St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MEDTRONIC PACEMAKER ADVDD01

Facility

$10,600.00

Service Code	HCPCS C1899
Hospital Charge Code	40208106
Hospital Revenue Code	278
Min. Negotiated Rate	$5,300.00
Max. Negotiated Rate	$5,300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,300.00

MEDTRONIC PACEMAKER ADVDD01

Facility

$10,600.00

Service Code	HCPCS C1899
Hospital Charge Code	40208106
Hospital Revenue Code	278
Min. Negotiated Rate	$3,710.00
Max. Negotiated Rate	$11,130.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,830.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,962.88
Rate for Payer: Aetna Government	$5,962.88
Rate for Payer: Brighton Health Commercial	$6,360.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,095.00
Rate for Payer: EmblemHealth Commercial	$5,300.00
Rate for Payer: Fidelis Medicare Advantage	$11,130.00
Rate for Payer: Group Health Inc Commercial	$5,300.00
Rate for Payer: Group Health Inc Medicare	$3,710.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,890.00

MEDTRONIC PACEMAKER DUAL CHAMBER

Facility

$13,590.00

Service Code	HCPCS C2619
Hospital Charge Code	40200395
Hospital Revenue Code	275
Min. Negotiated Rate	$3,302.17
Max. Negotiated Rate	$14,269.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,474.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,302.17
Rate for Payer: Aetna Government	$3,302.17
Rate for Payer: Brighton Health Commercial	$8,154.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,795.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,814.25
Rate for Payer: EmblemHealth Commercial	$6,795.00
Rate for Payer: Fidelis Medicare Advantage	$14,269.50
Rate for Payer: Group Health Inc Commercial	$6,795.00
Rate for Payer: Group Health Inc Medicare	$4,756.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,795.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,795.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,833.50

MEDTRONIC PACEMAKER VEDR01

Facility

$11,700.00

Service Code	HCPCS C2621
Hospital Charge Code	40201144
Hospital Revenue Code	275
Min. Negotiated Rate	$3,640.47
Max. Negotiated Rate	$12,285.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,435.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,640.47
Rate for Payer: Aetna Government	$3,640.47
Rate for Payer: Brighton Health Commercial	$7,020.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,850.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,727.50
Rate for Payer: EmblemHealth Commercial	$5,850.00
Rate for Payer: Fidelis Medicare Advantage	$12,285.00
Rate for Payer: Group Health Inc Commercial	$5,850.00
Rate for Payer: Group Health Inc Medicare	$4,095.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,850.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,605.00

MEDTRONIC PACING CABLES

Facility

$150.00

Hospital Charge Code	40203005
Hospital Revenue Code	270
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$75.00
Rate for Payer: Aetna Government	$75.00
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.00
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

MEDTRONIC PIN PLUG KIT

Facility

$200.00

Hospital Charge Code	40208185
Hospital Revenue Code	270
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$160.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$100.00
Rate for Payer: Aetna Government	$100.00
Rate for Payer: Brighton Health Commercial	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

MEDTRONIC SECURE S LEAD 6935-55

Facility

$10,678.00

Service Code	HCPCS C1777
Hospital Charge Code	66572903
Hospital Revenue Code	275
Min. Negotiated Rate	$988.18
Max. Negotiated Rate	$11,211.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,872.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$988.18
Rate for Payer: Aetna Government	$988.18
Rate for Payer: Brighton Health Commercial	$6,406.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,339.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,139.85
Rate for Payer: EmblemHealth Commercial	$5,339.00
Rate for Payer: Fidelis Medicare Advantage	$11,211.90
Rate for Payer: Group Health Inc Commercial	$5,339.00
Rate for Payer: Group Health Inc Medicare	$3,737.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,339.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,339.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,940.70

MEDTRONIC SENSE LEAD 407458

Facility

$1,248.00

Service Code	HCPCS C1898
Hospital Charge Code	66576686
Hospital Revenue Code	278
Min. Negotiated Rate	$624.00
Max. Negotiated Rate	$624.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$624.00
Rate for Payer: Hamaspik Choice Inc Medicare	$624.00

