|
Arthrodesis; subtalar
|
Facility
OP
|
$15,219.83
|
|
|
Service Code
|
CPT 28725
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$867.66 |
| Max. Negotiated Rate |
$15,219.83 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15,219.83
|
| Rate for Payer: Aetna Government |
$15,219.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15,219.83
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$15,219.83
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$867.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12,936.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13,545.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$15,219.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13,545.65
|
| Rate for Payer: Group Health Inc Commercial |
$15,219.83
|
| Rate for Payer: Group Health Inc Medicare |
$15,219.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15,219.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$964.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,936.86
|
| Rate for Payer: Healthfirst QHP |
$15,219.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15,219.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15,219.83
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12,175.86
|
| Rate for Payer: Wellcare Medicare |
$14,458.84
|
|
|
ARTHRODESIS TOES
|
Facility
OP
|
$792.83
|
|
|
Service Code
|
HCPCS 20600
|
| Hospital Charge Code |
40013177
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$38.34 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$342.51
|
| Rate for Payer: Aetna Government |
$342.51
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$342.51
|
| 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 |
$342.51
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$38.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$291.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$304.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$342.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$304.83
|
| Rate for Payer: Group Health Inc Commercial |
$342.51
|
| Rate for Payer: Group Health Inc Medicare |
$342.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$396.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$342.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$42.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$291.13
|
| Rate for Payer: Healthfirst QHP |
$342.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$342.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$342.51
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$274.01
|
| Rate for Payer: Wellcare Medicare |
$325.38
|
|
|
ARTHRODESIS TOES
|
Facility
OP
|
$792.83
|
|
|
Service Code
|
HCPCS 20600
|
| Hospital Charge Code |
30302000
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$38.34 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$342.51
|
| Rate for Payer: Aetna Government |
$342.51
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$342.51
|
| 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 |
$342.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$38.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$291.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$304.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$342.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$304.83
|
| 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 |
$396.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$342.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$42.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$291.13
|
| Rate for Payer: Healthfirst QHP |
$342.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$342.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$342.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$342.51
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$274.01
|
| Rate for Payer: Wellcare Medicare |
$325.38
|
|
|
ARTHRODESIS TOES
|
Facility
OP
|
$792.83
|
|
|
Service Code
|
HCPCS 20600
|
| Hospital Charge Code |
30102466
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$38.34 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$342.51
|
| Rate for Payer: Aetna Government |
$342.51
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$342.51
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$342.51
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$342.51
|
| 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 |
$342.51
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$38.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$291.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$304.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$342.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$304.83
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$396.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$342.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$342.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$342.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$342.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$342.51
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$274.01
|
| Rate for Payer: Wellcare Medicare |
$325.38
|
|
|
Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, Miller type procedure)
|
Facility
OP
|
$15,219.83
|
|
|
Service Code
|
CPT 28737
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$750.34 |
| Max. Negotiated Rate |
$15,219.83 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15,219.83
|
| Rate for Payer: Aetna Government |
$15,219.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15,219.83
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$15,219.83
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$750.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12,936.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13,545.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$15,219.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13,545.65
|
| Rate for Payer: Group Health Inc Commercial |
$15,219.83
|
| Rate for Payer: Group Health Inc Medicare |
$15,219.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15,219.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$833.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,936.86
|
| Rate for Payer: Healthfirst QHP |
$15,219.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15,219.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15,219.83
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12,175.86
|
| Rate for Payer: Wellcare Medicare |
$14,458.84
|
|
|
ARTHRODESIS WRIST
|
Facility
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 25800
|
| Hospital Charge Code |
40013174
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$831.78 |
| Max. Negotiated Rate |
$9,058.92 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$8,273.12
|
| Rate for Payer: 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 CHP/HARP/Medicaid |
$831.78
|
| 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 CHP/FHP/Medicaid |
$924.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Senior Whole Health 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
|
|
|
