|
LARGE 38-40 MEDEBRA WHTE
|
Facility
|
OP
|
$63.13
|
|
| Hospital Charge Code |
64905837
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.10 |
| Max. Negotiated Rate |
$50.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$34.72
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$31.56
|
| Rate for Payer: Aetna Government |
$31.56
|
| Rate for Payer: Brighton Health Commercial |
$47.35
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$50.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$42.93
|
| Rate for Payer: Group Health Inc Commercial |
$31.56
|
| Rate for Payer: Group Health Inc Medicare |
$22.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$31.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31.56
|
|
|
LARGE BEAN BAG W SHOULDER CUT
|
Facility
|
OP
|
$833.03
|
|
| Hospital Charge Code |
64905253
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$291.56 |
| Max. Negotiated Rate |
$666.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$458.17
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$416.52
|
| Rate for Payer: Aetna Government |
$416.52
|
| Rate for Payer: Brighton Health Commercial |
$624.77
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$666.42
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$566.46
|
| Rate for Payer: Group Health Inc Commercial |
$416.52
|
| Rate for Payer: Group Health Inc Medicare |
$291.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$416.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$416.52
|
|
|
LARGE BONE SAW BLADE
|
Facility
|
OP
|
$48.00
|
|
| Hospital Charge Code |
64905356
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.80 |
| Max. Negotiated Rate |
$38.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$26.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$24.00
|
| Rate for Payer: Aetna Government |
$24.00
|
| Rate for Payer: Brighton Health Commercial |
$36.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$38.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$32.64
|
| Rate for Payer: Group Health Inc Commercial |
$24.00
|
| Rate for Payer: Group Health Inc Medicare |
$16.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$24.00
|
|
|
LARGE DRAINABLE 1104
|
Facility
|
OP
|
$60.95
|
|
| Hospital Charge Code |
40203605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.33 |
| Max. Negotiated Rate |
$48.76 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.52
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$30.48
|
| Rate for Payer: Aetna Government |
$30.48
|
| Rate for Payer: Brighton Health Commercial |
$45.71
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$48.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$41.45
|
| Rate for Payer: Group Health Inc Commercial |
$30.48
|
| Rate for Payer: Group Health Inc Medicare |
$21.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.48
|
|
|
LARGE DRAINABLE BAGS MAXI
|
Facility
|
OP
|
$53.16
|
|
| Hospital Charge Code |
40203604
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.61 |
| Max. Negotiated Rate |
$42.53 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$29.24
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$26.58
|
| Rate for Payer: Aetna Government |
$26.58
|
| Rate for Payer: Brighton Health Commercial |
$39.87
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$42.53
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$36.15
|
| Rate for Payer: Group Health Inc Commercial |
$26.58
|
| Rate for Payer: Group Health Inc Medicare |
$18.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.58
|
|
|
LARGE GAUGE
|
Facility
|
OP
|
$1,130.00
|
|
| Hospital Charge Code |
40203564
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$395.50 |
| Max. Negotiated Rate |
$904.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$621.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$565.00
|
| Rate for Payer: Aetna Government |
$565.00
|
| Rate for Payer: Brighton Health Commercial |
$847.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$904.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$768.40
|
| Rate for Payer: Group Health Inc Commercial |
$565.00
|
| Rate for Payer: Group Health Inc Medicare |
$395.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$565.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$565.00
|
|
|
LARGE STAPLE 20 X 20MM
|
Facility
|
OP
|
$620.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40200699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$651.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$341.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Brighton Health Commercial |
$372.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$310.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$356.50
|
| Rate for Payer: EmblemHealth Commercial |
$310.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$651.00
|
| Rate for Payer: Group Health Inc Commercial |
$310.00
|
| Rate for Payer: Group Health Inc Medicare |
$217.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$310.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$310.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$403.00
|
|
|
LARGE STAPLE 20 X 20MM
|
Facility
|
IP
|
$620.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40200699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$310.00 |
| Max. Negotiated Rate |
$310.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$310.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$310.00
|
|
|
LARGE STAPLE 25 X 22MM
|
Facility
|
OP
|
$620.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40200800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$651.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$341.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Brighton Health Commercial |
$372.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$310.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$356.50
|
| Rate for Payer: EmblemHealth Commercial |
$310.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$651.00
|
| Rate for Payer: Group Health Inc Commercial |
$310.00
|
| Rate for Payer: Group Health Inc Medicare |
$217.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$310.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$310.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$403.00
|
|
|
LARGE STAPLE 25 X 22MM
|
Facility
|
IP
|
$620.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40200800
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$310.00 |
| Max. Negotiated Rate |
$310.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$310.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$310.00
|
|
|
LARGE VAKU-PAK DRESSING WITH PUMP
|
Facility
|
OP
|
$13,120.00
|
|
|
Service Code
|
HCPCS E2402
|
| Hospital Charge Code |
40208001
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,592.00 |
| Max. Negotiated Rate |
