|
ORIF - FINGER
|
Facility
|
IP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 26735
|
| Hospital Charge Code |
40021570
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,743.15
|
|
|
ORIF - FINGER
|
Facility
|
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 26735
|
| Hospital Charge Code |
40021570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,218.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,620.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,620.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,620.20
|
| Rate for Payer: Brighton Health Commercial |
$6,218.29
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,743.15
|
| 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 |
$3,743.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,181.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,331.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,743.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,331.40
|
| Rate for Payer: Group Health Inc Commercial |
$3,743.15
|
| Rate for Payer: Group Health Inc Medicare |
$3,743.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,145.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,743.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Humana Medicare |
$3,818.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,743.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,743.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,994.52
|
| Rate for Payer: Wellcare Medicare |
$3,555.99
|
|
|
ORIF - FOREARM
|
Facility
|
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 25515
|
| Hospital Charge Code |
40021575
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$13,588.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$8,273.12
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,791.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,791.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,791.18
|
| Rate for Payer: Brighton Health Commercial |
$13,588.37
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8,273.12
|
| 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 |
$8,273.12
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,032.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7,363.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$8,273.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7,363.08
|
| Rate for Payer: Group Health Inc Commercial |
$8,273.12
|
| Rate for Payer: Group Health Inc Medicare |
$8,273.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,058.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Humana Medicare |
$8,438.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8,273.12
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,273.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,273.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,618.50
|
| Rate for Payer: Wellcare Medicare |
$7,859.46
|
|
|
ORIF - FOREARM
|
Facility
|
IP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 25515
|
| Hospital Charge Code |
40021575
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,273.12
|
|
|
ORIF - HIP
|
Facility
|
OP
|
$4,008.41
|
|
|
Service Code
|
HCPCS 27244
|
| Hospital Charge Code |
40021580
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,272.85 |
| Max. Negotiated Rate |
$3,006.31 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,204.63
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,272.85
|
| Rate for Payer: Aetna Government |
$1,272.85
|
| Rate for Payer: Brighton Health Commercial |
$3,006.31
|
| 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 |
$2,004.20
|
| Rate for Payer: Group Health Inc Medicare |
$1,402.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,004.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,004.20
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
|
|
ORIF HUMERUS
|
Facility
|
IP
|
$36,044.28
|
|
|
Service Code
|
HCPCS 23615
|
| Hospital Charge Code |
40029803
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$15,219.83
|
|
|
ORIF HUMERUS
|
Facility
|
OP
|
$36,044.28
|
|
|
Service Code
|
HCPCS 23615
|
| Hospital Charge Code |
40029803
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$27,033.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15,219.83
|
| Rate for Payer: Aetna Government |
$15,219.83
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10,653.88
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10,653.88
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10,653.88
|
| Rate for Payer: Brighton Health Commercial |
$27,033.21
|
| Rate for Payer: Cash Price |
$15,219.83
|
| Rate for Payer: Cash Price |
$15,219.83
|
| Rate for Payer: Cash Price |
$15,219.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15,219.83
|
| 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 |
$15,219.83
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12,936.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13,545.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$15,219.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13,545.65
|
| Rate for Payer: Group Health Inc Commercial |
$15,219.83
|
| Rate for Payer: Group Health Inc Medicare |
$15,219.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,022.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15,219.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,936.86
|
| Rate for Payer: Healthfirst QHP |
$15,219.83
|
| Rate for Payer: Humana Medicare |
$15,524.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15,219.83
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,219.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15,219.83
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12,175.86
|
| Rate for Payer: Wellcare Medicare |
$14,458.84
|
|
|
ORIF ILIUM/SACRUM
|
Facility
|
OP
|
$2,534.40
|
|
|
Service Code
|
HCPCS 27217
|
| Hospital Charge Code |
40029590
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$877.95 |
| Max. Negotiated Rate |
$3,387.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$877.95
|
| Rate for Payer: Aetna Government |
$877.95
|
| Rate for Payer: Brighton Health Commercial |
$1,900.80
|
| 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 |
$1,267.20
|
| Rate for Payer: Group Health Inc Medicare |
$887.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,267.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,267.20
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
|
|
ORIF & INTRAMED NAIL FEMUR
|
Facility
|
OP
|
$4,378.06
|
|
|
Service Code
|
HCPCS 27506
|
| Hospital Charge Code |
40013172
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,382.28 |
| Max. Negotiated Rate |
$3,283.54 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,407.93
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,382.28
|
| Rate for Payer: Aetna Government |
$1,382.28
|
| Rate for Payer: Brighton Health Commercial |
$3,283.54
|
| 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 |
$2,189.03
|
| Rate for Payer: Group Health Inc Medicare |
$1,532.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,189.03
