|
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC
|
Facility
|
IP
|
$147,982.62
|
|
|
Service Code
|
MSDRG 957
|
| Min. Negotiated Rate |
$50,045.03 |
| Max. Negotiated Rate |
$147,982.62 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$106,643.21
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$107,623.72
|
| Rate for Payer: Aetna Government |
$107,623.72
|
| Rate for Payer: Brighton Health Commercial |
$104,871.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$109,776.19
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$124,898.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$103,071.23
|
| Rate for Payer: Elderplan Medicare Advantage |
$102,242.53
|
| Rate for Payer: EmblemHealth Commercial |
$62,018.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$107,623.72
|
| Rate for Payer: Group Health Inc Commercial |
$107,623.72
|
| Rate for Payer: Group Health Inc Medicare |
$107,623.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$107,623.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$50,045.03
|
| Rate for Payer: Humana Medicare |
$147,982.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$107,623.72
|
| Rate for Payer: United Healthcare Commercial |
$143,832.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$107,623.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$107,623.72
|
| Rate for Payer: Wellcare Medicare |
$102,242.53
|
|
|
OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC
|
Facility
|
IP
|
$58,362.70
|
|
|
Service Code
|
MSDRG 959
|
| Min. Negotiated Rate |
$19,737.20 |
| Max. Negotiated Rate |
$58,362.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$37,340.24
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$42,445.60
|
| Rate for Payer: Aetna Government |
$42,445.60
|
| Rate for Payer: Brighton Health Commercial |
$36,719.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$43,294.51
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$43,732.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$36,089.54
|
| Rate for Payer: Elderplan Medicare Advantage |
$40,323.32
|
| Rate for Payer: EmblemHealth Commercial |
$21,715.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$42,445.60
|
| Rate for Payer: Group Health Inc Commercial |
$42,445.60
|
| Rate for Payer: Group Health Inc Medicare |
$42,445.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$42,445.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$19,737.20
|
| Rate for Payer: Humana Medicare |
$58,362.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$42,445.60
|
| Rate for Payer: United Healthcare Commercial |
$50,361.84
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42,445.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$42,445.60
|
| Rate for Payer: Wellcare Medicare |
$40,323.32
|
|
|
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC
|
Facility
|
IP
|
$45,507.32
|
|
|
Service Code
|
MSDRG 803
|
| Min. Negotiated Rate |
$15,389.75 |
| Max. Negotiated Rate |
$45,507.32 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$27,399.16
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$33,096.23
|
| Rate for Payer: Aetna Government |
$33,096.23
|
| Rate for Payer: Brighton Health Commercial |
$26,943.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$33,758.15
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32,089.26
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$26,481.43
|
| Rate for Payer: Elderplan Medicare Advantage |
$31,441.42
|
| Rate for Payer: EmblemHealth Commercial |
$15,934.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$33,096.23
|
| Rate for Payer: Group Health Inc Commercial |
$33,096.23
|
| Rate for Payer: Group Health Inc Medicare |
$33,096.23
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33,096.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15,389.75
|
| Rate for Payer: Humana Medicare |
$45,507.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33,096.23
|
| Rate for Payer: United Healthcare Commercial |
$36,954.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,096.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33,096.23
|
| Rate for Payer: Wellcare Medicare |
$31,441.42
|
|
|
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC
|
Facility
|
IP
|
$75,493.12
|
|
|
Service Code
|
MSDRG 802
|
| Min. Negotiated Rate |
$25,530.40 |
| Max. Negotiated Rate |
$75,493.12 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$49,989.97
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$54,904.09
|
| Rate for Payer: Aetna Government |
$54,904.09
|
| Rate for Payer: Brighton Health Commercial |
$49,159.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$56,002.17
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$59,246.49
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$48,892.74
|
| Rate for Payer: Elderplan Medicare Advantage |
$52,158.89
|
| Rate for Payer: EmblemHealth Commercial |
$29,071.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$54,904.09
|
| Rate for Payer: Group Health Inc Commercial |