$10,496.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7,216.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9,052.47
|
| Rate for Payer: Aetna Government |
$9,052.47
|
| Rate for Payer: Brighton Health Commercial |
$9,840.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$10,496.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$8,921.60
|
| Rate for Payer: Group Health Inc Commercial |
$6,560.00
|
| Rate for Payer: Group Health Inc Medicare |
$4,592.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,560.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,560.00
|
|
|
LARYNGECTOMY
|
Facility
|
OP
|
$6,483.35
|
|
|
Service Code
|
HCPCS 31360
|
| Hospital Charge Code |
40109005
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,496.00 |
| Max. Negotiated Rate |
$4,862.51 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,565.84
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,243.37
|
| Rate for Payer: Aetna Government |
$2,243.37
|
| Rate for Payer: Brighton Health Commercial |
$4,862.51
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Group Health Inc Commercial |
$3,241.68
|
| Rate for Payer: Group Health Inc Medicare |
$2,269.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,241.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,241.68
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
LARYNGOSCOPY
|
Facility
|
IP
|
$474.15
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
40108850
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$229.07
|
|
|
LARYNGOSCOPY
|
Facility
|
OP
|
$474.15
|
|
|
Service Code
|
HCPCS 31505
|
| Hospital Charge Code |
40108850
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$160.35 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$229.07
|
| Rate for Payer: Aetna Government |
$229.07
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$160.35
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$160.35
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$160.35
|
| Rate for Payer: Brighton Health Commercial |
$355.61
|
| Rate for Payer: Cash Price |
$229.07
|
| Rate for Payer: Cash Price |
$229.07
|
| Rate for Payer: Cash Price |
$229.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$229.07
|
| 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 |
$229.07
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$194.71
|
| Rate for Payer: Fidelis Essential Plan QHP |
$203.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$229.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$203.87
|
| Rate for Payer: Group Health Inc Commercial |
$229.07
|
| Rate for Payer: Group Health Inc Medicare |
$229.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$237.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$194.71
|
| Rate for Payer: Healthfirst QHP |
$229.07
|
| Rate for Payer: Humana Medicare |
$233.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$229.07
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$229.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$229.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$183.26
|
| Rate for Payer: Wellcare Medicare |
$217.62
|
|
|
LARYNGOSCOPY,BIOPSY
|
Facility
|
OP
|
$8,895.18
|
|
|
Service Code
|
HCPCS 31510
|
| Hospital Charge Code |
40108860
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,409.00 |
| Max. Negotiated Rate |
$6,671.38 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,330.61
|
| Rate for Payer: Aetna Government |
$4,330.61
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,031.43
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,031.43
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,031.43
|
| Rate for Payer: Brighton Health Commercial |
$6,671.38
|
| Rate for Payer: Cash Price |
$4,330.61
|
| Rate for Payer: Cash Price |
$4,330.61
|
| Rate for Payer: Cash Price |
$4,330.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,330.61
|
| 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 |
$4,330.61
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,681.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,854.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,330.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,854.24
|
| Rate for Payer: Group Health Inc Commercial |
$4,330.61
|
| Rate for Payer: Group Health Inc Medicare |
$4,330.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,447.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,330.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,681.02
|
| Rate for Payer: Healthfirst QHP |
$4,330.61
|
| Rate for Payer: Humana Medicare |
$4,417.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,330.61
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,330.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,330.61
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,464.49
|
| Rate for Payer: Wellcare Medicare |
$4,114.08
|
|
|
LARYNGOSCOPY,BIOPSY
|
Facility
|
IP
|
$8,895.18
|
|
|
Service Code
|
HCPCS 31510
|
| Hospital Charge Code |
40108860
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,330.61
|
|
|
LARYNGOSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$458.00
|
|
|
Service Code
|
HCPCS 31575
|
| Hospital Charge Code |
30305919
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.35 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$229.07
|
| Rate for Payer: Aetna Government |
$229.07
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$160.35
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$160.35
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$160.35
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$229.07
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$229.07
|
| Rate for Payer: Cash Price |
$229.07
|
| Rate for Payer: Cash Price |
$229.07
|
| Rate for Payer: Cash Price |
$229.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$229.07
|
| 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 |
$229.07
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$194.71
|
| Rate for Payer: Fidelis Essential Plan QHP |
$203.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$229.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$203.87
|
| 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 |
$229.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$229.07
|
| Rate for Payer: Humana Medicare |
$233.65
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$229.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$229.07
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$229.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$229.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$183.26
|
| Rate for Payer: Wellcare Medicare |
$217.62
|
|
|
LARYNGOSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$458.00
|
|
|
Service Code
|
HCPCS 31575
|
| Hospital Charge Code |
30305919
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$229.07
