|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC
|
Facility
|
IP
|
$55,306.17
|
|
|
Service Code
|
MSDRG 330
|
| Min. Negotiated Rate |
$18,703.54 |
| Max. Negotiated Rate |
$55,306.17 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$34,976.61
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$40,222.67
|
| Rate for Payer: Aetna Government |
$40,222.67
|
| Rate for Payer: Brighton Health Commercial |
$34,395.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$41,027.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$40,963.79
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$33,805.08
|
| Rate for Payer: Elderplan Medicare Advantage |
$38,211.54
|
| Rate for Payer: EmblemHealth Commercial |
$20,340.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$40,222.67
|
| Rate for Payer: Group Health Inc Commercial |
$40,222.67
|
| Rate for Payer: Group Health Inc Medicare |
$40,222.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40,222.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18,703.54
|
| Rate for Payer: Humana Medicare |
$55,306.17
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40,222.67
|
| Rate for Payer: United Healthcare Commercial |
$47,173.95
|
| Rate for Payer: United Healthcare Medicare Advantage |
$40,222.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40,222.67
|
| Rate for Payer: Wellcare Medicare |
$38,211.54
|
|
|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC
|
Facility
|
IP
|
$96,200.57
|
|
|
Service Code
|
MSDRG 329
|
| Min. Negotiated Rate |
$32,533.28 |
| Max. Negotiated Rate |
$96,200.57 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$66,600.22
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69,964.05
|
| Rate for Payer: Aetna Government |
$69,964.05
|
| Rate for Payer: Brighton Health Commercial |
$65,493.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$71,363.33
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$78,000.62
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$64,369.46
|
| Rate for Payer: Elderplan Medicare Advantage |
$66,465.85
|
| Rate for Payer: EmblemHealth Commercial |
$38,731.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$69,964.05
|
| Rate for Payer: Group Health Inc Commercial |
$69,964.05
|
| Rate for Payer: Group Health Inc Medicare |
$69,964.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$69,964.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$32,533.28
|
| Rate for Payer: Humana Medicare |
$96,200.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$69,964.05
|
| Rate for Payer: United Healthcare Commercial |
$89,825.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$69,964.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$69,964.05
|
| Rate for Payer: Wellcare Medicare |
$66,465.85
|
|
|
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$41,956.89
|
|
|
Service Code
|
MSDRG 331
|
| Min. Negotiated Rate |
$14,189.06 |
| Max. Negotiated Rate |
$41,956.89 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24,653.64
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$30,514.10
|
| Rate for Payer: Aetna Government |
$30,514.10
|
| Rate for Payer: Brighton Health Commercial |
$24,244.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$31,124.38
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28,873.77
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$23,827.87
|
| Rate for Payer: Elderplan Medicare Advantage |
$28,988.40
|
| Rate for Payer: EmblemHealth Commercial |
$14,337.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$30,514.10
|
| Rate for Payer: Group Health Inc Commercial |
$30,514.10
|
| Rate for Payer: Group Health Inc Medicare |
$30,514.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30,514.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14,189.06
|
| Rate for Payer: Humana Medicare |
$41,956.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$30,514.10
|
| Rate for Payer: United Healthcare Commercial |
$33,251.06
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30,514.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$30,514.10
|
| Rate for Payer: Wellcare Medicare |
$28,988.40
|
|
|
MAJOR THUMB OR JOINT PROCEDURES
|
Facility
|
IP
|
$37,964.15
|
|
|
Service Code
|
MSDRG 506
|
| Min. Negotiated Rate |
$12,541.80 |
| Max. Negotiated Rate |
$37,964.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$21,566.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$27,610.29
|
| Rate for Payer: Aetna Government |
$27,610.29
|
| Rate for Payer: Brighton Health Commercial |
$21,207.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$28,162.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$25,257.64
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20,843.69
|
| Rate for Payer: Elderplan Medicare Advantage |
$26,229.78
|
| Rate for Payer: EmblemHealth Commercial |
$12,541.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$27,610.29
|
| Rate for Payer: Group Health Inc Commercial |
$27,610.29
|
| Rate for Payer: Group Health Inc Medicare |
$27,610.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$27,610.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,838.78
|
| Rate for Payer: Humana Medicare |
$37,964.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$27,610.29
|
| Rate for Payer: United Healthcare Commercial |
$29,086.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27,610.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$27,610.29
|
| Rate for Payer: Wellcare Medicare |
$26,229.78
|
|
|
MALAR AND/OR ZYGOMATIC ARCH CLOSE
|
Facility
|
OP
|
$1,409.00
|
|
|
Service Code
|
HCPCS D7760
|
| Hospital Charge Code |
42301925
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$493.15 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$774.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$516.39