Arthrodesis, wrist; with autograft (includes obtaining graft)
|
Facility
OP
|
$8,273.12
|
|
|
Service Code
|
CPT 25825
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$899.78 |
| Max. Negotiated Rate |
$8,273.12 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$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 CHP/HARP/Medicaid |
$899.78
|
| 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 Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$999.75
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Senior Whole Health 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
|
|
|
.ARTHROPLASTY
|
Facility
OP
|
$28.71
|
|
| Hospital Charge Code |
40000520
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$22.97 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.36
|
| Rate for Payer: Aetna Government |
$14.36
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22.97
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19.52
|
| Rate for Payer: Group Health Inc Commercial |
$14.36
|
| Rate for Payer: Group Health Inc Medicare |
$10.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.36
|
|
|
ARTHROPLASTY
|
Facility
OP
|
$5,075.00
|
|
|
Service Code
|
HCPCS D7865
|
| Hospital Charge Code |
42301990
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,776.25 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,791.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,556.21
|
| Rate for Payer: Aetna Government |
$2,556.21
|
| 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: Group Health Inc Commercial |
$2,537.50
|
| Rate for Payer: Group Health Inc Medicare |
$1,776.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,537.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,537.50
|
|
|
Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft
|
Facility
OP
|
$16,751.00
|
|
|
Service Code
|
CPT 27130
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,457.38 |
| Max. Negotiated Rate |
$16,751.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16,751.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15,219.83
|
| Rate for Payer: Aetna Government |
$15,219.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15,219.83
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$15,219.83
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,457.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12,936.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13,545.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$15,219.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13,545.65
|
| Rate for Payer: Group Health Inc Commercial |
$15,219.83
|
| Rate for Payer: Group Health Inc Medicare |
$15,219.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15,219.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,619.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,936.86
|
| Rate for Payer: Healthfirst QHP |
$15,219.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15,219.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15,219.83
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12,175.86
|
| Rate for Payer: Wellcare Medicare |
$14,458.84
|
|
|
Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))
|
Facility
OP
|
$22,108.00
|
|
|
Service Code
|
CPT 23472
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$22,108.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$22,108.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21,551.15
|
| Rate for Payer: Aetna Government |
$21,551.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21,551.15
|
| 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 |
$21,551.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,634.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$18,318.48
|
| Rate for Payer: Fidelis Essential Plan QHP |
$19,180.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$21,551.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$19,180.52
|
| Rate for Payer: Group Health Inc Commercial |
$21,551.15
|
| Rate for Payer: Group Health Inc Medicare |
$21,551.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21,551.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,815.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18,318.48
|
| Rate for Payer: Healthfirst QHP |
$21,551.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21,551.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21,551.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$17,240.92
|
| Rate for Payer: Wellcare Medicare |
$20,473.59
|
|
|
Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
|
Facility
OP
|
$44,507.00
|
|
|
Service Code
|
CPT 27447
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,455.57 |
| Max. Negotiated Rate |
$44,507.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$44,507.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15,219.83
|
| Rate for Payer: Aetna Government |
$15,219.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15,219.83
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$15,219.83
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,455.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12,936.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13,545.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$15,219.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13,545.65
|
| Rate for Payer: Group Health Inc Commercial |
$15,219.83
|
| Rate for Payer: Group Health Inc Medicare |
$15,219.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15,219.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,617.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,936.86
|
| Rate for Payer: Healthfirst QHP |
$15,219.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15,219.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15,219.83
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12,175.86
|
| Rate for Payer: Wellcare Medicare |
$14,458.84
|
|
|
ARTHROSC, KNEE, W LYSIS OF ADHES
|
Facility
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 29884
|
| Hospital Charge Code |
40029976
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$704.83 |
| Max. Negotiated Rate |
$4,145.52 |
| 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: 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 CHP/HARP/Medicaid |
$704.83
|
| 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 CHP/FHP/Medicaid |
$783.14
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Senior Whole Health 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
|
|
|
Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
|
Facility
OP
|
$8,273.12
|
|
|
Service Code
|
CPT 29888
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,103.30 |
| Max. Negotiated Rate |
$8,273.12 |
| 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: 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 CHP/HARP/Medicaid |
$1,103.30
|
| 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 Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,225.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Senior Whole Health 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
|
|
|
Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)
|
Facility