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,189.03
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
|
|
ORIF & INTRAMED NAIL TIBIA
|
Facility
|
IP
|
$36,044.28
|
|
|
Service Code
|
HCPCS 27759
|
| Hospital Charge Code |
40013171
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$15,219.83
|
|
|
ORIF & INTRAMED NAIL TIBIA
|
Facility
|
OP
|
$36,044.28
|
|
|
Service Code
|
HCPCS 27759
|
| Hospital Charge Code |
40013171
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$27,033.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15,219.83
|
| Rate for Payer: Aetna Government |
$15,219.83
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10,653.88
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10,653.88
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10,653.88
|
| Rate for Payer: Brighton Health Commercial |
$27,033.21
|
| Rate for Payer: Cash Price |
$15,219.83
|
| Rate for Payer: Cash Price |
$15,219.83
|
| Rate for Payer: Cash Price |
$15,219.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15,219.83
|
| 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 |
$15,219.83
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12,936.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13,545.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$15,219.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13,545.65
|
| Rate for Payer: Group Health Inc Commercial |
$15,219.83
|
| Rate for Payer: Group Health Inc Medicare |
$15,219.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,022.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15,219.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,936.86
|
| Rate for Payer: Healthfirst QHP |
$15,219.83
|
| Rate for Payer: Humana Medicare |
$15,524.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15,219.83
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,219.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15,219.83
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12,175.86
|
| Rate for Payer: Wellcare Medicare |
$14,458.84
|
|
|
ORIF MAND.
|
Facility
|
IP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 21462
|
| Hospital Charge Code |
40011255
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,772.21
|
|
|
ORIF MAND.
|
Facility
|
OP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 21462
|
| Hospital Charge Code |
40011255
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$11,018.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,772.21
|
| Rate for Payer: Aetna Government |
$6,772.21
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,740.55
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,740.55
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,740.55
|
| Rate for Payer: Brighton Health Commercial |
$11,018.29
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,772.21
|
| 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 |
$6,772.21
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,756.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6,027.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,772.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6,027.27
|
| Rate for Payer: Group Health Inc Commercial |
$6,772.21
|
| Rate for Payer: Group Health Inc Medicare |
$6,772.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,345.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,772.21
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,756.38
|
| Rate for Payer: Healthfirst QHP |
$6,772.21
|
| Rate for Payer: Humana Medicare |
$6,907.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,772.21
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,772.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,772.21
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,417.77
|
| Rate for Payer: Wellcare Medicare |
$6,433.60
|
|
|
ORIF - METACARPAL
|
Facility
|
IP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 26615
|
| Hospital Charge Code |
40021590
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,743.15
|
|
|
ORIF - METACARPAL
|
Facility
|
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 26615
|
| Hospital Charge Code |
40021590
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$6,218.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,620.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,620.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,620.20
|
| Rate for Payer: Brighton Health Commercial |
$6,218.29
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,743.15
|
| 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 |
$3,743.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,181.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,331.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,743.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,331.40
|
| Rate for Payer: Group Health Inc Commercial |
$3,743.15
|
| Rate for Payer: Group Health Inc Medicare |
$3,743.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,145.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,743.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Humana Medicare |
$3,818.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,743.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,743.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,994.52
|
| Rate for Payer: Wellcare Medicare |
$3,555.99
|
|
|
ORIF METATARSAL
|
Facility
|
IP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 28485
|
| Hospital Charge Code |
40082850
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,273.12
|
|
|
ORIF METATARSAL
|
Facility
|
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 28485
|
| Hospital Charge Code |
40082850
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$13,588.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$8,273.12
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,791.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,791.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,791.18
|
| Rate for Payer: Brighton Health Commercial |
$13,588.37
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8,273.12
|
| 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 |
$8,273.12
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,032.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7,363.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$8,273.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7,363.08
|
| Rate for Payer: Group Health Inc Commercial |
$8,273.12
|
| Rate for Payer: Group Health Inc Medicare |
$8,273.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,058.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Humana Medicare |
$8,438.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8,273.12
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,273.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,273.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,618.50
|
| Rate for Payer: Wellcare Medicare |
$7,859.46
|
|
|
ORIF NASAL FX
|
Facility
|
OP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 21330
|
| Hospital Charge Code |
40019515