|
| Rate for Payer: Aetna Government |
$516.39
|
| Rate for Payer: Brighton Health Commercial |
$1,056.75
|
| 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: Group Health Inc Commercial |
$704.50
|
| Rate for Payer: Group Health Inc Medicare |
$493.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$704.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$704.50
|
|
|
MALAR AND/OR ZYGOMATIC ARCH OPEN
|
Facility
|
OP
|
$4,638.00
|
|
|
Service Code
|
HCPCS D7750
|
| Hospital Charge Code |
42301920
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,286.95 |
| Max. Negotiated Rate |
$3,478.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,550.90
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,286.95
|
| Rate for Payer: Aetna Government |
$1,286.95
|
| Rate for Payer: Brighton Health Commercial |
$3,478.50
|
| 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: Group Health Inc Commercial |
$2,319.00
|
| Rate for Payer: Group Health Inc Medicare |
$1,623.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,319.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,319.00
|
|
|
MALAR/ZYGOMAT ARCH-OPEN REDUC
|
Facility
|
OP
|
$1,812.50
|
|
|
Service Code
|
HCPCS D7650
|
| Hospital Charge Code |
42303408
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$634.38 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$996.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$751.80
|
| Rate for Payer: Aetna Government |
$751.80
|
| Rate for Payer: Brighton Health Commercial |
$1,359.38
|
| 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: Group Health Inc Commercial |
$906.25
|
| Rate for Payer: Group Health Inc Medicare |
$634.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$906.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$906.25
|
|
|
MALATHIONE .5% TOPICAL
|
Facility
|
OP
|
$282.72
|
|
| Hospital Charge Code |
41648400
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$98.95 |
| Max. Negotiated Rate |
$226.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$155.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$141.36
|
| Rate for Payer: Aetna Government |
$141.36
|
| Rate for Payer: Brighton Health Commercial |
$212.04
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$226.18
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$192.25
|
| Rate for Payer: Group Health Inc Commercial |
$141.36
|
| Rate for Payer: Group Health Inc Medicare |
$98.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$141.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$141.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$183.77
|
|
|
MALATHIONE .5% TOPICAL
|
Facility
|
OP
|
$282.72
|
|
| Hospital Charge Code |
41658400
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$98.95 |
| Max. Negotiated Rate |
$226.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$155.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$141.36
|
| Rate for Payer: Aetna Government |
$141.36
|
| Rate for Payer: Brighton Health Commercial |
$212.04
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$226.18
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$192.25
|
| Rate for Payer: Group Health Inc Commercial |
$141.36
|
| Rate for Payer: Group Health Inc Medicare |
$98.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$141.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$141.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$183.77
|
|
|
MALA/ZYGO ARCH CLOSED REDUC
|
Facility
|
OP
|
$3,000.00
|
|
|
Service Code
|
HCPCS D7660
|
| Hospital Charge Code |
42303451
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$443.19 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,650.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$443.19
|
| Rate for Payer: Aetna Government |
$443.19
|
| Rate for Payer: Brighton Health Commercial |
$2,250.00
|
| 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: Group Health Inc Commercial |
$1,500.00
|
| Rate for Payer: Group Health Inc Medicare |
$1,050.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,500.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,500.00
|
|
|
MALICOT CATHETER
|
Facility
|
OP
|
$25.52
|
|
| Hospital Charge Code |
40203890
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.93 |
| Max. Negotiated Rate |
$20.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$14.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.76
|
| Rate for Payer: Aetna Government |
$12.76
|
| Rate for Payer: Brighton Health Commercial |
$19.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.42
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.35
|
| Rate for Payer: Group Health Inc Commercial |
$12.76
|
| Rate for Payer: Group Health Inc Medicare |
$8.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.76
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$30,758.46
|
|
|
Service Code
|
MSDRG 755
|
| Min. Negotiated Rate |
$9,301.30 |
| Max. Negotiated Rate |
$30,758.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15,993.90
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$22,369.79
|
| Rate for Payer: Aetna Government |
$22,369.79
|
| Rate for Payer: Brighton Health Commercial |
$15,728.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22,817.19
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$18,731.68
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15,458.19
|
| Rate for Payer: Elderplan Medicare Advantage |
$21,251.30
|
| Rate for Payer: EmblemHealth Commercial |
$9,301.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$22,369.79
|
| Rate for Payer: Group Health Inc Commercial |
$22,369.79
|
| Rate for Payer: Group Health Inc Medicare |
$22,369.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22,369.79