MEDTRONIC SENSE LEAD 407458

Facility

$1,248.00

Service Code	HCPCS C1898
Hospital Charge Code	66576686
Hospital Revenue Code	278
Min. Negotiated Rate	$98.92
Max. Negotiated Rate	$1,310.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$686.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.92
Rate for Payer: Aetna Government	$98.92
Rate for Payer: Brighton Health Commercial	$748.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$624.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$717.60
Rate for Payer: EmblemHealth Commercial	$624.00
Rate for Payer: Fidelis Medicare Advantage	$1,310.40
Rate for Payer: Group Health Inc Commercial	$624.00
Rate for Payer: Group Health Inc Medicare	$436.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$624.00
Rate for Payer: Hamaspik Choice Inc Medicare	$624.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$811.20

MEDTRONIC SENSIA PACEMAKER-SEDR01

Facility

$10,772.00

Service Code	HCPCS C1785
Hospital Charge Code	66573202
Hospital Revenue Code	275
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$11,310.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,924.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Brighton Health Commercial	$6,463.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,386.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,193.90
Rate for Payer: EmblemHealth Commercial	$5,386.00
Rate for Payer: Fidelis Medicare Advantage	$11,310.60
Rate for Payer: Group Health Inc Commercial	$5,386.00
Rate for Payer: Group Health Inc Medicare	$3,770.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,386.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,386.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,001.80

MEDTRONIC SINGLE CHAMBERPACEMAKER

Facility

$13,590.00

Service Code	HCPCS C2620
Hospital Charge Code	40201143
Hospital Revenue Code	275
Min. Negotiated Rate	$582.92
Max. Negotiated Rate	$14,269.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,474.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$582.92
Rate for Payer: Aetna Government	$582.92
Rate for Payer: Brighton Health Commercial	$8,154.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,795.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,814.25
Rate for Payer: EmblemHealth Commercial	$6,795.00
Rate for Payer: Fidelis Medicare Advantage	$14,269.50
Rate for Payer: Group Health Inc Commercial	$6,795.00
Rate for Payer: Group Health Inc Medicare	$4,756.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,795.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,795.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,833.50

MEDTRONIC SPRINT MRI LEAD 6935M72

Facility

$7,665.00

Service Code	HCPCS C1777
Hospital Charge Code	66576685
Hospital Revenue Code	275
Min. Negotiated Rate	$988.18
Max. Negotiated Rate	$8,048.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,215.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$988.18
Rate for Payer: Aetna Government	$988.18
Rate for Payer: Brighton Health Commercial	$4,599.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,832.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,407.38
Rate for Payer: EmblemHealth Commercial	$3,832.50
Rate for Payer: Fidelis Medicare Advantage	$8,048.25
Rate for Payer: Group Health Inc Commercial	$3,832.50
Rate for Payer: Group Health Inc Medicare	$2,682.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,832.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,832.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,982.25

MEDTRONIC SUCTION/ANTICOAGULATION

Facility

$48.00

Hospital Charge Code	40204001
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

MEDTRONIC TYRX ABSORBABLE ENVELOP

Facility

$2,590.00

Hospital Charge Code	66572898
Hospital Revenue Code	279
Min. Negotiated Rate	$906.50
Max. Negotiated Rate	$2,072.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,424.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,295.00
Rate for Payer: Aetna Government	$1,295.00
Rate for Payer: Brighton Health Commercial	$1,942.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,072.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,761.20
Rate for Payer: Group Health Inc Commercial	$1,295.00
Rate for Payer: Group Health Inc Medicare	$906.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,295.00

