 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$34,175.96
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$39,469.65
|
| Rate for Payer: Aetna Government |
$39,469.65
|
| Rate for Payer: Brighton Health Commercial |
$33,608.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$40,259.04
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$40,026.09
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$33,031.25
|
| Rate for Payer: Elderplan Medicare Advantage |
$37,496.17
|
| Rate for Payer: EmblemHealth Commercial |
$19,875.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$39,469.65
|
| Rate for Payer: Group Health Inc Commercial |
$39,469.65
|
| Rate for Payer: Group Health Inc Medicare |
$39,469.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$39,469.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18,353.39
|
| Rate for Payer: Humana Medicare |
$54,270.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$39,469.65
|
| Rate for Payer: United Healthcare Commercial |
$46,094.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$39,469.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39,469.65
|
| Rate for Payer: Wellcare Medicare |
$37,496.17
|
|
|
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$35,115.42
|
|
|
Service Code
|
MSDRG 419
|
| Min. Negotiated Rate |
$11,260.70 |
| Max. Negotiated Rate |
$35,115.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19,363.13
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$25,538.49
|
| Rate for Payer: Aetna Government |
$25,538.49
|
| Rate for Payer: Brighton Health Commercial |
$19,041.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26,049.26
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22,677.65
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18,714.57
|
| Rate for Payer: Elderplan Medicare Advantage |
$24,261.57
|
| Rate for Payer: EmblemHealth Commercial |
$11,260.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$25,538.49
|
| Rate for Payer: Group Health Inc Commercial |
$25,538.49
|
| Rate for Payer: Group Health Inc Medicare |
$25,538.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25,538.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11,875.40
|
| Rate for Payer: Humana Medicare |
$35,115.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25,538.49
|
| Rate for Payer: United Healthcare Commercial |
$26,115.61
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25,538.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25,538.49
|
| Rate for Payer: Wellcare Medicare |
$24,261.57
|
|
|
LAPAROSCOPIC LIVER PROCEDURE
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 47379
|
| Hospital Charge Code |
40019708
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
LAPAROSCOPIC LIVER PROCEDURE
|
Facility
|
IP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 47379
|
| Hospital Charge Code |
40019708
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,672.53
|
|
|
Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy
|
Facility
|
OP
|
$6,805.98
|
|
|
Service Code
|
CPT 59151
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$6,805.98 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,065.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
LAPAROSCOPIC TUBAL LIGATION
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 58670
|
| Hospital Charge Code |
40054311
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
LAPAROSCOPIC TUBAL LIGATION
|
Facility
|
IP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 58670
|
| Hospital Charge Code |
40054311
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,672.53
|
|
|
LAPAROSCOPY
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 49320
|
| Hospital Charge Code |
40011135
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
LAPAROSCOPY
|
Facility
|
IP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 49320
|
| Hospital Charge Code |
40011135
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,672.53
|
|
|
Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
|
Facility
|
OP
|
$6,805.98
|
|
|
Service Code
|
CPT 49320
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$6,805.98 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
LAPAROSCOPY, ASPIRATION
|
Facility
|
IP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 49322
|
| Hospital Charge Code |
40014157
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,672.53
|
|
|
LAPAROSCOPY, ASPIRATION
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 49322
|
| Hospital Charge Code |
40014157
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
LAPAROSCOPY EXCISE LESIONS
|
Facility
|
IP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 58662
|
| Hospital Charge Code |
40054374
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,672.53
|
|
|
LAPAROSCOPY EXCISE LESIONS
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 58662
|
| Hospital Charge Code |
40054374
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
