|
PARTIAL REPAIRS
|
Facility
|
OP
|
$138.56
|
|
| Hospital Charge Code |
42301095
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$48.50 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$76.21
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.28
|
| Rate for Payer: Aetna Government |
$69.28
|
| Rate for Payer: Brighton Health Commercial |
$103.92
|
| 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: Group Health Inc Commercial |
$69.28
|
| Rate for Payer: Group Health Inc Medicare |
$48.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$69.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$69.28
|
|
|
PARTIAL SPLEENECTOMY
|
Facility
|
OP
|
$2,783.55
|
|
|
Service Code
|
HCPCS 38101
|
| Hospital Charge Code |
40013186
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$974.24 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,530.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,218.47
|
| Rate for Payer: Aetna Government |
$1,218.47
|
| Rate for Payer: Brighton Health Commercial |
$2,087.66
|
| 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 |
$1,391.78
|
| Rate for Payer: Group Health Inc Medicare |
$974.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,391.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,391.78
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
PARTIAL SPLENECTOMY
|
Facility
|
OP
|
$2,783.55
|
|
|
Service Code
|
HCPCS 38101
|
| Hospital Charge Code |
40019522
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$974.24 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,530.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,218.47
|
| Rate for Payer: Aetna Government |
$1,218.47
|
| Rate for Payer: Brighton Health Commercial |
$2,087.66
|
| 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 |
$1,391.78
|
| Rate for Payer: Group Health Inc Medicare |
$974.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,391.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,391.78
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
PARTIAL THROMBOPLASTIN TIME
|
Facility
|
OP
|
$15.03
|
|
|
Service Code
|
HCPCS 85730
|
| Hospital Charge Code |
40621567
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$11.27 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.27
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.01
|
| Rate for Payer: Aetna Government |
$6.01
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4.21
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4.21
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4.21
|
| Rate for Payer: Brighton Health Commercial |
$11.27
|
| Rate for Payer: Cash Price |
$6.01
|
| Rate for Payer: Cash Price |
$6.01
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$9.54
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$8.07
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.01
|
| Rate for Payer: EmblemHealth Commercial |
$6.01
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.11
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.35
|
| Rate for Payer: Group Health Inc Commercial |
$6.01
|
| Rate for Payer: Group Health Inc Medicare |
$6.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.01
|
| Rate for Payer: Healthfirst QHP |
$6.01
|
| Rate for Payer: Humana Medicare |
$6.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.01
|
| Rate for Payer: United Healthcare Commercial |
$7.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.01
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.81
|
| Rate for Payer: Wellcare Medicare |
$5.41
|
|
|
PARTIAL THROMBOPLASTIN TIME
|
Facility
|
IP
|
$15.03
|
|
|
Service Code
|
HCPCS 85730
|
| Hospital Charge Code |
40621567
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$6.01
|
|
|
PARTIAL THROMSOPLASTIN TIME
|
Facility
|
OP
|
$15.03
|
|
|
Service Code
|
HCPCS 85730
|
| Hospital Charge Code |
40621565
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.21 |
| Max. Negotiated Rate |
$11.27 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.27
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.01
|
| Rate for Payer: Aetna Government |
$6.01
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4.21
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4.21
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4.21
|
| Rate for Payer: Brighton Health Commercial |
$11.27
|
| Rate for Payer: Cash Price |
$6.01
|
| Rate for Payer: Cash Price |
$6.01
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$9.54
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$8.07
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.01
|
| Rate for Payer: EmblemHealth Commercial |
$6.01
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.11
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.35
|
| Rate for Payer: Group Health Inc Commercial |
$6.01
|
| Rate for Payer: Group Health Inc Medicare |
$6.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.01
|
| Rate for Payer: Healthfirst QHP |
$6.01
|
| Rate for Payer: Humana Medicare |
$6.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.01
|
| Rate for Payer: United Healthcare Commercial |
$7.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.01
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.81
|
| Rate for Payer: Wellcare Medicare |
$5.41
|
|
|
PARTIAL THROMSOPLASTIN TIME
|
Facility
|
IP
|
$15.03
|
|
|
Service Code
|
HCPCS 85730
|
| Hospital Charge Code |
40621565
|
|
Hospital Revenue Code
|
305
|
| Rate for Payer: Cash Price |
$6.01
|
|
|
Partial thyroid lobectomy, unilateral; with or without isthmusectomy
|
Facility
|
OP
|
$6,805.98
|
|
|
Service Code
|
CPT 60210
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$6,805.98 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
PART REMOVAL METATARSAL
|
Facility
|
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28111
|
| Hospital Charge Code |
40084110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,218.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| 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
|
|
|
PART REMOVAL METATARSAL
|
Facility
|
IP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28111
|
| Hospital Charge Code |
40084110
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,743.15
|
|
|
PART REMOVAL METATARSAL 2,3, OR 4
|
Facility
|
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28112
|
| Hospital Charge Code |
40014226
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,218.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| 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
|
|
|
PART REMOVAL METATARSAL 2,3, OR 4
|
Facility
|
IP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28112
|
| Hospital Charge Code |
40014226
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,743.15
|
|
|
PART REMOVAL METATARSAL 5TH HEAD
|
Facility
|
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28110
|
| Hospital Charge Code |
40019899
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,218.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| 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
|
|
|
PART REMOVAL METATARSAL 5TH HEAD
|
Facility
|
IP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28110
|
| Hospital Charge Code |
40019899
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,743.15
|
|
|
PART REM TOE,PROX END PHALANX EA
|
Facility
|
IP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28160
|
| Hospital Charge Code |
40014516
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$3,743.15
|
|
|
PART REM TOE,PROX END PHALANX EA
|
Facility
|
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28160
|
| Hospital Charge Code |
40014516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,218.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| 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 |
$3,743.15
|
| 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
|
|
|
PARVOVIRUS B19 ABS.