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$11,018.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,772.21
|
| Rate for Payer: Aetna Government |
$6,772.21
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,740.55
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,740.55
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,740.55
|
| Rate for Payer: Brighton Health Commercial |
$11,018.29
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,772.21
|
| 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 |
$6,772.21
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,756.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6,027.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,772.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6,027.27
|
| Rate for Payer: Group Health Inc Commercial |
$6,772.21
|
| Rate for Payer: Group Health Inc Medicare |
$6,772.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,345.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,772.21
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,756.38
|
| Rate for Payer: Healthfirst QHP |
$6,772.21
|
| Rate for Payer: Humana Medicare |
$6,907.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,772.21
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,772.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,772.21
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,417.77
|
| Rate for Payer: Wellcare Medicare |
$6,433.60
|
|
|
ORIF NASAL FX
|
Facility
|
IP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 21330
|
| Hospital Charge Code |
40019515
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,772.21
|
|
|
ORIF NASAL FX SEPTUM
|
Facility
|
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 21336
|
| Hospital Charge Code |
40019514
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,218.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,620.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,620.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,620.20
|
| Rate for Payer: Brighton Health Commercial |
$6,218.29
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,743.15
|
| 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 |
$3,743.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,181.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,331.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,743.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,331.40
|
| Rate for Payer: Group Health Inc Commercial |
$3,743.15
|
| Rate for Payer: Group Health Inc Medicare |
$3,743.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,145.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,743.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Humana Medicare |
$3,818.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,743.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,743.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,994.52
|
| Rate for Payer: Wellcare Medicare |
$3,555.99
|
|
|
ORIF NASAL FX SEPTUM
|
Facility
|
IP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 21336
|
| Hospital Charge Code |
40019514
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,743.15
|
|
|
ORIF - ORBITAL FRACTURE
|
Facility
|
IP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 21385
|
| Hospital Charge Code |
40062385
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,772.21
|
|
|
ORIF - ORBITAL FRACTURE
|
Facility
|
OP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 21385
|
| Hospital Charge Code |
40062385
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$11,018.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,772.21
|
| Rate for Payer: Aetna Government |
$6,772.21
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,740.55
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,740.55
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,740.55
|
| Rate for Payer: Brighton Health Commercial |
$11,018.29
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,772.21
|
| 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 |
$6,772.21
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,756.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6,027.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,772.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6,027.27
|
| Rate for Payer: Group Health Inc Commercial |
$6,772.21
|
| Rate for Payer: Group Health Inc Medicare |
$6,772.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,345.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,772.21
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,756.38
|
| Rate for Payer: Healthfirst QHP |
$6,772.21
|
| Rate for Payer: Humana Medicare |
$6,907.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,772.21
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,772.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,772.21
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,417.77
|
| Rate for Payer: Wellcare Medicare |
$6,433.60
|
|
|
ORIF PUBIC SYMPHYSIS
|
Facility
|
OP
|
$3,322.73
|
|
|
Service Code
|
HCPCS 27218
|
| Hospital Charge Code |
40029591
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,162.96 |
| Max. Negotiated Rate |
$29,801.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$29,801.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,212.84
|
| Rate for Payer: Aetna Government |
$1,212.84
|
| Rate for Payer: Brighton Health Commercial |
$2,492.05
|
| 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 |
$1,661.36
|
| Rate for Payer: Group Health Inc Medicare |
$1,162.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,661.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,661.36
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
|
|
ORIF SHOULDER
|
Facility
|
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 23515
|
| Hospital Charge Code |
40021705
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$13,588.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$8,273.12
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,791.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,791.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,791.18
|
| Rate for Payer: Brighton Health Commercial |
$13,588.37
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8,273.12
|
| 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 |
$8,273.12
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,032.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7,363.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$8,273.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7,363.08
|
| Rate for Payer: Group Health Inc Commercial |
$8,273.12
|
| Rate for Payer: Group Health Inc Medicare |
$8,273.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,058.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Humana Medicare |
$8,438.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8,273.12
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,273.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,273.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,618.50
|
| Rate for Payer: Wellcare Medicare |
$7,859.46
|
|