$54,904.09
|
| Rate for Payer: Group Health Inc Medicare |
$54,904.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$54,904.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25,530.40
|
| Rate for Payer: Humana Medicare |
$75,493.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$54,904.09
|
| Rate for Payer: United Healthcare Commercial |
$68,228.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$54,904.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$54,904.09
|
| Rate for Payer: Wellcare Medicare |
$52,158.89
|
|
|
OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC
|
Facility
|
IP
|
$33,155.26
|
|
|
Service Code
|
MSDRG 804
|
| Min. Negotiated Rate |
$10,379.20 |
| Max. Negotiated Rate |
$33,155.26 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17,847.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$24,112.92
|
| Rate for Payer: Aetna Government |
$24,112.92
|
| Rate for Payer: Brighton Health Commercial |
$17,550.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$24,595.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20,902.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17,249.56
|
| Rate for Payer: Elderplan Medicare Advantage |
$22,907.27
|
| Rate for Payer: EmblemHealth Commercial |
$10,379.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$24,112.92
|
| Rate for Payer: Group Health Inc Commercial |
$24,112.92
|
| Rate for Payer: Group Health Inc Medicare |
$24,112.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$24,112.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11,212.51
|
| Rate for Payer: Humana Medicare |
$33,155.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$24,112.92
|
| Rate for Payer: United Healthcare Commercial |
$24,071.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$24,112.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$24,112.92
|
| Rate for Payer: Wellcare Medicare |
$22,907.27
|
|
|
OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC
|
Facility
|
IP
|
$44,593.96
|
|
|
Service Code
|
MSDRG 205
|
| Min. Negotiated Rate |
$15,080.87 |
| Max. Negotiated Rate |
$44,593.96 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$26,692.87
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$32,431.97
|
| Rate for Payer: Aetna Government |
$32,431.97
|
| Rate for Payer: Brighton Health Commercial |
$26,249.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$33,080.61
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$31,262.07
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$25,798.80
|
| Rate for Payer: Elderplan Medicare Advantage |
$30,810.37
|
| Rate for Payer: EmblemHealth Commercial |
$15,523.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$32,431.97
|
| Rate for Payer: Group Health Inc Commercial |
$32,431.97
|
| Rate for Payer: Group Health Inc Medicare |
$32,431.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$32,431.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15,080.87
|
| Rate for Payer: Humana Medicare |
$44,593.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$32,431.97
|
| Rate for Payer: United Healthcare Commercial |
$36,001.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,431.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$32,431.97
|
| Rate for Payer: Wellcare Medicare |
$30,810.37
|
|
|
OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC
|
Facility
|
IP
|
$27,494.09
|
|
|
Service Code
|
MSDRG 206
|
| Min. Negotiated Rate |
$7,833.26 |
| Max. Negotiated Rate |
$27,494.09 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13,469.56
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$19,995.70
|
| Rate for Payer: Aetna Government |
$19,995.70
|
| Rate for Payer: Brighton Health Commercial |
$13,245.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$20,395.61
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$15,775.23
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$13,018.40
|
| Rate for Payer: Elderplan Medicare Advantage |
$18,995.92
|
| Rate for Payer: EmblemHealth Commercial |
$7,833.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$19,995.70
|
| Rate for Payer: Group Health Inc Commercial |
$19,995.70
|
| Rate for Payer: Group Health Inc Medicare |
$19,995.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19,995.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9,298.00
|
| Rate for Payer: Humana Medicare |
$27,494.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19,995.70
|
| Rate for Payer: United Healthcare Commercial |
$18,166.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,995.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19,995.70
|
| Rate for Payer: Wellcare Medicare |
$18,995.92
|
|
|
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC
|
Facility
|
IP
|
$44,775.10
|
|
|
Service Code
|
MSDRG 167
|
| Min. Negotiated Rate |
$15,142.13 |
| Max. Negotiated Rate |
$44,775.10 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$26,832.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$32,563.71
