ORIF SHOULDER
|
Facility
|
IP
|
$18,117.83
|
|
Service Code
|
HCPCS 23515
|
Hospital Charge Code |
40021705
|
Hospital Revenue Code
|
360
|
Rate for Payer: Cash Price |
$8,273.12
|
|
ORIF - TIBIA
|
Facility
|
OP
|
$3,738.95
|
|
Service Code
|
HCPCS 27535
|
Hospital Charge Code |
40021600
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$927.00 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,056.42
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$927.00
|
Rate for Payer: Aetna Government |
$927.00
|
Rate for Payer: Brighton Health Commercial |
$2,804.21
|
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: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Group Health Inc Commercial |
$1,869.48
|
Rate for Payer: Group Health Inc Medicare |
$1,308.63
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,869.48
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1,869.48
|
Rate for Payer: United Healthcare Commercial |
$2,683.00
|
|
ORIF WRIST
|
Facility
|
IP
|
$18,117.83
|
|
Service Code
|
HCPCS 25685
|
Hospital Charge Code |
40021680
|
Hospital Revenue Code
|
360
|
Rate for Payer: Cash Price |
$8,273.12
|
|
ORIF WRIST
|
Facility
|
OP
|
$18,117.83
|
|
Service Code
|
HCPCS 25685
|
Hospital Charge Code |
40021680
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$1,468.00 |
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 |
$1,468.00
|
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 ZYGOMA
|
Facility
|
OP
|
$14,691.05
|
|
Service Code
|
HCPCS 21365
|
Hospital Charge Code |
40011305
|
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 ZYGOMA
|
Facility
|
IP
|
$14,691.05
|
|
Service Code
|
HCPCS 21365
|
Hospital Charge Code |
40011305
|
Hospital Revenue Code
|
360
|
Rate for Payer: Cash Price |
$6,772.21
|
|
OR LEVEL 1
|
Facility
|
OP
|
$30.00
|
|
Hospital Charge Code |
40004400
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$10.50 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16.50
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.00
|
Rate for Payer: Aetna Government |
$15.00
|
Rate for Payer: Brighton Health Commercial |
$22.50
|
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: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Group Health Inc Commercial |
$15.00
|
Rate for Payer: Group Health Inc Medicare |
$10.50
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$15.00
|
|
OR LEVEL 1 - 15 MINUTES
|
Facility
|
OP
|
$562.50
|
|
Hospital Charge Code |
64900701
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$196.88 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$309.38
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$281.25
|
Rate for Payer: Aetna Government |
$281.25
|
Rate for Payer: Brighton Health Commercial |
$421.88
|
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 |
$281.25
|
Rate for Payer: Group Health Inc Medicare |
$196.88
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$281.25
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$281.25
|
|
OR LEVEL 1 ADD 15 MIN
|
Facility
|
OP
|
$450.00
|
|
Hospital Charge Code |
40004501
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$157.50 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$247.50
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$225.00
|
Rate for Payer: Aetna Government |
$225.00
|
Rate for Payer: Brighton Health Commercial |
$337.50
|
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: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Group Health Inc Commercial |
$225.00
|
Rate for Payer: Group Health Inc Medicare |
$157.50
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$225.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$225.00
|
|
OR LEVEL 2
|
Facility
|
OP
|
$45.00
|
|
Hospital Charge Code |
40004401
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$15.75 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24.75
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$22.50
|
Rate for Payer: Aetna Government |
$22.50
|
Rate for Payer: Brighton Health Commercial |
$33.75
|
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: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Group Health Inc Commercial |
$22.50
|
Rate for Payer: Group Health Inc Medicare |
$15.75
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$22.50
|
|
OR LEVEL 2 - 15 MINUTES
|
Facility
|
OP
|
$687.50
|
|
Hospital Charge Code |
64900702
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$240.62 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$378.12
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$343.75
|
Rate for Payer: Aetna Government |
$343.75
|
Rate for Payer: Brighton Health Commercial |
$515.62
|
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 |
$343.75
|
Rate for Payer: Group Health Inc Medicare |
$240.62
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$343.75
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$343.75
|
|
OR LEVEL 2 ADD 15 MIN
|
Facility
|
OP
|
$675.00
|
|
Hospital Charge Code |
40004502
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$236.25 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$371.25
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$337.50
|
Rate for Payer: Aetna Government |
$337.50
|
Rate for Payer: Brighton Health Commercial |
$506.25
|
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 |
$337.50
|
Rate for Payer: Group Health Inc Medicare |
$236.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$337.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$337.50
|
|
OR LEVEL 3
|
Facility
|
OP
|
$60.00
|
|
Hospital Charge Code |
40004402