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,401.95
|
| Rate for Payer: Humana Medicare |
$30,758.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22,369.79
|
| Rate for Payer: United Healthcare Commercial |
$21,571.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,369.79
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22,369.79
|
| Rate for Payer: Wellcare Medicare |
$21,251.30
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$45,398.58
|
|
|
Service Code
|
MSDRG 754
|
| Min. Negotiated Rate |
$15,352.97 |
| Max. Negotiated Rate |
$45,398.58 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$27,315.11
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$33,017.15
|
| Rate for Payer: Aetna Government |
$33,017.15
|
| Rate for Payer: Brighton Health Commercial |
$26,861.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$33,677.49
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$31,990.82
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$26,400.20
|
| Rate for Payer: Elderplan Medicare Advantage |
$31,366.29
|
| Rate for Payer: EmblemHealth Commercial |
$15,885.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$33,017.15
|
| Rate for Payer: Group Health Inc Commercial |
$33,017.15
|
| Rate for Payer: Group Health Inc Medicare |
$33,017.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33,017.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15,352.97
|
| Rate for Payer: Humana Medicare |
$45,398.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33,017.15
|
| Rate for Payer: United Healthcare Commercial |
$36,840.67
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,017.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33,017.15
|
| Rate for Payer: Wellcare Medicare |
$31,366.29
|
|
|
MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$28,947.05
|
|
|
Service Code
|
MSDRG 756
|
| Min. Negotiated Rate |
$8,486.68 |
| Max. Negotiated Rate |
$28,947.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$14,593.13
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21,052.40
|
| Rate for Payer: Aetna Government |
$21,052.40
|
| Rate for Payer: Brighton Health Commercial |
$14,350.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21,473.45
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$17,091.13
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$14,104.33
|
| Rate for Payer: Elderplan Medicare Advantage |
$19,999.78
|
| Rate for Payer: EmblemHealth Commercial |
$8,486.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$21,052.40
|
| Rate for Payer: Group Health Inc Commercial |
$21,052.40
|
| Rate for Payer: Group Health Inc Medicare |
$21,052.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21,052.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9,789.37
|
| Rate for Payer: Humana Medicare |
$28,947.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21,052.40
|
| Rate for Payer: United Healthcare Commercial |
$19,682.16
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,052.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21,052.40
|
| Rate for Payer: Wellcare Medicare |
$19,999.78
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC
|
Facility
|
IP
|
$31,322.87
|
|
|
Service Code
|
MSDRG 723
|
| Min. Negotiated Rate |
$9,555.12 |
| Max. Negotiated Rate |
$31,322.87 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16,430.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$22,780.27
|
| Rate for Payer: Aetna Government |
$22,780.27
|
| Rate for Payer: Brighton Health Commercial |
$16,157.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$23,235.88
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19,242.85
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15,880.02
|
| Rate for Payer: Elderplan Medicare Advantage |
$21,641.26
|
| Rate for Payer: EmblemHealth Commercial |
$9,555.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$22,780.27
|
| Rate for Payer: Group Health Inc Commercial |
$22,780.27
|
| Rate for Payer: Group Health Inc Medicare |
$22,780.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22,780.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,592.83
|
| Rate for Payer: Humana Medicare |
$31,322.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22,780.27
|
| Rate for Payer: United Healthcare Commercial |
$22,160.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,780.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22,780.27
|
| Rate for Payer: Wellcare Medicare |
$21,641.26
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC
|
Facility
|
IP
|
$45,823.83
|
|
|
Service Code
|
MSDRG 722
|
| Min. Negotiated Rate |
$15,496.79 |
| Max. Negotiated Rate |
$45,823.83 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$27,643.93
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$33,326.42
|
| Rate for Payer: Aetna Government |
$33,326.42
|
| Rate for Payer: Brighton Health Commercial |
$27,184.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$33,992.95
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32,375.92
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$26,718.00
|
| Rate for Payer: Elderplan Medicare Advantage |
$31,660.10
|
| Rate for Payer: EmblemHealth Commercial |
$16,076.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$33,326.42
|
| Rate for Payer: Group Health Inc Commercial |
$33,326.42
|
| Rate for Payer: Group Health Inc Medicare |
$33,326.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33,326.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15,496.79
|
| Rate for Payer: Humana Medicare |
$45,823.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33,326.42
|
| Rate for Payer: United Healthcare Commercial |
$37,284.15