|
Facility
|
OP
|
$37.58
|
|
|
Service Code
|
HCPCS 86747
|
| Hospital Charge Code |
40717055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.52 |
| Max. Negotiated Rate |
$28.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20.67
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.03
|
| Rate for Payer: Aetna Government |
$15.03
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10.52
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10.52
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.52
|
| Rate for Payer: Brighton Health Commercial |
$28.18
|
| Rate for Payer: Cash Price |
$15.03
|
| Rate for Payer: Cash Price |
$15.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.03
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$23.89
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.22
|
| Rate for Payer: Elderplan Medicare Advantage |
$15.03
|
| Rate for Payer: EmblemHealth Commercial |
$15.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13.38
|
| Rate for Payer: Group Health Inc Commercial |
$15.03
|
| Rate for Payer: Group Health Inc Medicare |
$15.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.03
|
| Rate for Payer: Healthfirst QHP |
$15.03
|
| Rate for Payer: Humana Medicare |
$15.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.03
|
| Rate for Payer: United Healthcare Commercial |
$19.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.03
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.02
|
| Rate for Payer: Wellcare Medicare |
$13.53
|
|
|
PARVOVIRUS B19 ABS.
|
Facility
|
IP
|
$37.58
|
|
|
Service Code
|
HCPCS 86747
|
| Hospital Charge Code |
40717055
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$15.03
|
|
|
PARVOVIRUS B19, IGG
|
Facility
|
OP
|
$37.58
|
|
|
Service Code
|
HCPCS 86747
|
| Hospital Charge Code |
40619178
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.52 |
| Max. Negotiated Rate |
$28.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20.67
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.03
|
| Rate for Payer: Aetna Government |
$15.03
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10.52
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10.52
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.52
|
| Rate for Payer: Brighton Health Commercial |
$28.18
|
| Rate for Payer: Cash Price |
$15.03
|
| Rate for Payer: Cash Price |
$15.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.03
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$23.89
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.22
|
| Rate for Payer: Elderplan Medicare Advantage |
$15.03
|
| Rate for Payer: EmblemHealth Commercial |
$15.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13.38
|
| Rate for Payer: Group Health Inc Commercial |
$15.03
|
| Rate for Payer: Group Health Inc Medicare |
$15.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.03
|
| Rate for Payer: Healthfirst QHP |
$15.03
|
| Rate for Payer: Humana Medicare |
$15.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.03
|
| Rate for Payer: United Healthcare Commercial |
$19.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.03
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.02
|
| Rate for Payer: Wellcare Medicare |
$13.53
|
|
|
PARVOVIRUS B19, IGG
|
Facility
|
IP
|
$37.58
|
|
|
Service Code
|
HCPCS 86747
|
| Hospital Charge Code |
40619178
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$15.03
|
|
|
PARVOVIRUS B19, IGM
|
Facility
|
OP
|
$37.58
|
|
|
Service Code
|
HCPCS 86747
|
| Hospital Charge Code |
40619177
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.52 |
| Max. Negotiated Rate |
$28.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20.67
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.03
|
| Rate for Payer: Aetna Government |
$15.03
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10.52
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10.52
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.52
|
| Rate for Payer: Brighton Health Commercial |
$28.18
|
| Rate for Payer: Cash Price |
$15.03
|
| Rate for Payer: Cash Price |
$15.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.03
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$23.89
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.22
|
| Rate for Payer: Elderplan Medicare Advantage |
$15.03
|
| Rate for Payer: EmblemHealth Commercial |
$15.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13.38
|
| Rate for Payer: Group Health Inc Commercial |
$15.03
|
| Rate for Payer: Group Health Inc Medicare |
$15.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.03
|
| Rate for Payer: Healthfirst QHP |
$15.03
|
| Rate for Payer: Humana Medicare |
$15.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.03
|
| Rate for Payer: United Healthcare Commercial |
$19.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.03
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.02
|
| Rate for Payer: Wellcare Medicare |
$13.53
|
|
|
PARVOVIRUS B19, IGM
|
Facility
|
IP
|
$37.58
|
|
|
Service Code
|
HCPCS 86747
|
| Hospital Charge Code |
40619177
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$15.03
|
|
|
PASSER CATHETER DISP LG CODMAN
|
Facility
|
OP
|
$1,877.50
|
|
| Hospital Charge Code |
64904208
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$657.12 |
| Max. Negotiated Rate |
$1,502.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,032.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$938.75
|
| Rate for Payer: Aetna Government |
$938.75
|
| Rate for Payer: Brighton Health Commercial |
$1,408.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,502.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,276.70
|
| Rate for Payer: Group Health Inc Commercial |
$938.75
|
| Rate for Payer: Group Health Inc Medicare |
$657.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$938.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$938.75
|
|
|
PASSER CATHETER DISP SHORT
|
Facility
|
OP
|
$1,790.00
|
|
| Hospital Charge Code |
64904210
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$626.50 |
| Max. Negotiated Rate |
$1,432.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$984.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$895.00
|
| Rate for Payer: Aetna Government |
$895.00
|
| Rate for Payer: Brighton Health Commercial |
$1,342.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,432.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,217.20
|
| Rate for Payer: Group Health Inc Commercial |
$895.00
|
| Rate for Payer: Group Health Inc Medicare |
$626.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$895.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$895.00
|
|
|
PASSER MED CIRCLAGE
|
Facility
|
OP
|
$562.50
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
64907471
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$196.88 |
| Max. Negotiated Rate |
$590.62 |
| 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 |
$337.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$281.25
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$323.44
|
| Rate for Payer: EmblemHealth Commercial |
$281.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$590.62
|
| 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
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$365.62
|
|