|
|
|
LARYNGOSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$458.00
|
|
|
Service Code
|
HCPCS 31575
|
| Hospital Charge Code |
30105919
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$160.35 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$229.07
|
| Rate for Payer: Aetna Government |
$229.07
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$160.35
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$160.35
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$160.35
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$229.07
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$229.07
|
| Rate for Payer: Cash Price |
$229.07
|
| Rate for Payer: Cash Price |
$229.07
|
| Rate for Payer: Cash Price |
$229.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$229.07
|
| 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 |
$229.07
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$194.71
|
| Rate for Payer: Fidelis Essential Plan QHP |
$203.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$229.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$203.87
|
| 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 |
$229.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$229.07
|
| Rate for Payer: Humana Medicare |
$233.65
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$229.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$229.07
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$229.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$229.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$183.26
|
| Rate for Payer: Wellcare Medicare |
$217.62
|
|
|
LARYNGOSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$458.00
|
|
|
Service Code
|
HCPCS 31575
|
| Hospital Charge Code |
30105919
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$229.07
|
|
|
LARYNGOSCOPY -DIRECT
|
Facility
|
IP
|
$4,332.95
|
|
|
Service Code
|
HCPCS 31530
|
| Hospital Charge Code |
40109214
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,962.76
|
|
|
LARYNGOSCOPY -DIRECT
|
Facility
|
OP
|
$4,332.95
|
|
|
Service Code
|
HCPCS 31530
|
| Hospital Charge Code |
40109214
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,373.93 |
| Max. Negotiated Rate |
$3,249.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,962.76
|
| Rate for Payer: Aetna Government |
$1,962.76
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,373.93
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,373.93
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,373.93
|
| Rate for Payer: Brighton Health Commercial |
$3,249.71
|
| Rate for Payer: Cash Price |
$1,962.76
|
| Rate for Payer: Cash Price |
$1,962.76
|
| Rate for Payer: Cash Price |
$1,962.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,962.76
|
| 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 |
$1,962.76
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,668.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,746.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,962.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,746.86
|
| Rate for Payer: Group Health Inc Commercial |
$1,962.76
|
| Rate for Payer: Group Health Inc Medicare |
$1,962.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,166.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,962.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,668.35
|
| Rate for Payer: Healthfirst QHP |
$1,962.76
|
| Rate for Payer: Humana Medicare |
$2,002.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,962.76
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,962.76
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,962.76
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,570.21
|
| Rate for Payer: Wellcare Medicare |
$1,864.62
|
|
|
Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope
|
Facility
|
OP
|
$4,417.22
|
|
|
Service Code
|
CPT 31536
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$4,417.22 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,330.61
|
| Rate for Payer: Aetna Government |
$4,330.61
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,031.43
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,031.43
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,031.43
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,330.61
|
| 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 |
$4,330.61
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,681.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,854.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,330.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,854.24
|
| Rate for Payer: Group Health Inc Commercial |
$4,330.61
|
| Rate for Payer: Group Health Inc Medicare |
$4,330.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,330.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,681.02
|
| Rate for Payer: Healthfirst QHP |
$4,330.61
|
| Rate for Payer: Humana Medicare |
$4,417.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,330.61
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,330.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,330.61
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,464.49
|
| Rate for Payer: Wellcare Medicare |
$4,114.08
|
|
|
Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope
|
Facility
|
OP
|
$4,417.22
|
|
|
Service Code
|
CPT 31541
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$4,417.22 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,330.61
|
| Rate for Payer: Aetna Government |
$4,330.61
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,031.43
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,031.43
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,031.43
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,330.61
|
| 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 |
$4,330.61
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,681.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,854.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,330.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,854.24
|
| Rate for Payer: Group Health Inc Commercial |
$4,330.61
|
| Rate for Payer: Group Health Inc Medicare |
$4,330.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,330.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,681.02
|
| Rate for Payer: Healthfirst QHP |
$4,330.61
|
| Rate for Payer: Humana Medicare |
$4,417.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,330.61
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,330.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,330.61
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,464.49
|
| Rate for Payer: Wellcare Medicare |
$4,114.08
|
|
|
LARYNGOSCOPY FOR ASPIRATION
|
Facility
|
IP
|
$1,144.53
|
|
|
Service Code
|
HCPCS 31515
|
| Hospital Charge Code |
30106000
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$472.20
|
|