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$21.00 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.00
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$30.00
|
Rate for Payer: Aetna Government |
$30.00
|
Rate for Payer: Brighton Health Commercial |
$45.00
|
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: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Group Health Inc Commercial |
$30.00
|
Rate for Payer: Group Health Inc Medicare |
$21.00
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$30.00
|
|
OR LEVEL 3 - 15 MINUTES
|
Facility
|
OP
|
$812.50
|
|
Hospital Charge Code |
64900703
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$284.38 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$446.88
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$406.25
|
Rate for Payer: Aetna Government |
$406.25
|
Rate for Payer: Brighton Health Commercial |
$609.38
|
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: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Group Health Inc Commercial |
$406.25
|
Rate for Payer: Group Health Inc Medicare |
$284.38
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$406.25
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$406.25
|
|
OR LEVEL 3 ADD 15 MIN
|
Facility
|
OP
|
$900.00
|
|
Hospital Charge Code |
40004504
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$315.00 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$495.00
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$450.00
|
Rate for Payer: Aetna Government |
$450.00
|
Rate for Payer: Brighton Health Commercial |
$675.00
|
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: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Group Health Inc Commercial |
$450.00
|
Rate for Payer: Group Health Inc Medicare |
$315.00
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$450.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$450.00
|
|
OR LEVEL 4
|
Facility
|
OP
|
$75.00
|
|
Hospital Charge Code |
40004403
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$26.25 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$41.25
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$37.50
|
Rate for Payer: Aetna Government |
$37.50
|
Rate for Payer: Brighton Health Commercial |
$56.25
|
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 |
$37.50
|
Rate for Payer: Group Health Inc Medicare |
$26.25
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$37.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$37.50
|
|
OR LEVEL 4 - 15 MINUTES
|
Facility
|
OP
|
$1,125.00
|
|
Hospital Charge Code |
64900704
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$393.75 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$618.75
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$562.50
|
Rate for Payer: Aetna Government |
$562.50
|
Rate for Payer: Brighton Health Commercial |
$843.75
|
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: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Group Health Inc Commercial |
$562.50
|
Rate for Payer: Group Health Inc Medicare |
$393.75
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$562.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$562.50
|
|
OR LEVEL 4 ADD 15 MIN
|
Facility
|
OP
|
$1,125.00
|
|
Hospital Charge Code |
40004506
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$393.75 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$618.75
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$562.50
|
Rate for Payer: Aetna Government |
$562.50
|
Rate for Payer: Brighton Health Commercial |
$843.75
|
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: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Group Health Inc Commercial |
$562.50
|
Rate for Payer: Group Health Inc Medicare |
$393.75
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$562.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$562.50
|
|
OR LEVEL 5
|
Facility
|
OP
|
$150.00
|
|
Hospital Charge Code |
40004404
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$52.50 |
Max. Negotiated Rate |
$2,915.00 |
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 |
$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 |
$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
|
|
OR LEVEL 5 - 15 MINUTES
|
Facility
|
OP
|
$1,625.00
|
|
Hospital Charge Code |
64900705
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$568.75 |
Max. Negotiated Rate |
$2,915.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$893.75
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$812.50
|
Rate for Payer: Aetna Government |
$812.50
|
Rate for Payer: Brighton Health Commercial |
$1,218.75
|
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: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Group Health Inc Commercial |
$812.50
|
Rate for Payer: Group Health Inc Medicare |
$568.75
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$812.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$812.50
|
|
OR LEVEL 5 ADD 15 MIN
|
Facility
|
OP
|
$22,500.00
|
|
Hospital Charge Code |
40004508
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$1,505.00 |
Max. Negotiated Rate |
$16,875.00 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$12,375.00
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11,250.00
|
Rate for Payer: Aetna Government |
$11,250.00
|
Rate for Payer: Brighton Health Commercial |
$16,875.00
|
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: EmblemHealth Commercial |
$1,505.00
|
Rate for Payer: Group Health Inc Commercial |
$11,250.00
|
Rate for Payer: Group Health Inc Medicare |
$7,875.00
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$11,250.00