MEDTRONIC VALVE MEDIUM PRESSURE

Facility

$1,156.40

Hospital Charge Code	40203373
Hospital Revenue Code	272
Min. Negotiated Rate	$404.74
Max. Negotiated Rate	$925.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$636.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$578.20
Rate for Payer: Aetna Government	$578.20
Rate for Payer: Brighton Health Commercial	$867.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$925.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$786.35
Rate for Payer: Group Health Inc Commercial	$578.20
Rate for Payer: Group Health Inc Medicare	$404.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.20
Rate for Payer: Hamaspik Choice Inc Medicare	$578.20

MEDTRONIC VALVE MEDIUM PRESSURE

Facility

$1,156.40

Hospital Charge Code	40009357
Hospital Revenue Code	272
Min. Negotiated Rate	$404.74
Max. Negotiated Rate	$925.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$636.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$578.20
Rate for Payer: Aetna Government	$578.20
Rate for Payer: Brighton Health Commercial	$867.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$925.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$786.35
Rate for Payer: Group Health Inc Commercial	$578.20
Rate for Payer: Group Health Inc Medicare	$404.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.20
Rate for Payer: Hamaspik Choice Inc Medicare	$578.20

MEDTRONIC VDD PACE LEAD-5038S

Facility

$1,882.00

Service Code	HCPCS C1779
Hospital Charge Code	66573203
Hospital Revenue Code	275
Min. Negotiated Rate	$215.00
Max. Negotiated Rate	$1,976.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,035.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$215.00
Rate for Payer: Aetna Government	$215.00
Rate for Payer: Brighton Health Commercial	$1,129.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$941.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,082.15
Rate for Payer: EmblemHealth Commercial	$941.00
Rate for Payer: Fidelis Medicare Advantage	$1,976.10
Rate for Payer: Group Health Inc Commercial	$941.00
Rate for Payer: Group Health Inc Medicare	$658.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$941.00
Rate for Payer: Hamaspik Choice Inc Medicare	$941.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,223.30

MEDTRONIC VENTRICULAR LEAD 58CM

Facility

$1,300.00

Hospital Charge Code	40201146
Hospital Revenue Code	270
Min. Negotiated Rate	$455.00
Max. Negotiated Rate	$1,040.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$715.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$650.00
Rate for Payer: Aetna Government	$650.00
Rate for Payer: Brighton Health Commercial	$975.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,040.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$884.00
Rate for Payer: Group Health Inc Commercial	$650.00
Rate for Payer: Group Health Inc Medicare	$455.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$650.00
Rate for Payer: Hamaspik Choice Inc Medicare	$650.00

MEDTRONIC VISIA AF ICD DVAB1D4

Facility

$26,040.00

Service Code	HCPCS C1722
Hospital Charge Code	66576687
Hospital Revenue Code	275
Min. Negotiated Rate	$3,988.80
Max. Negotiated Rate	$27,342.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14,322.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,988.80
Rate for Payer: Aetna Government	$3,988.80
Rate for Payer: Brighton Health Commercial	$15,624.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13,020.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$14,973.00
Rate for Payer: EmblemHealth Commercial	$13,020.00
Rate for Payer: Fidelis Medicare Advantage	$27,342.00
Rate for Payer: Group Health Inc Commercial	$13,020.00
Rate for Payer: Group Health Inc Medicare	$9,114.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$13,020.00
Rate for Payer: Hamaspik Choice Inc Medicare	$13,020.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$16,926.00

MEDTRON VISIA AF VR SURESCAN DFB

Facility

$29,190.00

Service Code	HCPCS C1722
Hospital Charge Code	66573148
Hospital Revenue Code	275
Min. Negotiated Rate	$3,988.80
Max. Negotiated Rate	$30,649.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16,054.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,988.80
Rate for Payer: Aetna Government	$3,988.80
Rate for Payer: Brighton Health Commercial	$17,514.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14,595.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$16,784.25
Rate for Payer: EmblemHealth Commercial	$14,595.00
Rate for Payer: Fidelis Medicare Advantage	$30,649.50
Rate for Payer: Group Health Inc Commercial	$14,595.00
Rate for Payer: Group Health Inc Medicare	$10,216.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$14,595.00
Rate for Payer: Hamaspik Choice Inc Medicare	$14,595.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18,973.50