|
| Rate for Payer: Aetna Government |
$32,563.71
|
| Rate for Payer: Brighton Health Commercial |
$26,387.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$33,214.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$31,426.13
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$25,934.19
|
| Rate for Payer: Elderplan Medicare Advantage |
$30,935.52
|
| Rate for Payer: EmblemHealth Commercial |
$15,604.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$32,563.71
|
| Rate for Payer: Group Health Inc Commercial |
$32,563.71
|
| Rate for Payer: Group Health Inc Medicare |
$32,563.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$32,563.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15,142.13
|
| Rate for Payer: Humana Medicare |
$44,775.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$32,563.71
|
| Rate for Payer: United Healthcare Commercial |
$36,190.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$32,563.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$32,563.71
|
| Rate for Payer: Wellcare Medicare |
$30,935.52
|
|
|
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC
|
Facility
|
IP
|
$87,448.53
|
|
|
Service Code
|
MSDRG 166
|
| Min. Negotiated Rate |
$29,573.50 |
| Max. Negotiated Rate |
$87,448.53 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$59,832.26
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$63,598.93
|
| Rate for Payer: Aetna Government |
$63,598.93
|
| Rate for Payer: Brighton Health Commercial |
$58,838.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$64,870.91
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$70,074.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$57,828.19
|
| Rate for Payer: Elderplan Medicare Advantage |
$60,418.98
|
| Rate for Payer: EmblemHealth Commercial |
$34,795.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$63,598.93
|
| Rate for Payer: Group Health Inc Commercial |
$63,598.93
|
| Rate for Payer: Group Health Inc Medicare |
$63,598.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$63,598.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29,573.50
|
| Rate for Payer: Humana Medicare |
$87,448.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$63,598.93
|
| Rate for Payer: United Healthcare Commercial |
$80,697.47
|
| Rate for Payer: United Healthcare Medicare Advantage |
$63,598.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$63,598.93
|
| Rate for Payer: Wellcare Medicare |
$60,418.98
|
|
|
OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$35,925.79
|
|
|
Service Code
|
MSDRG 168
|
| Min. Negotiated Rate |
$11,625.10 |
| Max. Negotiated Rate |
$35,925.79 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19,989.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$26,127.85
|
| Rate for Payer: Aetna Government |
$26,127.85
|
| Rate for Payer: Brighton Health Commercial |
$19,657.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26,650.41
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$23,411.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19,320.24
|
| Rate for Payer: Elderplan Medicare Advantage |
$24,821.46
|
| Rate for Payer: EmblemHealth Commercial |
$11,625.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$26,127.85
|
| Rate for Payer: Group Health Inc Commercial |
$26,127.85
|
| Rate for Payer: Group Health Inc Medicare |
$26,127.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26,127.85
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,149.45
|
| Rate for Payer: Humana Medicare |
$35,925.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26,127.85
|
| Rate for Payer: United Healthcare Commercial |
$26,960.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,127.85
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26,127.85
|
| Rate for Payer: Wellcare Medicare |
$24,821.46
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC
|
Facility
|
IP
|
$43,379.32
|
|
|
Service Code
|
MSDRG 580
|
| Min. Negotiated Rate |
$14,670.10 |
| Max. Negotiated Rate |
$43,379.32 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$25,753.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$31,548.60
|
| Rate for Payer: Aetna Government |
$31,548.60
|
| Rate for Payer: Brighton Health Commercial |
$25,325.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$32,179.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$30,162.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$24,891.01
|
| Rate for Payer: Elderplan Medicare Advantage |
$29,971.17
|
| Rate for Payer: EmblemHealth Commercial |
$14,977.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$31,548.60
|
| Rate for Payer: Group Health Inc Commercial |
$31,548.60
|
| Rate for Payer: Group Health Inc Medicare |
$31,548.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31,548.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14,670.10
|
| Rate for Payer: Humana Medicare |
$43,379.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$31,548.60
|
| Rate for Payer: United Healthcare Commercial |
