|
PARICALCITOL 5 MCG/ML IV SOLN [22960]
|
Facility
|
IP
|
$12.60
|
|
|
Service Code
|
HCPCS J2501
|
| Hospital Charge Code |
16729031193
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$6.30 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.30
|
|
|
PARICALCITOL 5 MCG/ML IV SOLN [22960]
|
Facility
|
IP
|
$12.60
|
|
|
Service Code
|
HCPCS J2501
|
| Hospital Charge Code |
16729031163
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$6.30 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.30
|
|
|
PARICALCITOL 5 MCG/ML IV SOLN [22960]
|
Facility
|
OP
|
$12.60
|
|
|
Service Code
|
HCPCS J2501
|
| Hospital Charge Code |
16729031193
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$13.23 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6.93
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.65
|
| Rate for Payer: Aetna Government |
$0.65
|
| Rate for Payer: Brighton Health Commercial |
$7.56
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.30
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.24
|
| Rate for Payer: EmblemHealth Commercial |
$6.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$13.23
|
| Rate for Payer: Group Health Inc Commercial |
$6.30
|
| Rate for Payer: Group Health Inc Medicare |
$4.41
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.19
|
|
|
PARICALCITOL 5 MCG/ML IV SOLN [22960]
|
Facility
|
IP
|
$18.18
|
|
|
Service Code
|
HCPCS J2501
|
| Hospital Charge Code |
00074165801
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9.09 |
| Max. Negotiated Rate |
$9.09 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.09
|
|
|
PARIETAL CRANIOTOMY
|
Facility
|
OP
|
$4,737.97
|
|
|
Service Code
|
HCPCS 61556
|
| Hospital Charge Code |
40000105
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,496.00 |
| Max. Negotiated Rate |
$3,553.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,605.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,943.48
|
| Rate for Payer: Aetna Government |
$1,943.48
|
| Rate for Payer: Brighton Health Commercial |
$3,553.48
|
| 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 |
$2,368.98
|
| Rate for Payer: Group Health Inc Medicare |
$1,658.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,368.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,368.98
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
PARIETEX PCO HERINA MESH
|
Facility
|
OP
|
$782.46
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40209489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$821.58 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$430.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.35
|
| Rate for Payer: Aetna Government |
$69.35
|
| Rate for Payer: Brighton Health Commercial |
$469.48
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$391.23
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$449.91
|
| Rate for Payer: EmblemHealth Commercial |
$391.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$821.58
|
| Rate for Payer: Group Health Inc Commercial |
$391.23
|
| Rate for Payer: Group Health Inc Medicare |
$273.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$391.23
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$391.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$508.60
|
|
|
PARIETEX PCO HERINA MESH
|
Facility
|
IP
|
$782.46
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40209489
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$391.23 |
| Max. Negotiated Rate |
$391.23 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$391.23
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$391.23
|
|
|
PARING 2-4 LESIONS
|
Facility
|
IP
|
$529.23
|
|
|
Service Code
|
HCPCS 11056
|
| Hospital Charge Code |
42500184
|
|
Hospital Revenue Code
|
510
|
| Rate for Payer: Cash Price |
$231.52
|
|
|
PARING 2-4 LESIONS
|
Facility
|
OP
|
$529.23
|
|
|
Service Code
|
HCPCS 11056
|
| Hospital Charge Code |
42500184
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$162.06 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$231.52
|
| Rate for Payer: Aetna Government |
$231.52
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$162.06
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$162.06
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$162.06
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$231.52
|
| Rate for Payer: Cash Price |
$231.52
|
| Rate for Payer: Cash Price |
$231.52
|
| Rate for Payer: Cash Price |
$231.52
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$231.52
|
| 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 |
$231.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$196.79
|
| Rate for Payer: Fidelis Essential Plan QHP |
$206.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$231.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$206.05
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$264.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$231.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$196.79
|
| Rate for Payer: Healthfirst QHP |
$231.52
|
| Rate for Payer: Humana Medicare |
$236.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$231.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$231.52
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$231.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$231.52
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$185.22
|
| Rate for Payer: Wellcare Medicare |
$219.94
|
|
|
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 lesions
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 11056
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$162.06 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$231.52
|
| Rate for Payer: Aetna Government |
$231.52
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$162.06
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$162.06