MEDTRON VISIA ICD-VR MRI DVFB1D4

Facility

$29,190.00

Service Code	HCPCS C1722
Hospital Charge Code	66576683
Hospital Revenue Code	275
Min. Negotiated Rate	$3,988.80
Max. Negotiated Rate	$30,649.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16,054.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,988.80
Rate for Payer: Aetna Government	$3,988.80
Rate for Payer: Brighton Health Commercial	$17,514.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14,595.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$16,784.25
Rate for Payer: EmblemHealth Commercial	$14,595.00
Rate for Payer: Fidelis Medicare Advantage	$30,649.50
Rate for Payer: Group Health Inc Commercial	$14,595.00
Rate for Payer: Group Health Inc Medicare	$10,216.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$14,595.00
Rate for Payer: Hamaspik Choice Inc Medicare	$14,595.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18,973.50

MEDTRON VIVA QUAD XT ICD DTBA1QQ

Facility

$40,220.00

Service Code	HCPCS C1882
Hospital Charge Code	66573444
Hospital Revenue Code	275
Min. Negotiated Rate	$4,752.01
Max. Negotiated Rate	$42,231.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22,121.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,752.01
Rate for Payer: Aetna Government	$4,752.01
Rate for Payer: Brighton Health Commercial	$24,132.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20,110.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$23,126.50
Rate for Payer: EmblemHealth Commercial	$20,110.00
Rate for Payer: Fidelis Medicare Advantage	$42,231.00
Rate for Payer: Group Health Inc Commercial	$20,110.00
Rate for Payer: Group Health Inc Medicare	$14,077.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,110.00
Rate for Payer: Hamaspik Choice Inc Medicare	$20,110.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26,143.00

MEDTR VIVA CRT-P PACEMAKER C6TR01

Facility

$22,868.00

Service Code	HCPCS C2621
Hospital Charge Code	66576657
Hospital Revenue Code	275
Min. Negotiated Rate	$3,640.47
Max. Negotiated Rate	$24,011.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12,577.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,640.47
Rate for Payer: Aetna Government	$3,640.47
Rate for Payer: Brighton Health Commercial	$13,720.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11,434.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13,149.10
Rate for Payer: EmblemHealth Commercial	$11,434.00
Rate for Payer: Fidelis Medicare Advantage	$24,011.40
Rate for Payer: Group Health Inc Commercial	$11,434.00
Rate for Payer: Group Health Inc Medicare	$8,003.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,434.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11,434.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14,864.20

MED VENTRICULAR L E

Facility

$1,984.50

Hospital Charge Code	40004031
Hospital Revenue Code	279
Min. Negotiated Rate	$694.58
Max. Negotiated Rate	$1,587.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,091.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$992.25
Rate for Payer: Aetna Government	$992.25
Rate for Payer: Brighton Health Commercial	$1,488.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,587.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,349.46
Rate for Payer: Group Health Inc Commercial	$992.25
Rate for Payer: Group Health Inc Medicare	$694.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$992.25
Rate for Payer: Hamaspik Choice Inc Medicare	$992.25

MED VISIA AF VR ICD- DVAB1D1

Facility

$26,040.00

Service Code	HCPCS C1722
Hospital Charge Code	66573442
Hospital Revenue Code	275
Min. Negotiated Rate	$3,988.80
Max. Negotiated Rate	$27,342.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14,322.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,988.80
Rate for Payer: Aetna Government	$3,988.80
Rate for Payer: Brighton Health Commercial	$15,624.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13,020.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$14,973.00
Rate for Payer: EmblemHealth Commercial	$13,020.00
Rate for Payer: Fidelis Medicare Advantage	$27,342.00
Rate for Payer: Group Health Inc Commercial	$13,020.00
Rate for Payer: Group Health Inc Medicare	$9,114.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$13,020.00
Rate for Payer: Hamaspik Choice Inc Medicare	$13,020.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$16,926.00

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