$34,734.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31,548.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$31,548.60
|
| Rate for Payer: Wellcare Medicare |
$29,971.17
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC
|
Facility
|
IP
|
$73,803.69
|
|
|
Service Code
|
MSDRG 579
|
| Min. Negotiated Rate |
$24,959.07 |
| Max. Negotiated Rate |
$73,803.69 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$49,280.74
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$53,675.41
|
| Rate for Payer: Aetna Government |
$53,675.41
|
| Rate for Payer: Brighton Health Commercial |
$48,461.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$54,748.92
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$57,716.45
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$47,630.09
|
| Rate for Payer: Elderplan Medicare Advantage |
$50,991.64
|
| Rate for Payer: EmblemHealth Commercial |
$28,659.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$53,675.41
|
| Rate for Payer: Group Health Inc Commercial |
$53,675.41
|
| Rate for Payer: Group Health Inc Medicare |
$53,675.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$53,675.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24,959.07
|
| Rate for Payer: Humana Medicare |
$73,803.69
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$53,675.41
|
| Rate for Payer: United Healthcare Commercial |
$66,466.33
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53,675.41
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$53,675.41
|
| Rate for Payer: Wellcare Medicare |
$50,991.64
|
|
|
OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$35,754.19
|
|
|
Service Code
|
MSDRG 581
|
| Min. Negotiated Rate |
$11,548.00 |
| Max. Negotiated Rate |
$35,754.19 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19,857.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$26,003.05
|
| Rate for Payer: Aetna Government |
$26,003.05
|
| Rate for Payer: Brighton Health Commercial |
$19,527.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26,523.11
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$23,256.16
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19,191.98
|
| Rate for Payer: Elderplan Medicare Advantage |
$24,702.90
|
| Rate for Payer: EmblemHealth Commercial |
$11,548.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$26,003.05
|
| Rate for Payer: Group Health Inc Commercial |
$26,003.05
|
| Rate for Payer: Group Health Inc Medicare |
$26,003.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26,003.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,091.42
|
| Rate for Payer: Humana Medicare |
$35,754.19
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26,003.05
|
| Rate for Payer: United Healthcare Commercial |
$26,781.82
|
| Rate for Payer: United Healthcare Medicare Advantage |
$26,003.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26,003.05
|
| Rate for Payer: Wellcare Medicare |
$24,702.90
|
|
|
OTHER TMJ FILMS, BY REPORT
|
Facility
|
IP
|
$72.50
|
|
|
Service Code
|
HCPCS D0321
|
| Hospital Charge Code |
42300175
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$105.08
|
|
|
OTHER TMJ FILMS, BY REPORT
|
Facility
|
OP
|
$72.50
|
|
|
Service Code
|
HCPCS D0321
|
| Hospital Charge Code |
42300175
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$36.25 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$39.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$105.08
|
| Rate for Payer: Aetna Government |
$105.08
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$73.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$73.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$73.56
|
| Rate for Payer: Brighton Health Commercial |
$54.38
|
| Rate for Payer: Cash Price |
$105.08
|
| Rate for Payer: Cash Price |
$105.08
|
| Rate for Payer: Cash Price |
$105.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$105.08
|
| 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 |
$105.08
|
| Rate for Payer: EmblemHealth Commercial |
$105.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$89.32
|
| Rate for Payer: Fidelis Essential Plan QHP |
$93.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$105.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$93.52
|
| Rate for Payer: Group Health Inc Commercial |
$105.08
|
| Rate for Payer: Group Health Inc Medicare |
$105.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$105.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$89.32
|
| Rate for Payer: Healthfirst QHP |
$105.08
|
| Rate for Payer: Humana Medicare |
$107.18
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$105.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$105.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$105.08
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$84.06
|
| Rate for Payer: Wellcare Medicare |
$99.83
|
|
|
OTHER VASCULAR PROCEDURES WITH CC
|
Facility
|
IP
|
$58,719.26
|
|
|
Service Code
|
MSDRG 253
|
| Min. Negotiated Rate |
$19,857.79 |
| Max. Negotiated Rate |