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$162.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$231.52
|
| 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 |
$231.52
|
| Rate for Payer: EmblemHealth Commercial |
$231.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$196.79
|
| Rate for Payer: Fidelis Essential Plan QHP |
$206.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$231.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$206.05
|
| Rate for Payer: Group Health Inc Commercial |
$231.52
|
| Rate for Payer: Group Health Inc Medicare |
$231.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$231.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$196.79
|
| Rate for Payer: Healthfirst QHP |
$231.52
|
| Rate for Payer: Humana Medicare |
$236.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$231.52
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$231.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$231.52
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$185.22
|
| Rate for Payer: Wellcare Medicare |
$219.94
|
|
|
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 lesions
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 11057
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$162.06 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$231.52
|
| Rate for Payer: Aetna Government |
$231.52
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$162.06
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$162.06
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$162.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$231.52
|
| 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 |
$231.52
|
| Rate for Payer: EmblemHealth Commercial |
$231.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$196.79
|
| Rate for Payer: Fidelis Essential Plan QHP |
$206.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$231.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$206.05
|
| Rate for Payer: Group Health Inc Commercial |
$231.52
|
| Rate for Payer: Group Health Inc Medicare |
$231.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$231.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$196.79
|
| Rate for Payer: Healthfirst QHP |
$231.52
|
| Rate for Payer: Humana Medicare |
$236.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$231.52
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$231.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$231.52
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$185.22
|
| Rate for Payer: Wellcare Medicare |
$219.94
|
|
|
Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 11055
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$162.06 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$231.52
|
| Rate for Payer: Aetna Government |
$231.52
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$162.06
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$162.06
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$162.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$231.52
|
| 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 |
$231.52
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$196.79
|
| Rate for Payer: Fidelis Essential Plan QHP |
$206.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$231.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$206.05
|
| Rate for Payer: Group Health Inc Commercial |
$231.52
|
| Rate for Payer: Group Health Inc Medicare |
$231.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$231.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$196.79
|
| Rate for Payer: Healthfirst QHP |
$231.52
|
| Rate for Payer: Humana Medicare |
$236.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$231.52
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$231.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$231.52
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$185.22
|
| Rate for Payer: Wellcare Medicare |
$219.94
|
|
|
PARING SKIN LESION
|
Facility
|
OP
|
$502.69
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
42500183
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$162.06 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$231.52
|
| Rate for Payer: Aetna Government |
$231.52
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$162.06
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$162.06
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$162.06
|
| Rate for Payer: Brighton Health Commercial |
$377.02
|
| Rate for Payer: Cash Price |
$231.52
|
| Rate for Payer: Cash Price |
$231.52
|
| Rate for Payer: Cash Price |
$231.52
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$231.52
|
| 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 |
$231.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$196.79
|
| Rate for Payer: Fidelis Essential Plan QHP |
$206.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$231.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$206.05
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$251.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$231.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$196.79
|
| Rate for Payer: Healthfirst QHP |
$231.52
|
| Rate for Payer: Humana Medicare |
$236.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$231.52
|
| Rate for Payer: United Healthcare Medicare Advantage |
$231.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$231.52
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$185.22
|
| Rate for Payer: Wellcare Medicare |
$219.94
|
|
|
PARING SKIN LESION
|
Facility
|
IP
|
$502.69
|
|
|
Service Code
|
HCPCS 11055
|
| Hospital Charge Code |
42500183
|
|
Hospital Revenue Code
|
761
|
| Rate for Payer: Cash Price |
$231.52
|
|
|
PAROMOMYCIN SULF 250MG
|
Facility
|
OP
|
$567.00
|
|
| Hospital Charge Code |
41650315
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$198.45 |