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,326.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33,326.42
|
| Rate for Payer: Wellcare Medicare |
$31,660.10
|
|
|
MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC
|
Facility
|
IP
|
$25,511.04
|
|
|
Service Code
|
MSDRG 724
|
| Min. Negotiated Rate |
$6,941.46 |
| Max. Negotiated Rate |
$25,511.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11,936.08
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18,553.48
|
| Rate for Payer: Aetna Government |
$18,553.48
|
| Rate for Payer: Brighton Health Commercial |
$11,737.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18,924.55
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13,979.26
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11,536.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$17,625.81
|
| Rate for Payer: EmblemHealth Commercial |
$6,941.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$18,553.48
|
| Rate for Payer: Group Health Inc Commercial |
$18,553.48
|
| Rate for Payer: Group Health Inc Medicare |
$18,553.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18,553.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,627.37
|
| Rate for Payer: Humana Medicare |
$25,511.04
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18,553.48
|
| Rate for Payer: United Healthcare Commercial |
$16,098.53
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,553.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18,553.48
|
| Rate for Payer: Wellcare Medicare |
$17,625.81
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC
|
Facility
|
IP
|
$31,063.57
|
|
|
Service Code
|
MSDRG 436
|
| Min. Negotiated Rate |
$9,438.50 |
| Max. Negotiated Rate |
$31,063.57 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16,229.82
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$22,591.69
|
| Rate for Payer: Aetna Government |
$22,591.69
|
| Rate for Payer: Brighton Health Commercial |
$15,960.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$23,043.52
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19,007.99
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15,686.21
|
| Rate for Payer: Elderplan Medicare Advantage |
$21,462.11
|
| Rate for Payer: EmblemHealth Commercial |
$9,438.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$22,591.69
|
| Rate for Payer: Group Health Inc Commercial |
$22,591.69
|
| Rate for Payer: Group Health Inc Medicare |
$22,591.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22,591.69
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,505.14
|
| Rate for Payer: Humana Medicare |
$31,063.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22,591.69
|
| Rate for Payer: United Healthcare Commercial |
$21,889.62
|
| Rate for Payer: United Healthcare Medicare Advantage |
$22,591.69
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22,591.69
|
| Rate for Payer: Wellcare Medicare |
$21,462.11
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC
|
Facility
|
IP
|
$43,632.96
|
|
|
Service Code
|
MSDRG 435
|
| Min. Negotiated Rate |
$14,755.87 |
| Max. Negotiated Rate |
$43,632.96 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$25,949.73
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$31,733.06
|
| Rate for Payer: Aetna Government |
$31,733.06
|
| Rate for Payer: Brighton Health Commercial |
$25,518.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$32,367.72
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$30,391.71
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$25,080.55
|
| Rate for Payer: Elderplan Medicare Advantage |
$30,146.41
|
| Rate for Payer: EmblemHealth Commercial |
$15,091.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$31,733.06
|
| Rate for Payer: Group Health Inc Commercial |
$31,733.06
|
| Rate for Payer: Group Health Inc Medicare |
$31,733.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31,733.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14,755.87
|
| Rate for Payer: Humana Medicare |
$43,632.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$31,733.06
|
| Rate for Payer: United Healthcare Commercial |
$34,999.13
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31,733.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$31,733.06
|
| Rate for Payer: Wellcare Medicare |
$30,146.41
|
|
|
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC
|
Facility
|
IP
|
$25,922.90
|
|
|
Service Code
|
MSDRG 437
|
| Min. Negotiated Rate |
$7,126.68 |
| Max. Negotiated Rate |
$25,922.90 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$12,254.57
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18,853.02
|
| Rate for Payer: Aetna Government |
$18,853.02
|
| Rate for Payer: Brighton Health Commercial |
$12,050.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19,230.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14,352.27
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11,844.11
|
| Rate for Payer: Elderplan Medicare Advantage |
$17,910.37
|
| Rate for Payer: EmblemHealth Commercial |
$7,126.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$18,853.02
|
| Rate for Payer: Group Health Inc Commercial |
$18,853.02
|
| Rate for Payer: Group Health Inc Medicare |
$18,853.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18,853.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,766.65
|
| Rate for Payer: Humana Medicare |
$25,922.90
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18,853.02
|
| Rate for Payer: United Healthcare Commercial |
$16,528.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18,853.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18,853.02
|
| Rate for Payer: Wellcare Medicare |
$17,910.37
|
|
|
MALIGNANT BREAST DISORDERS WITH CC
|
Facility
|
IP
|
$32,934.10
|
|
|
Service Code
|
MSDRG 598
|
| Min. Negotiated Rate |