OP
|
$8,273.12
|
|
|
Service Code
|
CPT 29892
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$703.33 |
| Max. Negotiated Rate |
$8,273.12 |
| 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: 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 CHP/HARP/Medicaid |
$703.33
|
| 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 Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$781.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Senior Whole Health 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
|
|
|
ARTHROSCOPY
|
Facility
IP
|
$26,797.53
|
|
|
Service Code
|
MS-DRG 509
|
| Min. Negotiated Rate |
$11,372.20 |
| Max. Negotiated Rate |
$26,797.53 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19,554.82
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$26,272.09
|
| Rate for Payer: Aetna Government |
$26,272.09
|
| Rate for Payer: Brighton Health Commercial |
$19,229.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26,797.53
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$23,591.18
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19,468.46
|
| Rate for Payer: Elderplan Medicare Advantage |
$24,958.49
|
| Rate for Payer: EmblemHealth Commercial |
$11,372.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$26,272.09
|
| Rate for Payer: Group Health Inc Commercial |
$26,272.09
|
| Rate for Payer: Group Health Inc Medicare |
$26,272.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26,272.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,216.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26,272.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26,272.09
|
| Rate for Payer: Wellcare Medicare |
$24,958.49
|
|
|
ARTHROSCOPY ANKLE
|
Facility
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 29891
|
| Hospital Charge Code |
40023192
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$748.11 |
| Max. Negotiated Rate |
$4,145.52 |
| 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: 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 CHP/HARP/Medicaid |
$748.11
|
| 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 CHP/FHP/Medicaid |
$831.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Senior Whole Health 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
|
|
|
ARTHROSCOPY ANKLE DEBRIDE. EXTENS
|
Facility
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 29898
|
| Hospital Charge Code |
40029939
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$623.12 |
| Max. Negotiated Rate |
$4,145.52 |
| 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: 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 CHP/HARP/Medicaid |
$623.12
|
| 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 CHP/FHP/Medicaid |
$692.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Senior Whole Health 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
|
|
|
ARTHROSCOPY ANKLE DEBRIDE.LIMITED
|
Facility
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 29897
|
| Hospital Charge Code |
40029429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$555.89 |
| Max. Negotiated Rate |
$4,145.52 |
| 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: 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 CHP/HARP/Medicaid |
$555.89
|
| 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 CHP/FHP/Medicaid |
$617.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Senior Whole Health 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
|
|
|
ARTHROSCOPY ANKLE PARTIAL
|
Facility
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 29895
|
| Hospital Charge Code |
40029412
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.97 |
| Max. Negotiated Rate |
$4,145.52 |
| 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: 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 CHP/HARP/Medicaid |
$512.97
|
| 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 CHP/FHP/Medicaid |
$569.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Senior Whole Health 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
|
|
|
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial
|
Facility
OP
|
$3,743.15
|
|
|
Service Code
|
CPT 29895
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$512.97 |
| Max. Negotiated Rate |
$3,743.15 |
| 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: 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 CHP/HARP/Medicaid |
$512.97
|
| 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 Medicare |
$3,743.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$569.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Senior Whole Health 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
|
|
|
ARTHROSCOPY CASSETTE TUBE
|
Facility
OP
|
$118.80
|
|
| Hospital Charge Code |
40203053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.58 |
| Max. Negotiated Rate |
$95.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$65.34
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$59.40
|
| Rate for Payer: Aetna Government |
$59.40
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$95.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$80.78
|
| Rate for Payer: Group Health Inc Commercial |
$59.40
|
| Rate for Payer: Group Health Inc Medicare |
$41.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$59.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$59.40
|
|
|
ARTHROSCOPY-DIAGNOSIS, WITH OR WI
|
Facility
OP
|
$1,812.50
|
|
|
Service Code
|
HCPCS D7872
|
| Hospital Charge Code |
42302000
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$634.38 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$996.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$901.54
|
| Rate for Payer: Aetna Government |
$901.54
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Group Health Inc Commercial |
$906.25
|
| Rate for Payer: Group Health Inc Medicare |
$634.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$906.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$906.25
|
|
|
ARTHROSCOPY KNEE
|
Facility
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 29880
|
| Hospital Charge Code |
40023190
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$640.18 |
| Max. Negotiated Rate |
$4,145.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: 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 CHP/HARP/Medicaid |
$640.18
|
| 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 CHP/FHP/Medicaid |
$711.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Senior Whole Health 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
|
|
|
ARTHROSCOPY KNEE-ABRASION ARTHROP
|
Facility
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 29879
|
| Hospital Charge Code |
40029910
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$752.66 |
| Max. Negotiated Rate |
$4,145.52 |
| 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: 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 CHP/HARP/Medicaid |
$752.66
|
| 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 CHP/FHP/Medicaid |
$836.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Senior Whole Health 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
|
|