$58,719.26 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$37,615.97
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$42,704.92
|
| Rate for Payer: Aetna Government |
$42,704.92
|
| Rate for Payer: Brighton Health Commercial |
$36,990.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$43,559.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$44,054.95
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$36,356.03
|
| Rate for Payer: Elderplan Medicare Advantage |
$40,569.67
|
| Rate for Payer: EmblemHealth Commercial |
$21,875.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$42,704.92
|
| Rate for Payer: Group Health Inc Commercial |
$42,704.92
|
| Rate for Payer: Group Health Inc Medicare |
$42,704.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$42,704.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$19,857.79
|
| Rate for Payer: Humana Medicare |
$58,719.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$42,704.92
|
| Rate for Payer: United Healthcare Commercial |
$50,733.73
|
| Rate for Payer: United Healthcare Medicare Advantage |
$42,704.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$42,704.92
|
| Rate for Payer: Wellcare Medicare |
$40,569.67
|
|
|
OTHER VASCULAR PROCEDURES WITH MCC
|
Facility
|
IP
|
$74,024.87
|
|
|
Service Code
|
MSDRG 252
|
| Min. Negotiated Rate |
$25,033.87 |
| Max. Negotiated Rate |
$74,024.87 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$49,451.78
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$53,836.27
|
| Rate for Payer: Aetna Government |
$53,836.27
|
| Rate for Payer: Brighton Health Commercial |
$48,630.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$54,913.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$57,916.77
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$47,795.41
|
| Rate for Payer: Elderplan Medicare Advantage |
$51,144.46
|
| Rate for Payer: EmblemHealth Commercial |
$28,758.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$53,836.27
|
| Rate for Payer: Group Health Inc Commercial |
$53,836.27
|
| Rate for Payer: Group Health Inc Medicare |
$53,836.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$53,836.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25,033.87
|
| Rate for Payer: Humana Medicare |
$74,024.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$53,836.27
|
| Rate for Payer: United Healthcare Commercial |
$66,697.02
|
| Rate for Payer: United Healthcare Medicare Advantage |
$53,836.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$53,836.27
|
| Rate for Payer: Wellcare Medicare |
$51,144.46
|
|
|
OTHER VASCULAR PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$43,160.07
|
|
|
Service Code
|
MSDRG 254
|
| Min. Negotiated Rate |
$14,595.95 |
| Max. Negotiated Rate |
$43,160.07 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$25,584.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$31,389.14
|
| Rate for Payer: Aetna Government |
$31,389.14
|
| Rate for Payer: Brighton Health Commercial |
$25,158.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$32,016.92
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$29,963.44
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$24,727.12
|
| Rate for Payer: Elderplan Medicare Advantage |
$29,819.68
|
| Rate for Payer: EmblemHealth Commercial |
$14,878.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$31,389.14
|
| Rate for Payer: Group Health Inc Commercial |
$31,389.14
|
| Rate for Payer: Group Health Inc Medicare |
$31,389.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31,389.14
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14,595.95
|
| Rate for Payer: Humana Medicare |
$43,160.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$31,389.14
|
| Rate for Payer: United Healthcare Commercial |
$34,505.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$31,389.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$31,389.14
|
| Rate for Payer: Wellcare Medicare |
$29,819.68
|
|
|
OT HIP KIT ISSUE TRAINING
|
Facility
|
OP
|
$122.26
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
41809060
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$97.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$67.24
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.01
|
| Rate for Payer: Aetna Government |
$0.01
|
| Rate for Payer: Brighton Health Commercial |
$91.70
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$97.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$83.14
|
| Rate for Payer: Group Health Inc Commercial |
$61.13
|
| Rate for Payer: Group Health Inc Medicare |
$42.79
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$61.13
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$61.13
|
|
|
OTHOPED 1.60MM THREADED
|
Facility
|
OP
|
$33.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
40205510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$34.65 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$18.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.08
|