$10,279.70 |
| Max. Negotiated Rate |
$32,934.10 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17,676.31
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23,952.07
|
| Rate for Payer: Aetna Government |
$23,952.07
|
| Rate for Payer: Brighton Health Commercial |
$17,382.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$24,431.11
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20,702.08
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17,084.24
|
| Rate for Payer: Elderplan Medicare Advantage |
$22,754.47
|
| Rate for Payer: EmblemHealth Commercial |
$10,279.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$23,952.07
|
| Rate for Payer: Group Health Inc Commercial |
$23,952.07
|
| Rate for Payer: Group Health Inc Medicare |
$23,952.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23,952.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11,137.71
|
| Rate for Payer: Humana Medicare |
$32,934.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23,952.07
|
| Rate for Payer: United Healthcare Commercial |
$23,840.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,952.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23,952.07
|
| Rate for Payer: Wellcare Medicare |
$22,754.47
|
|
|
MALIGNANT BREAST DISORDERS WITH MCC
|
Facility
|
IP
|
$40,593.56
|
|
|
Service Code
|
MSDRG 597
|
| Min. Negotiated Rate |
$13,724.30 |
| Max. Negotiated Rate |
$40,593.56 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23,599.37
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$29,522.59
|
| Rate for Payer: Aetna Government |
$29,522.59
|
| Rate for Payer: Brighton Health Commercial |
$23,207.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$30,113.04
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$27,639.03
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$22,808.92
|
| Rate for Payer: Elderplan Medicare Advantage |
$28,046.46
|
| Rate for Payer: EmblemHealth Commercial |
$13,724.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$29,522.59
|
| Rate for Payer: Group Health Inc Commercial |
$29,522.59
|
| Rate for Payer: Group Health Inc Medicare |
$29,522.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29,522.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13,728.00
|
| Rate for Payer: Humana Medicare |
$40,593.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$29,522.59
|
| Rate for Payer: United Healthcare Commercial |
$31,829.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,522.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$29,522.59
|
| Rate for Payer: Wellcare Medicare |
$28,046.46
|
|
|
MALIGNANT BREAST DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$22,904.52
|
|
|
Service Code
|
MSDRG 599
|
| Min. Negotiated Rate |
$5,328.51 |
| Max. Negotiated Rate |
$22,904.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9,162.54
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16,657.83
|
| Rate for Payer: Aetna Government |
$16,657.83
|
| Rate for Payer: Brighton Health Commercial |
$9,010.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16,990.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11,618.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9,588.15
|
| Rate for Payer: Elderplan Medicare Advantage |
$15,824.94
|
| Rate for Payer: EmblemHealth Commercial |
$5,328.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$16,657.83
|
| Rate for Payer: Group Health Inc Commercial |
$16,657.83
|
| Rate for Payer: Group Health Inc Medicare |
$16,657.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16,657.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,745.89
|
| Rate for Payer: Humana Medicare |
$22,904.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16,657.83
|
| Rate for Payer: United Healthcare Commercial |
$13,379.97
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16,657.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16,657.83
|
| Rate for Payer: Wellcare Medicare |
$15,824.94
|
|
|
MALIGNT-RMVL SKIN LESION 1.1-2.0
|
Facility
|
IP
|
$1,847.58
|
|
|
Service Code
|
HCPCS 11642
|
| Hospital Charge Code |
30300176
|
|
Hospital Revenue Code
|
510
|
| Rate for Payer: Cash Price |
$813.63
|
|
|
MALIGNT-RMVL SKIN LESION 1.1-2.0
|
Facility
|
OP
|
$1,847.58
|
|
|
Service Code
|
HCPCS 11642
|
| Hospital Charge Code |
30300176
|
|
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 |
$813.63
|
| Rate for Payer: Aetna Government |
$813.63
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$569.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$569.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$569.54
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$813.63
|
| Rate for Payer: Cash Price |
$813.63
|
| Rate for Payer: Cash Price |
$813.63
|
| Rate for Payer: Cash Price |
$813.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$813.63
|
| 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 |
$813.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$691.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$724.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$813.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$724.13
|
| 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 |
$923.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$813.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$691.59
|
| Rate for Payer: Healthfirst QHP |
$813.63
|
| Rate for Payer: Humana Medicare |
$829.90
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$813.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$813.63
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$813.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$813.63
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$650.90
|
| Rate for Payer: Wellcare Medicare |
$772.95
|
|