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$11,250.00
|
|
O.R. PROCEDURES FOR OBESITY WITH CC
|
Facility
|
IP
|
$41,007.31
|
|
Service Code
|
MSDRG 620
|
Min. Negotiated Rate |
$13,867.93 |
Max. Negotiated Rate |
$41,007.31 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23,919.34
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$29,823.50
|
Rate for Payer: Aetna Government |
$29,823.50
|
Rate for Payer: Brighton Health Commercial |
$23,521.90
|
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$30,419.97
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28,013.77
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$23,118.17
|
Rate for Payer: Elderplan Medicare Advantage |
$28,332.32
|
Rate for Payer: EmblemHealth Commercial |
$13,910.40
|
Rate for Payer: Fidelis Medicare Advantage |
$29,823.50
|
Rate for Payer: Group Health Inc Commercial |
$29,823.50
|
Rate for Payer: Group Health Inc Medicare |
$29,823.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$29,823.50
|
Rate for Payer: Healthfirst Medicare Advantage |
$13,867.93
|
Rate for Payer: Humana Medicare |
$41,007.31
|
Rate for Payer: Senior Whole Health Medicare Advantage |
$29,823.50
|
Rate for Payer: United Healthcare Commercial |
$32,260.69
|
Rate for Payer: United Healthcare Medicare Advantage |
$29,823.50
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$29,823.50
|
Rate for Payer: Wellcare Medicare |
$28,332.32
|
|
O.R. PROCEDURES FOR OBESITY WITH MCC
|
Facility
|
IP
|
$59,699.34
|
|
Service Code
|
MSDRG 619
|
Min. Negotiated Rate |
$20,189.23 |
Max. Negotiated Rate |
$59,699.34 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$38,167.43
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$43,417.70
|
Rate for Payer: Aetna Government |
$43,417.70
|
Rate for Payer: Brighton Health Commercial |
$37,533.25
|
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$44,286.05
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$44,942.57
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$37,088.54
|
Rate for Payer: Elderplan Medicare Advantage |
$41,246.82
|
Rate for Payer: EmblemHealth Commercial |
$22,196.40
|
Rate for Payer: Fidelis Medicare Advantage |
$43,417.70
|
Rate for Payer: Group Health Inc Commercial |
$43,417.70
|
Rate for Payer: Group Health Inc Medicare |
$43,417.70
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$43,417.70
|
Rate for Payer: Healthfirst Medicare Advantage |
$20,189.23
|
Rate for Payer: Humana Medicare |
$59,699.34
|
Rate for Payer: Senior Whole Health Medicare Advantage |
$43,417.70
|
Rate for Payer: United Healthcare Commercial |
$51,755.92
|
Rate for Payer: United Healthcare Medicare Advantage |
$43,417.70
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43,417.70
|
Rate for Payer: Wellcare Medicare |
$41,246.82
|
|
O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC
|
Facility
|
IP
|
$39,007.14
|
|
Service Code
|
MSDRG 621
|
Min. Negotiated Rate |
$13,010.80 |
Max. Negotiated Rate |
$39,007.14 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$22,372.59
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$28,368.83
|
Rate for Payer: Aetna Government |
$28,368.83
|
Rate for Payer: Brighton Health Commercial |
$22,000.85
|
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$28,936.21
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$26,202.25
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$21,623.22
|
Rate for Payer: Elderplan Medicare Advantage |
$26,950.39
|
Rate for Payer: EmblemHealth Commercial |
$13,010.80
|
Rate for Payer: Fidelis Medicare Advantage |
$28,368.83
|
Rate for Payer: Group Health Inc Commercial |
$28,368.83
|
Rate for Payer: Group Health Inc Medicare |
$28,368.83
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$28,368.83
|
Rate for Payer: Healthfirst Medicare Advantage |
$13,191.51
|
Rate for Payer: Humana Medicare |
$39,007.14
|
Rate for Payer: Senior Whole Health Medicare Advantage |
$28,368.83
|
Rate for Payer: United Healthcare Commercial |
$30,174.55
|
Rate for Payer: United Healthcare Medicare Advantage |
$28,368.83
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$28,368.83
|
Rate for Payer: Wellcare Medicare |
$26,950.39
|
|
O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC
|
Facility
|
IP
|
$51,387.74
|
|
Service Code
|
MSDRG 940
|
Min. Negotiated Rate |
$17,378.40 |
Max. Negotiated Rate |
$51,387.74 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$31,946.52
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$37,372.90
|
Rate for Payer: Aetna Government |
$37,372.90
|
Rate for Payer: Brighton Health Commercial |
$31,415.70
|
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$38,120.36
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$37,415.02
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$30,876.48
|
Rate for Payer: Elderplan Medicare Advantage |
$35,504.26
|
Rate for Payer: EmblemHealth Commercial |
$18,578.60
|
Rate for Payer: Fidelis Medicare Advantage |
$37,372.90
|
Rate for Payer: Group Health Inc Commercial |
$37,372.90
|
Rate for Payer: Group Health Inc Medicare |
$37,372.90
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$37,372.90
|
Rate for Payer: Healthfirst Medicare Advantage |
$17,378.40
|
Rate for Payer: Humana Medicare |
$51,387.74
|
Rate for Payer: Senior Whole Health Medicare Advantage |
$37,372.90
|
Rate for Payer: United Healthcare Commercial |
$43,087.17
|
Rate for Payer: United Healthcare Medicare Advantage |
$37,372.90
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$37,372.90
|
Rate for Payer: Wellcare Medicare |
$35,504.26
|
|