| Rate for Payer: Aetna Government |
$4.08
|
| Rate for Payer: Brighton Health Commercial |
$19.80
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$16.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18.98
|
| Rate for Payer: EmblemHealth Commercial |
$16.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$34.65
|
| Rate for Payer: Group Health Inc Commercial |
$16.50
|
| Rate for Payer: Group Health Inc Medicare |
$11.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21.45
|
|
|
OTHOPED 1.60MM THREADED
|
Facility
|
IP
|
$33.00
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
40205510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.50 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.50
|
|
|
OT HOT/COLD PACKS
|
Facility
|
OP
|
$36.86
|
|
|
Service Code
|
HCPCS 97010 GO
|
| Hospital Charge Code |
41809468
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$2,902.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20.27
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.75
|
| Rate for Payer: Aetna Government |
$3.75
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$65.30
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$65.30
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$29.02
|
| Rate for Payer: Amida Care Medicaid |
$29.02
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$147.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$124.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,902.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$29.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$30.47
|
| Rate for Payer: Group Health Inc Commercial |
$18.43
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.02
|
| Rate for Payer: Healthfirst Essential Plan |
$65.30
|
| Rate for Payer: Healthfirst QHP |
$29.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$29.02
|
| Rate for Payer: SOMOS Essential |
$65.30
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$65.30
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$31.92
|
| Rate for Payer: United Healthcare Medicaid |
$29.02
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$29.02
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
OT IISOTONER GLOVE
|
Facility
|
OP
|
$16.31
|
|
|
Service Code
|
HCPCS S8427
|
| Hospital Charge Code |
41808080
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.66 |
| Max. Negotiated Rate |
$13.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.97
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.66
|
| Rate for Payer: Aetna Government |
$3.66
|
| Rate for Payer: Brighton Health Commercial |
$12.23
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.05
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.09
|
| Rate for Payer: Group Health Inc Commercial |
$8.16
|
| Rate for Payer: Group Health Inc Medicare |
$5.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.16
|
|
|
OT INSPECTION MIRROR
|
Facility
|
OP
|
$36.00
|
|
| Hospital Charge Code |
41809542
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$222.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18.00
|
| Rate for Payer: Aetna Government |
$18.00
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$147.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$124.95
|
| Rate for Payer: Group Health Inc Commercial |
$18.00
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.00
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
|
OT IONTOPHORESIS 15MTS
|
Facility
|
OP
|
$60.78
|
|
|
Service Code
|
HCPCS 97033 GO
|
| Hospital Charge Code |
41809479
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$15.94 |
| Max. Negotiated Rate |
$2,902.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.43
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.94
|
| Rate for Payer: Aetna Government |
$15.94
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$65.30
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$65.30
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$29.02
|
| Rate for Payer: Amida Care Medicaid |
$29.02
|
| Rate for Payer: Brighton Health Commercial |
$182.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$147.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$124.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,902.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$29.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$30.47
|
| Rate for Payer: Group Health Inc Commercial |
$30.39
|
| Rate for Payer: Group Health Inc Medicare |
$120.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.02
|
| Rate for Payer: Healthfirst Essential Plan |
$65.30
|
| Rate for Payer: Healthfirst QHP |
$29.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$29.02
|
| Rate for Payer: SOMOS Essential |
$65.30
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$65.30
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$31.92
|
| Rate for Payer: United Healthcare Medicaid |
$29.02
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$29.02
|
| Rate for Payer: Wellcare Medicare |
$55.00
|
|