| Max. Negotiated Rate |
$453.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$311.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$283.50
|
| Rate for Payer: Aetna Government |
$283.50
|
| Rate for Payer: Brighton Health Commercial |
$425.25
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$453.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$385.56
|
| Rate for Payer: Group Health Inc Commercial |
$283.50
|
| Rate for Payer: Group Health Inc Medicare |
$198.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$283.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$283.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$368.55
|
|
|
PAROMOMYCIN SULF 250MG CAPSULE
|
Facility
|
OP
|
$567.00
|
|
| Hospital Charge Code |
41640315
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$198.45 |
| Max. Negotiated Rate |
$453.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$311.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$283.50
|
| Rate for Payer: Aetna Government |
$283.50
|
| Rate for Payer: Brighton Health Commercial |
$425.25
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$453.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$385.56
|
| Rate for Payer: Group Health Inc Commercial |
$283.50
|
| Rate for Payer: Group Health Inc Medicare |
$198.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$283.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$283.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$368.55
|
|
|
PAROMOMYCIN SULFATE 250 MG PO CAPS [10854]
|
Facility
|
OP
|
$5.67
|
|
|
Service Code
|
NDC 23155003801
|
| Hospital Charge Code |
23155003801
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.98 |
| Max. Negotiated Rate |
$4.54 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.12
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.84
|
| Rate for Payer: Aetna Government |
$2.84
|
| Rate for Payer: Brighton Health Commercial |
$4.25
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4.54
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.86
|
| Rate for Payer: Group Health Inc Commercial |
$2.84
|
| Rate for Payer: Group Health Inc Medicare |
$1.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.69
|
|
|
PAROTIDECTOMY
|
Facility
|
OP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 42410
|
| Hospital Charge Code |
40011125
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$11,018.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| 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
|
|
|
PAROTIDECTOMY
|
Facility
|
IP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 42410
|
| Hospital Charge Code |
40011125
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,772.21
|
|
|
PAROXETINE 10 MG TAB
|
Facility
|
OP
|
$1.28
|
|
| Hospital Charge Code |
41641895
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$1.02 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.64
|
| Rate for Payer: Aetna Government |
$0.64
|
| Rate for Payer: Brighton Health Commercial |
$0.96
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.87
|
| Rate for Payer: Group Health Inc Commercial |
$0.64
|
| Rate for Payer: Group Health Inc Medicare |
$0.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.83
|
|
|
PAROXETINE 10 MG TAB
|
Facility
|
OP
|
$1.28
|
|
| Hospital Charge Code |
41651895
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$1.02 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.64
|
| Rate for Payer: Aetna Government |
$0.64
|
| Rate for Payer: Brighton Health Commercial |
$0.96
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.87
|
| Rate for Payer: Group Health Inc Commercial |
$0.64
|
| Rate for Payer: Group Health Inc Medicare |
$0.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.83
|
|
|
PAROXETINE 20 MG TAB
|
Facility
|
OP
|
$1.00
|
|
| Hospital Charge Code |
41650289
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$0.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.50
|
| Rate for Payer: Aetna Government |
$0.50
|
| Rate for Payer: Brighton Health Commercial |
$0.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.68
|
| Rate for Payer: Group Health Inc Commercial |
$0.50
|
| Rate for Payer: Group Health Inc Medicare |
$0.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.65
|
|
|
PAROXETINE 20 MG TAB
|
Facility
|
OP
|
$1.00
|
|
| Hospital Charge Code |
41640289
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$0.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.50
|
| Rate for Payer: Aetna Government |
$0.50
|
| Rate for Payer: Brighton Health Commercial |
$0.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.68
|
| Rate for Payer: Group Health Inc Commercial |
$0.50
|
| Rate for Payer: Group Health Inc Medicare |
$0.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.65
|
|
|
PAROXETINE 30 MG TAB
|
Facility
|
OP
|
$1.28
|
|
| Hospital Charge Code |
41653152
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$1.02 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.64
|
| Rate for Payer: Aetna Government |
$0.64
|
| Rate for Payer: Brighton Health Commercial |
$0.96
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.87
|
| Rate for Payer: Group Health Inc Commercial |
$0.64
|
| Rate for Payer: Group Health Inc Medicare |
$0.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.83
|
|
|
PAROXETINE 30 MG TAB
|
Facility
|
OP
|
$1.28
|
|
| Hospital Charge Code |
41643152
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$1.02 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.64
|
| Rate for Payer: Aetna Government |
$0.64
|
| Rate for Payer: Brighton Health Commercial |
$0.96
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.87
|
| Rate for Payer: Group Health Inc Commercial |
$0.64
|
| Rate for Payer: Group Health Inc Medicare |
$0.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.83
|
|
